Article

Local clinical excellence award (LCEA) arrangements

Information for employers on the arrangements for the local clinical excellence awards.

30 March 2022

In 2017, NHS Employers and the British Medical Association (BMA) agreed an amendment to the terms and conditions for consultants (England) 2003. Between 1 April 2018 and 31 March 2021 (now extended to 31 March 2022), trusts must run annual local clinical excellence award (LCEA) rounds.

The tripartite negotiating group (NHS Employers, the British Medical Association (BMA) and HCSA) recently concluded negotiations for a new LCEA scheme from 2022. 

Read about the outcome.

Watch our webinar.

Schedule 30 and next steps for employers

From 1 April 2022 a reversion to the contractual arrangements in schedule 30 of the 2003 terms and conditions of service (TCS) for consultants applies. This is currently being updated to remove outdated provisions and to make the remaining requirements clearer.

Employers will still need to run annual schemes but you will have relative flexibility about how the process is managed locally. 

Access the briefing and more details about the next steps.

2021 LCEA round

The tripartite negotiating group sought and received ministerial approval for an approach to 2021-22 LCEAs.

Please read our April 2021 joint statement (pdf) about this from NHS Employers, the BMA and HCSA.

In light of the ongoing effects of the pandemic, and requirement to focus resources on recovery efforts, employers are required to take the same approach as last year, and to equally distribute this year’s LCEA funds (and any remaining from previous years) among all eligible consultants. This will be a one‐off, non‐consolidated payment in place of a normal LCEA round. This has been agreed with NHS England and NHS Improvement (NHSEI) and the Department for Health and Social Care (DHSC).

Calculating the investment fund for 2021 round

Read our employer briefing that explains how to calculate the investment funds for the 2021 round, setting out the steps employers need to take to ensure that they have calculated the necessary funds for investment across the four years covered by the interim arrangements from 2018/19 - 2021/22. This page includes a new financial monitoring tool to support you to do this.

Updated schedule 30 (pdf)

 

Local clinical excellence awards FAQS

This below section contains information that responds to the frequently asked questions from employers about the LCEA scheme.

These FAQs were updated in February 2022.

  • Q1. Are there any changes to eligibility for the 2021-22 round? 

    Yes. 2021-22 is an additional year of the interim agreement (given that schedule 30 arrangements have been extended due to the pandemic; schedule 30 is being amended accordingly and will be published soon). As above, employers are to equally distribute the funds among all consultants, to enable employers and doctors to focus on the impact of the pandemic, and recovery efforts. Some changes to normal eligibility criteria have been agreed for this year (as set out below).

    Funding that will have been allocated to employers to pay for new LCEA in respect of 2020-2021 together with any outstanding LCEA funding which has been rolled over since 2018, shall be distributed equally among all eligible consultants by way of a one-off non-consolidated payment through the employer’s payroll. It has now been agreed, as part of the amended schedule 30 provisions extending to the 2021-22 round, that this equal distribution shall include and be made in full to consultants on the 2003 terms and conditions that have completed a minimum of 12 months of service and who:

    • are working part-time
    • are not at work by reason of sickness, including sickness or self- isolation relating to the COVID-19 pandemic
    • are absent on maternity, paternity, adoption or shared parental leave
    • are clinical academics employed via an honorary contract (which applies the terms set out in schedule 23)
    • are working for multiple employers and will only be eligible for a single payment from their main substantive employer)
    • are employed on a fixed term basis.

    Q2. Does the 12 months minimum service eligibility requirement need to be continuous?

    For a consultant to be eligible they should have at least 12 month's service as a consultant employed on the 2003 TCS as at 1 April 2021. The one year of service does not need to be continuous or with the same employer.  

    Q3. Are locum consultants eligible?

    The minimum criteria for eligibility for an award is set out in FAQ 1, which stipulates that equal distribution shall include and be made in full to consultants on the 2003 TCS that have completed a minimum of 12 months of service. This includes those on fixed term contracts employed under 2003 TCS  

    We understand that the term ‘locum’ is used variably across trusts and that there are some locum consultants who have been in post longer than the recommended 6 to 12 months. For the purposes of eligibility, providing the locum consultant has met the minimum criteria for eligibility (as set out in Q1.) they could be eligible for an award. Agency locums should not be eligible. 

