Ministers and dentists’ leaders are still a long way from agreement on new-look ‘clinical excellence awards’ (CEAs) – nine months after a report called for changes.
The Department of Health announced a ‘heads of terms agreement’ on a shake-up, as recommended by the independent Review Body on Doctors’ and Dentists’ Remuneration (DDRB).
But the NHS Employers negotiating team has only held talks with doctors’ leaders – which means talks with the British Dental Association (BDA) have yet to start.
And the document revealed a long list of areas where agreement must still be thrashed out, including:
• Whether local and national awards will remain pensionable
• Whether awards will, in future, be time limited and, if so, their duration
• Whether there should be separate arrangements for national and local CEA schemes
• How to ensure ‘fairness, transparency and equity’ in making awards with ‘clearly defined appeals criteria and processes’
• Whether there should be self-nomination for local awards.
However, government ministers have pledged that the current funding set aside for CEAs will not be reduced as a result of the changes. And the new schemes will ‘continue to encourage and reward those eligible under current arrangements’.
The awards are intended to reward ‘those who demonstrate excellence in some key areas, such as clinical care, leadership and management, innovation, education, training and research’.
If an overall agreement is reached, the remuneration will be incorporated into the new contract currently being tested out for dentists, in various trials.
As a ‘national nominating body’, the BDA is among organisations with the right to provide supportive citations for applications for CEAs.
December’s DDRB report called for substantial changes to the system to reward current performance and to focus on outstanding contributions to patient care.
It described CEAs as a small part of the pay bill for health professionals, but having a strong effect on recruitment, retention and motivation.
It called for new schemes for national and local awards to be introduced as soon as possible – with a stronger link between local awards and performance appraisals.
Local awards should be one-off, annual lump-sum payments, while national awards should be held for a maximum of five years.
New awards should be non-pensionable and existing awards should be non-pensionable for future service, the DDRB said.
In December, health secretary Jeremy Hunt said: ‘The government does not necessarily accept that consultants should be prohibited from holding awards simultaneously in the old and new schemes.
‘I am also prepared to consider the issue of pensionability of future awards, as there is nothing inherent in a career average pension scheme that prohibits this.’
He added: ‘I would wish to see a heads of agreement reached by the spring of 2013 on changes across both contracts with the intention of implementation beginning from April 2014.’
by parliamentary correspondent Rob Merrick