Medical trade unions have voted to reject proposed reforms to bonus payments for senior doctors, after two years of negotiations broke down.
NHS Employers said in a statement that a proposed framework was rejected by unions, citing “a number of concerns that could not be resolved”.
It added: “These included national funding investment commitments, local variability in available funds across trusts and a number of other flexibilities in application.”
Local CEAs were last reformed in 2018 and were due to be reviewed in 2021. This review was delayed because of the pandemic.
The negotiations included NHS Employers, the Department of Health and Social Care, NHS England, the British Medical Association and the Hospital Consultants and Specialists Association, with support from managers and workforce directors from NHS trusts.
The payments – worth £445m in total pay – will now revert to a “default” scheme set out in the 2003 consultants’ contract. The scheme will come into play from April 2022.
Trusts will still be required to run the awards but will have more flexibility on how they are applied.
The HCSA highlighted multiple issues with the scheme proposed by national bodies. These included the banning of multi-year awards, the failure to address concerns about inequalities, freedom for employers to set awards values at whatever level they chose locally, and the creation of a “postcode lottery” in which different local schemes would start at different times.
In a statement the union said: “In recent months it has become clear that any attempt at a future nationally standardised scheme will be fatally undermined by conditions imposed by NHS England/Improvement on funding.”
It added it could not “endorse a new scheme we believe would fail consultants but could be stamped ‘with union approval’”.
BMA consultants committee chair Vishal Sharma said the union was “extremely disappointed that due to an insistence from NHSE/I to alter how the scheme is funded, the net result is a scheme that is not only too complicated but one that will in some areas drive further unfairness”.
He added: “Some trusts will have very little funding available to spend on new awards. These trusts will be the ones with a higher proportion of older, existing CEA holders and in these trusts, it will be the younger consultants, a greater proportion of whom are women, that will be denied the opportunity to access new awards.
”We believe the fairest solution is to extend the arrangements that operated during the pandemic and [to] distribute this element of consultant pay via equal distribution.”