    Q4 Is there any flexibility to agree eligibility outside the criteria set out in FAQ 1.?

    Yes, employers may use their discretion with agreement from their joint local negotiating committee (JLNC) to extend eligibility beyond the criteria set out in FAQ 1, with the understanding that this would dilute the pot for those already eligible. Alternatively, employers could choose to top up the investment to prevent dilution. 

    Q5. Is entry on the specialist register essential to be considered eligible for an award? 

    If someone is employed as a consultant on the 2003 TCS, they should be fully registered on the specialist register of the General Medical Council (GMC) or specialist list of the General Dental Council (GDC). This is expressed in the LCEA guidance. The negotiation parties recognise that some doctors may be temporarily employed under the 2003 terms without being on the register. In such circumstances, and where the individual meets all other criteria the national negotiation parties are content that access to the arrangements can be agreed locally.  

    Q6. Are NCEA holders, L9 award holders, consultants working in general management positions, or those with conduct warnings ineligible under the equal distribution arrangements in 2021-22?  

    Yes, these consultants are still ineligible, as set out in the LCEA guidance, although some flexibility to extend eligibility locally is applicable - as per Q4.   

    As per Q4, employers may use their discretion with agreement from their joint local negotiating committee (JLNC) to extend eligibility beyond the criteria set out, subject to the conditions in Q4.

    Q7. Should Level 9 award holders and NCEA award holders be counted in the funding calculations?

    Level 9, NCEA and distinction award holders are not included in the funding investment calculations.  

    Q8. Consultants who work less-than full time (LTFT) are entitled to awards as per the LCEA guidance, but these are usually pro-rated in line with their working hours. Should we pro-rata the payment, or pay our LTFT consultants an equal share of the funds?

    As above, consultants who are working part time should receive an equal share of the award pot in 2021-22.

    Q9. If an LTFT consultant works across two organisations, which organisation would pay for their award? 

    In the 2020-21 and 2021-22 rounds, as there is an equal distribution of awards across all eligible consultants, the principle should be that no doctor should receive more than one full-time award in 2020-21 or 2021-22. The consultant also has a responsibility to ensure that this does not happen and to flag with their employer any concerns about this. However employers are free to agree locally:

    • Which employer is the principal employer, and should therefore pay the award.
    • Whether there should be a contribution from the secondary employer if that is deemed fair.
    • Or if each employer pays a proportion of the award.

    Q10. Should SAS doctors or trust grades working under the 2003 terms and conditions of service (TCS) be eligible?                              

    Access to the LCEA scheme is a contractual entitlement for all consultants employed on the 2003 terms and conditions who meet the other eligibility criteria (as set out in Q1). If a SAS doctor is acting up but remains on the Specialty doctor contract, they do not have a contractual entitlement to receive an LCEA payment. However, eligibility may be extended via local agreement as set out in Q4. 

    Please note however, that eligibility for calculating the funding pot is based on all consultants irrespective of which contract they are employed on (except Level 9 and NCEA holders), and on headcount not FTE status, except for the additional funding in 2021-22 of 0.218 FTE. (Please read our employer briefing which explains how to calculate the investment funds for the 2021-22 LCEA round. This page includes a new financial monitoring tool to support you to do this.) 

    Q11. When a consultant starts in a new locum post are we required to pay a previous CEA award?

    No, they would not be entitled. The LCEA arrangements applied to their previous post, which was fulfilled, as were the previous award arrangements.  

    Q12. How should any identified LCEA underspend from 2018-2021 be addressed?

    Any identified underspend from the 2018-19, 2019-20 and 2020-21 years should be paid out in the 2021-22 award year. Please read our employer briefing which explains how to calculate the investment funds for the 2021-22 LCEA round.  

    Q13. If a trust is unable to make the payment before April, can it be carried forward? 

