Consultants' clinical excellence awards (CEAs): local agreement for 2008 round
15 November 2007
The annual employer-based CEA process is governed by four documents. Each of these documents must be read by those applying for CEAs and by the members of the Employer-Based Awards Committee (EBAC).
1. The guides to the scheme from the Advisory Committee on Clinical Excellence Awards, available on their web site at http://www.advisorybodies.doh.gov.uk/accea/index.htm. ACCEA publishes several guides to the scheme and frequently-asked questions, both available from this link.
2. The application forms are at http://www.advisorybodies.doh.gov.uk/accea/forms.htm and no other form can be accepted.
3. The [TRUST] agreement made in the Medical Negotiating Committee. This is available from the medical staffing department and is circulated with the invitation to apply for a CEA and to members of the EBAC. The employer-based agreement details the employer-based application of the national scheme.
4. The [TRUST] guide to completing and marking applications. This is available from the medical staffing department and is circulated with the invitation to apply for a CEA and to members of the EBAC. The [TRUST] guide assures a consistent and coherent approach to the annual process.
1. General principles on the allocation and spread of points
1.1. The local application of the clinical excellence awards scheme will be applied in line with ‘The new NHS consultant reward scheme: clinical excellence awards’ (Department of Health, August 2003) and the Advisory Committee on Clinical Excellence Awards’ (ACCEA) ‘Guide to the NHS Consultants’ Clinical Excellence Awards Scheme’ (published annually by ACCEA).
1.2. This agreement covers only the application of the local element of the Clinical Excellence Awards scheme. Local awards can be made at levels 1-9 of the scheme at values set out annually by the Doctors and Dentists Review Body. Eligible consultants are in addition eligible to receive CEAs awarded by the ACCEA and its subcommittees at levels 9 (bronze), 10 (silver), 11 (gold) and 12 (platinum). Consultants are advised to refer to the ACCEA’s guides to the scheme at the web site listed above, for further details.
1.3. Each year, subject to the minimum of 0.35 CEAs per consultant with one year of service, the trust will determine, following consultation with the Local Negotiating Committee (LNC) the overall number of CEAs to be awarded by the Employer-Based Awards Committee (EBAC) with effect from the following 1 April. All consultants with one year of service generate local CEAs to be awarded by the trust. For the sake of clarity, this includes all current discretionary point holders, distinction award holders and future national CEA award holders.
1.4. Part-time consultants will be granted awards on a pro-rata basis but will count as whole-time equivalents when the minimum number of awards is calculated.
1.5. CEAs will not be awarded other than through the procedures laid out here. Where a consultant transfers from another trust with CEAs these will be continued and are not new awards under this policy.
1.6. Consultants can be awarded any level of CEA up to nine, as deemed appropriate by the EBAC. Particular consideration will be given to making multiple awards to consultants currently in receipt of discretionary points, given that the value of those discretionary points will be between levels of CEAs. For individual transition from the Discretionary Point scheme to CEAs, the minimum award will be one full CEA value.
1.7. The EBAC will liaise with the regional ACCEA subcommittee regarding consultants towards the top of the local CEA scale. Where the EBAC decision on awards precedes that of the national ACCEA, the EBAC awards will be reviewed to consider whether any consultants given awards locally have also received national awards. If there are any such consultants, the local award(s) made during that year may be reallocated with backdating (see paragraph 7.12).
1.8. The trust and the LNC will review this agreement annually in the light of experience and taking into account guidance from the Department of Health, ACCEA or BMA. Any changes will only be made with the full agreement of the LNC.
2. Eligible consultants
2.1. The eligibility criteria outlined in part III of the ACCEA’s guide to the scheme are those applied locally. Substantive consultants are eligible irrespective of the contract they are employed under.
2.2. The trust will provide a list of all eligible consultants (all of those with at least one year of service) for discussion and agreement with the LNC. The number of eligible consultants multiplied by the agreed figure in paragraph 1.3 will determine the minimum number of awards under the scheme each year.
