A new reward system for NHS consultants

Surgeon washing hands

NHS Employers has an opportunity to work with the doctors’ unions to redesign the consultants’ reward scheme. Our aim is to agree a lasting and sustainable system using the £160 million available nationally every year, which:

  • is based on a set of agreed principles 
  • meets the needs of employers and consultants 
  • encourages engagement and rewards excellence. 

We would like a firm view from employers on what form this redesign should take, principles for how the scheme should operate, and how employers should recognise and reward excellence across the whole consultant workforce. This will enable us to accurately represent your needs as we develop a new system with the tripartite negotiating group, which includes the Department for Health and Social Care (DHSC), the British Medical Association (BMA) and the HCSA.  

NHS organisations face a huge challenge to rebuild and reset local service provision in the wake of COVID-19.  Many want to retain and develop the agile and collaborative ways of working across organisations and systems, driven by their response to the crisis, in order to realign traditional clinical services in new ways to meet the changing needs of patients and communities

Consultants will be central to making this happen - as leaders, educators, researchers, innovators and, of course, as highly skilled clinicians. 

Clinical excellence awards have existed in one form or other since the inception of the NHS. The current employer-based local clinical excellence award (LCEA) scheme has undergone some recent changes but we know (as noted in the 2020 DDRB report) that the current LCEA system is not working as it should; it is unfair for: 

  • women (exacerbating the gender pay gap)
  • Black, asian and minority ethnic doctors
  • consultants who work part time
  • some specialties (where it is more difficult to demonstrate excellence).

Administration of the scheme is burdensome for employers and doctors, and workforce confidence in it (and therefore applications) have been dropping for some time.

The gender pay gap, the preference for more flexible ways of working, pensions tax reform, the development of system-wide working and the consultant leadership required to deliver significant change all combine to make a convincing case for creating a reward scheme which recognises outstanding contributions equally across all areas of consultant activity. 

Employers have also said that they would prefer a scheme which is more closely aligned to the delivery of organisational aims and objectives.

This is a real opportunity to influence the biggest change to the 2003 Consultant contract in nearly 20 years. If employers do not put forward a convincing case for change (which we know exists), the very basic contractual arrangements will remain in place, with all its inequities, and little national guidance.

Please use the supporting resources below to support as conversation with your board about what matters to your trust and its consultants, and how a new reward system could support you locally. Please fill in this 16-question survey by Thursday 10 September to help us gather a representative response that influences this important reform.    

Supporting resources 

These resources may be helpful when talking to your board or your consultants about this:

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