President's view: Clinical Excellence Awards

It was with no great relish that HCSA rejected NHS Employer overtures to sign a deal on the future of Clinical Excellence Awards which has been hailed by the BMA as a major victory for consultants, writes HCSA President Ross Welch.

Our very real fear is that in return for a few short-lived incentives, CEAs will now mutate into an annual bonus scheme with criteria, dictated by Trust management, based on a narrow range of targets.

While there are undoubtedly issues with the fairness and application of CEAs in their current form, the prospect now is the worst possible outcome of all: their conversion into a pure management control mechanism.

It is to be hoped that this fear is unfounded, of course – there will be little satisfaction to be had in saying: “We told you so.” Yet clauses in the deal are a signpost.

Short-term arrangements will protect current recipients, but other clauses threaten a fait accompli on the replacement of CEAs before negotiations on national standards have even begun.

It will be a “performance” scheme, and crucially variations can be introduced by employers with local consultation – not the same as negotiation, and enshrining in black and white the right of Trusts locally to undermine any new national agreement.

HCSA maintained that as CEAs are part of the overall wage bill for Consultants, reform should be agreed under the aegis of any new contract as a whole.

Unfortunately the other negotiating parties seem intent and content respectively to approach negotiations in a piecemeal way, which threatens a worse overall outcome for doctors.

The CEAs deal truly is a “dog’s dinner”, and I predict it won’t be long before the profession at large begins to realise this.