EMBARGOED UNTIL 00:01HRS GMT WEDNESDAY 4 OCTOBER 2006
Performance pay for NHS consultants discriminatory
A leading Professor of General Practice in the UK has called for a fundamental review of the Department of Health’s Clinical Excellence Awards.
Writing in the Journal of the Royal Society of Medicine, Aneez Esmail argues the awards are not fair and fit for purpose.
The Clinical Excellence Awards (CEA) came into operation in 2003/2004. They replaced the Distinction Award Scheme which was introduced in 1948 at the formation of the NHS and the Discretionary Points Schemes. The CEA are a performance pay review system which rewards high-performing doctors for their contribution to the NHS.
"The Clinical Excellence Awards are unfair, discriminatory and not suitable for the modern NHS," said Professor Esmail.
"Despite reforms designed to make the awards more transparent and accountable, the majority of recipients are white, male doctors usually working in high-profile specialties."
There are 12 levels of award within the CEA. Payments are awarded in ascending order, with the highest, Level 12 [platinum] worth £71,495 per year. The award is paid to individual consultants in addition to salary, on a yearly basis until retirement. It is pensionable for life.
"Figures released in spring 2005 by the Advisory Committee on Clinical Excellence Awards showed that during the 2004 round, Bronze awards were granted to 259 white consultants out of 19,020 and 20 to non-white consultants out of 3,049," said Professor Esmail.
"In other words, a non-white consultant was two times less likely to have been awarded a Bronze CEA compared to a white colleague."
Professor Esmail said the CEA should be reviewed to reflect the way medical or clinical teams work in the NHS and private sector workplaces.
"The Awards only recognise individual efforts," said Professor Esmail. "However, the reality is that consultants work in teams. It is only fair that team members such as nurses and other clinicians are recognised and rewarded for their contributions."
"The Department of Health spends up to £250 million each year rewarding consultants. If the CEA were abolished, every consultant would be entitled to a pay rise of £10,000 per annum.
"However, if the Department is committed to reward effort, it should do so in a way that meets the needs of the NHS in the 21st century and reward team work," he said.
Dr Kamran Abbasi, editor of JRSM, added: "The NHS has been shown to be discriminatory yet again. This is particularly worrying since non-white doctors are a large proportion of our medical workforce. These findings will also heighten concerns about the appropriateness of economic incentives to reward clinical productivity."
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‘Performance pay remuneration for consultants in the NHS: is the current system fair and fit for purpose?’ by A Esmail & P Abel is published in the October 2006 issue of the Journal of the Royal Society of Medicine.
JRSM is the flagship journal of the Royal Society of Medicine. It has been published continuously since 1809. Its Editor is Dr Kamran Abbasi.
