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‘Lifetime’ Bonuses even for Underperforming Consultants

NHS Scheme under Review

Large pay bonuses cannot be taken away from doctors, even if their performance deteriorates, because of a loophole in the system, the BBC has found.

It means more than half of the 36,000 consultants in England now get what are effectively “lifetime” awards on top of the average £89,400 basic pay.The scheme is worth more than £75,000 a year to the best-performing consultants.

The bonus scheme dates back to 1948 when the NHS was created. In England, there are 16 different levels, ranging from £2,957 to £75,889 a year. In England, the cost of the awards was over £200m last year. News of the pay protection clause has added weight to calls for the scheme to be scrapped.

According to latest figures, 19,892 consultants in England are paid the bonuses. To apply for an award, consultants nominate themselves and are asked to provide details of excellent performance and innovation in terms of clinical care, research and training.

The awards are reassessed every five years, but critics said the loophole had created a culture where that checking process was effectively obsolete. In fact, evidence to a government review by the Advisory Committee on Clinical Excellence Awards, the body which oversees the top payouts, acknowledges that reassessments have not always taken place.

In 2010, the committee chased up those doctors who had not been taking part in the reassessment process. However, because of the pay protection clause all these doctors have continued to get the payouts even though the ‘bonuses’ have been formally withdrawn from them.

A review is being carried out by independent Doctors’ and Dentists’ Review Body and is due to report next summer.

Suzanne is a Partner and is head of the clinical negligence department.

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