    Contractually, no, employers are obliged to make the payment in year and any employer breaching this may be subject to legal challenge. If trusts are experiencing difficulties making the 2021-22 LCEA payments on time, they need to agree arrangements locally to ensure payments are made as soon as possible. Trusts need to ensure funding for the current LCEA arrangements is not carried forwards into the LCEA arrangements from April 2022. 

    Q14. What is the difference between the additional funding ratio for each year and the cumulative funding, in reference to the ‘calculating the minimum funds for investment in the 2021/22 employer briefing? 

    Link to the 2021/22 employer briefing.

    The additional funding ratio and the cumulative funding are describing the build-up of investment over the years. The ‘in year additional funding column’ simply sets the annual investment ratio as agreed by the parties to negotiation; what employers are required to do is apply the cumulative ratios when determining the minimum investment levels each year. The cumulative build up in the level of investment over the four-year period reflects previous investment levels (prior to 2018) as awards were paid on a consolidated and pensionable basis until retirement (a Level 1 on the pre 2018 arrangements was equivalent to about £90k over the lifetime of their career as a consultant). Moving to non-consolidated and non-pensionable new style LCEAs releases significant funds, hence the significant build up over the period covered by the interim arrangements. 

    Q15. Should we have always been calculating the required investment based on FTE, not on headcount? 

    No, it has changed for this year’s arrangements (2021/22) and for LCEA arrangements from April 2022. 

    Q16. Will there be any reviews of Level 9 award holders this year? 

    As set out in Schedule 30 reviews of Level 9 award holders are to be postponed for this year, until after April 2022. Existing Level 9 LCEAs will continue to be subject to renewal arrangements and the same scoring mechanism as all other existing LCEAs, as set out in paragraph 18. 

    Q17. Can we offer a higher proportion of the award money to eligible consultants who have performed over and above what is expected of them in terms of their response to COVID-19? 

    Funds are to be distributed equally (see Q1). This particular arrangement is not intended to be an award for excellence, but simply a one-off non-consolidated lump sum that meets the commitment to spend the allocated investment funds in light of extraordinary circumstances.

    As there is no excellence or performance-based criteria to be met to access an award for this round, any evidence of individual excellence (related to COVID-19 or pre-COVID-19 activity) can be saved for when arrangements return to normal in the next round of competitive applications.

    Q18. We feel that all staff have contributed to an outstanding COVID-19 response. Can we share this funding with other staff, such as SAS doctors and nurses?

    This funding comes from NHS England’s ring-fenced consultants’ pay budget. Whilst we know there may be some local appetite for sharing awards to other staff who contribute to the delivery of services alongside consultants, it is not the intention of the arrangements.

    Q19. With this one-off payment, are the doctors then in receipt of a CEA award?

    Technically, the answer would be no. The intention is to equally distribute the available LCEA funds in a way which is not administratively burdensome on the trust or doctors at a time when resource is needed on the frontline. As there is no excellence or performance-based criteria to be met to access an award, the payment can’t really be considered as an award for clinical excellence. As such, any evidence of individual excellence can be saved back for when we return to normal in the next round of competitive applications.

    Q20. How much money is each eligible consultant entitled to?

    The size of the award ‘pot’ will differ in each trust. As per the LCEA guidance, the level of investment is calculated using an ‘award value’ and an ‘investment ratio’.

    The award value currently stands at £3,092 and the investment ratio at 0.218 per eligible consultant (the cumulative nature of the awards makes the total ratio this year 1.242).

    Please refer to the joint statement for more information.

    Those trusts who have rolled funding forward will have more to add to ‘the pot’, so the individual payments may be higher. If employers are running rounds in arrears, then there is scope to combine all outstanding investment funds into this one-off consolidated payment.

    The value of existing awards (old style LCEAs) will remain static going forward.

National clinical excellence awards (NCEA)

The response to the consultation on reforms to the national CEAs has been published and includes a new name for the awards scheme. See our news page for more information.

The full consultation response is available on the GOV.UK website.