2.3. By this local agreement, consultants progressing by two or more CEA levels in one year will not be considered again the following year for a further award. This measure is intended to improve the equitable treatment of consultants under this scheme. Consultants not considered will still count towards the eligible numbers to determine the number of awards granted. Members of the EBAC shall not be considered for awards.
2.4. A list of eligible consultants, taking into account paragraph 2.3, will be given to the chairman of the Senior Hospital Medical Staffs Committee (SHMSC) to encourage consultants to apply.
3. Criteria
3.1. The criteria to be used for the local implementation of the scheme are detailed in the ACCEA’s guide to the scheme. Consultants should read the guide for further details. No other criteria will be applied to the consideration of CEAs.
3.2. The format of application forms will be as set out by the ACCEA in Form A. An appropriate scoring system will be agreed between the trust and the LNC and reviewed each year in the light of national guidance. It is agreed that the scoring system must be demonstrably objective and clearly based on the above-mentioned criteria. The scoring system and weightings shall be agreed between the trust and the LNC with an emphasis in the local scheme on rewarding contribution within the trust. For the current year of the scheme the scoring system is as follows:
- Domain area - Weighting
1. Delivering a high quality service. - 2.5
2. Developing a high quality service. - 2.0
3. Managing a high quality service. - 1.5
4. Research and innovation. - 1.0
5. Teaching and training. - 1.5
4.1. A local timetable will be agreed with the LNC that will allow payment of awards to be received by successful applicants in the April payslip at the start of the awards year.
4.2. The EBAC secretary will invite all eligible consultants to apply for CEAs using the ACCEA application form. Invitations will be circulated by email to trust email addresses, with a short note announcing the existence of the email circulated on paper by the trust internal mail system. The invitation will include a copy of this agreement with all of the appropriate criteria, the application form with notes for completion, the qualifying date for attaining consultant status and an explanation that those consultants who received more than one CEA in the previous year will not be considered for an award in this round (see paragraph 2.3). There will be a time limit for the completion and return of the application form; eligible consultants will be sent an email reminder seven days in advance of the closing date for applications. The application form must be returned by email as a Word attachment containing the completed ACCEA form. Forms not returned by email will not be accepted. Late entries will not be accepted.
4.3. Each applicant will be advised of their application reference number so that this can be cross-referenced to documentation later.
4.4. The employer will not submit citations for any candidates applying for local awards. Nor will nominating citations from third parties be referred to during the EBAC’s deliberations.
5. Employer-Based Awards Committee (EBAC)
5.1. The function of the EBAC is to take the annual decision as to which consultants will receive local CEAs. The EBAC will base its decisions on the criteria laid down in the ACCEA’s guide to the scheme. The points scoring system agreed with the LNC will be strictly adhered to by the EBAC.
5.2. The EBAC will be constituted as follows:
- EBAC chairman: the chief executive or nominated deputy.
- EBAC secretary: the chief operating officer or director of human resources.
- The trust chairman or nominated deputy.
- The medical director or nominated deputy.
- The dean of the [name] Medical School or nominated deputy.
- A PCT representative nominated by the chief executive.
- A lay representative nominated by the chief executive.
- A consultant member of the Local Negotiating Committee.
- Eight consultants nominated from the consultant body including honorary contract holders in accordance with paragraph 5.3.
5.4. Members of the national ACCEA and its regional subcommittee will be eligible to attend meetings of the EBAC in an observer capacity.
5.5. The EBAC secretary’s duties are as follows.
- To advise the EBAC of the total number of awards available each year..
- To advise the EBAC of the number and names of eligible consultants.
- To be responsible for convening the meetings.
- To be responsible for an equal opportunities analysis and its circulation.
- To be responsible for keeping the records of all scores and raw score sheets.
