Doctors’ pay should be linked to performance

Consultant doctors’ pay should be capped nationally and locally, and linked to performance, according to an independent report by the Doctors and Dentists Review Board, which was commissioned by the government.

The Doctors and Dentists Review Board report on consultant contracts and clinical excellence, published on 17 December, made recommendations around changes to consultant contracts and clinical excellence awards so that they better recognise current excellence in providing high-quality care, medical teaching and research.

Consultants are currently eligible to receive national or local awards for outstanding clinical excellence, ranging up to £75,000 per annum. These awards are pensionable, in addition to a doctor’s regular salary, and payment currently continues until a doctor retires.

Using the report, the government will look at medical pay as a whole, including the £5.5 billion spent annually on consultants’ pay, so that it can offer national terms and conditions that are affordable and fit for purpose.

Recommendations included:

  • Rewards for clinical excellence should be linked to performance, including patient feedback.
  • Rewards for clinical excellence should be capped nationally at £40,000 and locally at £35,000 per annum.
  • Consultants should be rewarded for current excellence, rather than past performance. Rewards should be awarded for no more than five years nationally and one year locally.
  • A new ‘principal consultant’ grade should be introduced, paid between £100,000 to £120,000, to reward very senior and outstanding doctors (capped at 10% of consultants across the country).
  • Progression through the current consultant grade (£74,000 to £100,000) should be based on performance and contribution rather than time served, with progression to the top of the scale being at the employer’s discretion, recognising each doctor’s increasing skills and performance in providing high-quality patient care.

Dr Dan Poulter, health minister, said: “This independent report gives us a once-in-a-generation opportunity to work with medical colleagues to take a holistic view of how doctors should be trained, educated and rewarded for their life-saving work. 

“This means making sure we have the right rewards to encourage hospital doctors of all specialities to continue to provide the very best care for their patients.

“Clinical contracts must support high-quality training, and change in this area is long overdue.

“The government accepts the majority of recommendations and observations in the independent report as a basis for discussion, and will work with the medical profession to achieve the best outcome for doctors and patients.”

The report, and the government’s response, will be followed by further discussions with the medical profession in 2013.