More doctors to get bonuses under government’s new scheme

The government has announced reforms to the “clinical excellence awards” bonus scheme for senior doctors, in an effort to make the process more inclusive.

The Department of Health and Social Care will also rename the bonus payments system – which has existed since 1948 and from 2004 in their current form – as the “national clinical impact awards”.

The changes are expected to mean more doctors receive the payments, but that each award is generally smaller.

Previously, CEAs could be worth up to around £77,000, whereas under the new scheme, the highest level of award (national 3) is worth £40,000 per year for five years with 350 awards available in England. New national 2 awards are worth £30,000 per year for five years with 1,000 available, and national 1 awards are worth £20,000 per year with 1,650 available.

Current award holders (including those who were successfully awarded or renewed their awards for 2021) will retain their award at its current value and under the current terms and conditions for the remaining duration of their award, the DHSC confirmed.

The DHSC said: ”To increase the number of awards available, the value of the awards will decrease slightly… This will increase the number of senior clinicians who will hold an award during their professional career.”

The exact numbers which are awarded and their values will not be certain until the scheme is implemented.

The CEA system applies to medical consultants, dentists and academic GPs. Bonus payments are meant to be awarded to staff who perform over and above the expected standards while also fulfilling the requirements of their post. 

But there have long been complaints about inequity in the system, and successive efforts to reform it.

From April, the awards will – for the first time – pay doctors who work less than full time the full value instead of pro-rata. This was one of the key recommendations of the Independent Review of the Gender Pay Gap in Medicine, which found men were more likely to earn more additional income from CEAs than women, who in turn were more likely to work part-time.

The reforms this spring will also open all award levels to all applicants, removing the requirement to move up through the tiers of awards over subsequent years. The DHSC said this would “ensure outstanding contributions from younger consultants are equitably recognised”.

Employers will not need to contribute to an award recipient’s pension funds to reflect “modern remuneration arrangements” and align with the local clinical excellence awards, which were reformed in 2018 to make the local awards non-pensionable.

There are two types of awards; national CEAs, awarded by the Advisory Committee on Clinical Excellence and local award schemes, managed by individual employers in England; the reforms only concern the former.

The reforms also include:

• Refreshed assessment criteria to reflect “modern careers” and “recognise contributions from under-represented groups, including allowing more flexibility in the type of evidence provided in applications”;
• Although awards can still be held for five years, reapplication after this will be assessed in competition with new applicants to create “a more level playing field”;
• The scheme will move from four award levels to three and the first level will “become more attainable”; and
• More awards will be available at each level than in previous years.

The DHSC added the closing date for the awards would be announced in due course.

Health minister Edward Argar said: “The new national clinical impact awards will help level the playing field and recognise the extraordinary contributions made by NHS doctors and dentists.

“We’re increasing the number of people who will be recognised, and making the awards more accessible for under-represented groups, including women and younger consultants.”

Chair of the gender pay gap review Dame Jane Dacre said: “I am pleased the new national clinical impact awards will reflect the recommendations made in the gender pay gap review.

“I am particularly encouraged to see that those who work part-time (often women) will now be eligible for a full value award as awards will no longer be paid pro-rata.

“Highlighting the contributions from specialities, such as geriatrics and palliative medicine, with more female staff, will also help keep more talented women working in the NHS. Together these changes will encourage more women to apply for awards.”

She described the reforms as ”another step on our path to closing the [gender pay] gap”.