- To be responsible for keeping full minutes of all the meetings, together with a list of those attending.
- To convey the results of the EBAC's deliberations to all consultants who have applied.
- To convene and manage the appeals process.
- To advise the Board of the decisions of the EBAC and the results of any appeals decisions.
5.7. The deliberations of the EBAC will be based solely on the contents of the application forms.
5.8. Full minutes, scoring and ranking records must be maintained, and released, anonymised and highlighted to individuals on request.
5.9. The EBAC will be quorate with at least 75% of the full membership in attendance. The committee will be inquorate if there is not a majority of consultants present. The trust will ensure that consultant members of the EBAC are not prevented from attending these meetings by other trust duties except in the case of a clinical emergency that cannot be managed by any other consultant.
5.10. Decisions will be made by reference to the scoring process. In the case of an equality of scores, the EBAC will consider the applications in the light of all the information contained in the application forms. In the event that the EBAC does not reach a consensus, the chairman shall have a deciding role.
5.11. Each year the EBAC will review the names of all eligible consultants who have not received awards in the previous ten years to ensure that there are bona fide reasons for non-receipt of awards.
5.12. Appropriate guidance and training regarding the process and equal opportunities will be given to each member of the EBAC.
6. Consultants under investigation
6.1. Consultants who are under investigation may apply in the normal way for CEAs whether or not the process is internal or external (e.g. GMC, NICE or Police Authority).
6.2. If a consultant who is the subject of a formal investigation or disciplinary process chooses to submit an application for CEAs, the application will be scored in the usual way. Should that consultant following the scoring process be granted an award, that award will be withheld until such time as the formal investigation or disciplinary process is completed and will be informed of this by the EBAC secretary as soon as practicable. Neither the fact nor the details of the disciplinary concern or investigation will be disclosed to the EBAC.
6.3. Following completion of the formal investigation or disciplinary process, the award will either be made if no disciplinary action is taken or may be withheld if disciplinary action is taken or while a warning is extant. Withheld awards will be put forward to a subsequent round once the warning has lapsed. The fact that an award has been withheld will be disclosed to the LNC chairman so that the next year’s allocation may be properly verified. If the award is not made to the individual, it will be reallocated retrospectively with backdating.
7. Annual process
7.1. The EBAC secretary will convene an initial meeting to set the agenda for the detailed process. The methodology of the scoring process including the target allocations (see below) shall be discussed at the initial meeting of the EBAC in order to reach a uniform approach.
7.2. All of the members of the EBAC will be given the applications for consideration with the equal opportunities monitoring sheet removed. The applications will not be anonymised.
7.3. Each individual member of the committee (scoring members) will independently score each of the applications (by allocating a score to each of the domains) and forward these raw scores to the EBAC secretary who will be responsible for collating the information for the next meeting of the EBAC.
7.4. Scorers will consider each application for scoring along with the local guide to completion and marking of forms.
7.5. The EBAC secretary will also provide an equal opportunity analysis across the applications, including for specialty and whether the applicant holds an academic post.
7.6. Awards will be allocated according to an objective formula that recognises the ceiling quota in the scheme. Scores will be aggregated to give a weighted total for each applicant; the weighted totals will be ranked in descending order. The number of consultants receiving awards shall be determined so as to achieve the following allocations in the final distribution. [This is an example and NOT a recommendation.]
- Awards made to applicant - Proportion of total awards in each class
4 - 25%
3 - 35%
2 - 25%
1 - 15%
7.8. The allocations are made by descending the rank table and allocating awards to applicants from the highest class remaining, to the maximum that consultant can receive. If the EBAC determines that the target allocations produce unacceptable distortions, or the numbers of applicants change significantly, then the proportions may be varied so long as an explicit record is kept of the reasons that this is done.
