Member briefing: New National CIA awards replace NCEAs

The Department of Health & Social Care, Welsh Government and Advisory Committee on CEAs have published the consultation response on ‘Reforming the national Clinical Excellence Awards scheme’. HCSA participated in the consultation. The following FAQ should assist members in understanding the proposed new scheme based on the consultation outcome.

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What is the name of the new scheme?
The replacement scheme for National Clinical Excellence Awards’ (NCEAs) will be called 'National Clinical Impact Awards' (NCIAs) from 2022. ACCEA will become ACCIA (Advisory Committee on Clinical Impact Awards).

I currently have an NCEA – will my pay be protected?
Yes, both the value and pensionability will be protected at least until your renewal date (although there is no longer a renewal process). Transitional pay protection is established in Schedule 30 of the English 2003 Consultant contract and can only be reconsidered if altered by collective agreement with negotiating unions (HCSA and BMA).

The precise details will vary depending on your own circumstances - whether you apply for a NCIA and whether you are successful and at which level. If you are successful in securing a new NCIA then you will receive no less than your previous NCEA award (if securing an equal or higher level NCIA) or no less than the equivalent NCEA value of your new NCIA (if you secure a lower level award than previously).

If unsuccessful in securing an NCIA once your NCEA ends, there is also provision depending on your score to revert to a Level 7 or 8 LCEA which is pensionable.

What are the plans for award levels and values?
In England, the lowest level (formerly “Bronze”) will be removed. HCSA fundamentally disagrees with this shift. We see a natural fit for regional activity and ICS work not undertaken for the local employer to fall under the remit of the national award scheme. We also have concerns that the removal of this layer is counter-productive to broadening access.

 The new national levels and their values are as follows:

  • National 1 – £20,000 per year for 5 years (approx. 330 awards available)
  • National 2 – £30,000 per year for 5 years (approx. 200 awards available)
  • National 3 – £40,000 per year for 5years (approx. 70 awards available)

Wales will retain a 4th level, but with new levels and values as follows:

  • National Level 0 – £10,000 per year for 5 years (20 awards available each year)
  • National Level 1 – £20,000 per year for 5 years (10 awards available each year)
  • National Level 2 – £30,000 per year for 5 years (5 awards available each year)
  • National Level 3 – £40,000 per year for 5 years (2 awards available each year)

Can I hold local and national awards concurrently?
In England, Consultants will not be able to hold local and national awards concurrently. This will be reviewed in 2025.

In Wales, Consultants will be allowed to hold NCIA and commitment awards concurrently. 

What are the changes to domains?
Consultants will still be required to evidence across all five domains, but there are some changes to the scope of the domains.

Domain 1 will now incorporate both service development and delivery. This is a merger of the former domains 1 and 2.  

The new domain 2 is focused on leadership, as opposed to the former "management".

There is also a new domain 5, "additional national impact".

Will the application process change?
Yes – an IT system will be launched with a single-level application, intended to simplify the process.

What is the impact on less-than-full-time (LTFT) doctors?
The pro rata element for those who work LTFT will be removed, meaning LTFT workers have the opportunity to receive the entire award amount. The assessment process will be the same for full-time and LTFT applicants. Candidates will require a minimum of three clinically relevant PAs and five PAs in total.

Can I include future outcomes in my application?
No – the position is that only work already undertaken can be scored, therefore aspirations and future outcomes cannot be used as an indicator of excellence or impact and should not be scored.

Will I be able to renew my award?
No. Current award-holders will need to apply for a new award before their current award is due to expire.

Will the awards be pensionable?
No. NCIAs will be non-pensionable and non-consolidated. This represents a much lower overall value of the award, compared to the former NCEA scheme.

What about tax implications?
Non-consolidated CIAs will be counted as taxable income and as such may still have annual allowance implications for some award holders.

Are the new awards more inclusive?
The DHSC and Welsh Government response suggests they will be collecting more diversity data and considering developing guidance to include requirements for employers to publish their data on diversity of applicants using NHS Digital diversity data as a benchmark.

What role will employers play?
Requirements for employers to score and rank applications will be removed. There will be guidance on employer responsibilities to encourage and support applications for awards. Employers will also be required to outline their processes to the ACCEA.

How will the scheme be governed?
The Main Committee will continue to govern the scheme nationally.  

What is HCSA’s view on the new scheme?
HCSA is concerned that the financial awards in the NCIA scheme are far less valuable than the current scheme. This is compounded by the lack of pensionability, and limited term of payment.

If the scheme is successful in making more awards to those with protected characteristics, the award holders will receive a much lower financial award than the previous award holders, further widening the gap.

Overall, it will be significantly less attractive than the scheme it replaces, and represents a further intolerable squeeze on the remuneration available to hospital doctors.