7.9. On completion of the collation and analysis the secretary of the EBAC will reconvene the meeting to decide the allocation of awards to the applicants. The secretary will keep a full record of the allocations. The secretary of the EBAC will write to all applicants as soon as possible after the decision informing them of the allocation. In the letter the EBAC secretary will detail the process to be followed in the event of an appeal.
7.10. Following the allocation of awards the EBAC shall hold a final meeting, no later than two months from the date of the allocation meeting, to review the process for the current year. At this meeting the equal opportunity analysis will be provided having been updated to analyse for success and failure in awards. This information and the result of the review will be passed to the LNC to enable a review of the whole process to be undertaken.
7.11. The local process shall be completed by the April payroll.
7.12. National level awards will be notified in October, with pay backdated to April. It is possible for consultants receiving local awards to find later that they have received a national award. Where this happens, the EBAC may determine that any local awards granted to such consultants will be recycled and awarded with backdating to other candidates, in order to maintain the local value of the CEA scheme.
7.13. The EBAC secretary will provide formal feedback to individual applicants after the award process has been completed. This will be anonymised, will refer to the scoring process and will take the form of a graphical representation of the distribution of the scores, with the candidate’s position marked thereon. The applicants will be given their code number to refer to the information report.
7.14. The EBAC secretary will publish each year an information report containing the equal opportunities analysis detailed in paragraph 7.5.
8. Appeal arrangements
8.1. Inevitably, some candidates will be disappointed with the final outcome of the awards. One cannot, of course, appeal simply because one disagrees with the collective judgement of ACCEA or the EBAC. However, where procedures have not been followed, or there is evidence of the process not being objective, one may appeal for a review.
8.2. Appeals must be lodged within four weeks of the consultant receiving the results of the allocation of clinical excellence awards.
8.3. Informal steps to resolve the issue should be taken first, prior to instigating the formal process.
8.4. The EBAC Secretary will use their best endeavours to ensure that appeals are heard within six weeks of the receipt of the appeal.
8.5. It is intended that the proceedings of a Clinical Excellence Award Hearing be conducted as informally as possible, whilst at the same time having regard to procedure. The objective is to allow each party to fully and frankly explain its position.
8.6. Where the correct procedures have not been followed, or there is evidence of unfairness in the process, the objectivity of decisions is called into question and consultants may appeal in order to have the processes reviewed. No appeal can be brought against the fact that the substance of the application was judged insufficiently strong to merit an award in the absence of reason to believe that there were procedural failings.
8.7. Grounds for appeal may include the following:
- The material submitted was not considered by the relevant committee.
- Extraneous factors or material were taken into account.
- There has been unlawful discrimination, for example on the bases of gender, ethnicity or age.
- The established evaluation processes were not followed.
- There was bias or conflict of interest on the part of the committee.
- A non-executive director of the trust as chairman.
- A senior clinical manager employed by [TRUST].
- A senior clinical manager who is employed by another trust.
- Two consultant members appointed by the Local Negotiating Committee.
- A member of the human resources department will service the appeal.
- 8.9.1. The panel will consider the appeal, in the first instance, on the basis of the following documentation and without oral evidence and representation:
- Statement of complaint from the appellant.
- The local procedure.
- A written statement of the actual procedure followed by the EBAC (produced for the purpose of the appeal if not already available).
- Any further representations in writing.
8.9.3. The Chair of the Appeal Panel will consider any written representation from the consultant giving reasons why an oral hearing may be necessary.
- 8.10.1. The Appellant or representative shall state their case in the presence of the Management representative.
8.10.2. The Management representative and members of the Appeal Panel, hearing the appeal, shall have the opportunity to ask questions of the Appellant/the representative.
8.10.3. The Management representative shall state the management case in the presence of the Appellant and his/her representative.
8.10.4. The Appellant or representative and members of the Appeal Panel, hearing the appeal, shall have the opportunity to ask questions of the management representative.
8.10.5. The Appellant or representative shall have the opportunity to re-examine any matter referred to in their examination by members of the Appeal Panel or the Management representative.
8.10.6. The Management representative shall have the opportunity to re-examine any matter referred to in their examination by the Appeal Panel, the Appellant or representative.
8.10.7. The Management representative and the Appellant or representative shall have the opportunity to sum up their cases if they so wish. The Appellant shall have the right to speak last. In summing up neither party may introduce any new matter. The Management representative, the Appellant and representative, will then withdraw.
8.10.8. Nothing in the foregoing procedure shall prevent the Appeal Panel, hearing the appeal, from inviting either party to elucidate or amplify any statement made.
8.10.9. The Appeal Panel may exercise discretion to adjourn the Appeal in order that further evidence may be produced by either party or for any other reason.
8.10.10. The Appeal Panel hearing the appeal shall deliberate in private, only recalling both parties to clear points of uncertainty on evidence already given. If recall is necessary both parties shall return notwithstanding only one is concerned with the point giving rise to doubt.
8.10.11. The decision of the Appeal Panel will be announced at the end of the Hearing wherever possible.
- 8.11.1. The EBAC secretary will write formally to the appellant with the outcome within three working days of the decision. The EBAC will also be informed within the same time period. This will be achieved by way of sending a copy of the letter (to the appellant) to each member of the EBAC.
8.11.2. If successful, the appellant will receive the revised allocation of CEAs backdated to 1 April in the relevant year.
8.11.3. Appeals against decisions of employer-based committees are initially handled by employers, according to local grievance or Clinical Excellence Awards procedures. ACCEA would only become involved if cases remained unresolved. Any appeal against the EBAC Appeal Panel decision should be referred in writing to the Head of the ACCEA Secretariat within four weeks of receiving the written decision from the Chair of the EBAC, giving full reasons for the appeal.
8.11.4. The Head of the ACCEA Secretariat will usually ask the Chair of the relevant ACCEA Regional Sub-Committee to investigate and advise ACCEA of the findings. Where these findings indicate that local procedures have been unsatisfactory, ACCEA will ask the EBAC to reconsider the consultants’ application. It may also make recommendations to the EBAC as to how it should proceed.
8.11.5. The decision of the ACCEA will be final.
9.1. Local CEA awards will only be reviewed on an exceptional basis by the EBAC (for example, when the consultant’s contractual duties have changed dramatically and it is questionable whether the original reasons for the award still apply).
9.2. Section 6 deals with the issue of disciplinary warnings.
10. Annual report
10.1. The EBAC secretary will produce an annual report for the regional ACCEA subcommittee, containing its recommendations for award and a description of how it reached its conclusions. The ACCEA guide provides further details of the information required.
11. Support for applicants
11.1. The trust shall ensure that appropriate advice, education and training is made available to all consultants in regard to the completion of application forms in order to promote equality of opportunity.
11.2. The trust will ensure that all applicants have adequate access to secretarial and ICT resources in order to ensure that applicants are not disadvantaged in completing their application form.
11.3. In establishing the scheme, the Department of Health announced that: “we expect the number of consultants in receipt of an award to increase from around one half of all consultants at present to around two-thirds.” While this does not offer a guarantee that all consultants will receive an award during their careers, the trust will offer particular support to those consultants who have not received a clinical excellence award (or discretionary point under the previous scheme) in the preceding ten years.
11.4. The EBAC secretary will draw up lists of such consultants annually and circulate them to the appropriate clinical directors. Clinical directors are responsible for reviewing the professional portfolios of such consultants, through the appraisal system if appropriate, in order to identify those consultants who should be encouraged and further supported in making an application.
This agreement on policies and procedures for the CEA scheme has been made in the Medical Negotiating Committee.
Signed (on behalf of the Trust):
Date: xx xxxxxxx 2007
Signed (on behalf of the LNC):
Date: xx xxxxxxx 2007
To be reviewed jointly by the Trust and LNC by: November 2008