EMPLOYER BASED CLINICAL EXCELLENCE AWARDS POLICY JANUARY2016
Policy title Employer Based Clinical Excellence Awards Policy Policy HR49 reference Policy category Human Resources Relevant to All eligible Consultants Date published February 2016 Implementation February 2016 date Date last N/A reviewed Next review February 2017 date Policy lead Robert Walley, Medical Resourcing Manager Contact details Email: Robert.walley@candi.nhs.uk Telephone: 020 3317 7172 Accountable director Approved by (Group): Approved by (Committee): Document history Joanne Shand, Associate Director of HR/OD Workforce Partnership Group Workforce Committee 29 January 2016 Date Version Summary of amendments Jan 2016 1 New Policy Membership of the policy development/ review team Consultation Policy Lead and HR Staff Workforce Partnership Group members and Local Negotiating Committee members DO NOT AMEND THIS DOCUMENT Further copies of this document can be found on the Foundation Trust intranet. Employer Based Clinical Excellence Awards Policy_HR49_January 2016
Contents Page 1 Introduction 3 2 Principles on the allocation and spread of awards 3 3 Eligible Consultants 5 4 Eligible Consultants Under Investigation 5 5 Consultants employed through alternative Trusts 6 6 Criteria 6 7 Application Procedure 7 8 Employer Based Awards Committee 7 9 The Process 9 10 Appeal Arrangements 9 11 Review of Employer Based Awards 10 12 Annual Report 12 13 Review of the policy 12 14 Timetable 12 15 Appendix 1 Equality Impact Assessment 13 Employer Based Clinical Excellence Awards Policy July 2015 ii
1. Introduction 1.1 Clinical Excellence Awards recognise and reward NHS consultants who perform over and above the standard expected of their role. Awards are given for quality and excellence, acknowledging exceptional personal contributions. 1.2 The Terms and Conditions Consultant (England) 2003 sets out the agreement for the payment of Clinical Excellence Awards to Consultant Medical and Dental Staff, as a seamless scheme comprising both local and national elements. 1.3 This document sets out the agreement for the local operation of the scheme in Camden and Islington NHS Foundation Trust. 2. Principles on the allocation and spread of awards 2.1 Local awards (Levels 1-9) will be payable to those consultants and clinical academics making an outstanding contribution at a local level against nationally set criteria (see section 4, below). 2.2 Awards will be decided on a competitive basis, on the relative merits of individual cases, as presented on the CV Questionnaire. 2.3 Clinical excellence awards are intended to reward those individuals who achieve over and above the standard expected of a consultant and who locally, nationally or internationally, provide many of the following characteristics (applicants are not expected to possess them all) Demonstrate sustained commitment to patient care and wellbeing, or improving public health Sustain high standards of both technical and clinical aspects of service whilst providing patient focused care Make an outstanding contribution to professional leadership In their day to day practice, demonstrate a sustained commitment to the values and goals of the NHS, by participating actively in annual job planning, observing the Private Practice Code of Conduct and showing a commitment to achieving agreed service objectives Through active participation in clinical governance contribute to continuous improvement in service organisation and delivery Embrace the principles of evidence based practice Contribute to knowledge base through research and participate actively in research governance Are recognised as excellent teachers and/or trainers and/or managers Contribute to policy writing and planning in health and health care Employer Based Clinical Excellence Awards Policy July 2015 3
2.4 In the 2003 Consultant Contract Clinical Excellence Awards replaced Discretionary Points and Distinction Awards. 2.5 The scheme is intended to: be transparent, fair and based on clear evidence and perceived to be so, both by the public and the profession; be open and accessible to all eligible consultants; place a strong emphasis on quality of care; make eligibility dependent on: a satisfactory level of performance; satisfactory participation in the annual appraisal process; 100% compliance in statutory and mandatory training; meeting standards of best practice in relation to job planning; meeting the standards of best practice set out in the Code of Conduct for Private Practice (for NHS consultants who participate in private practice). ensure fair distribution of awards through appropriate application of the criteria; ensure that Consultants with any of the nine protected characteristics (Equalities Act 2010) are not discriminated against; allow early intervention to review an award where concerns or allegations about a doctor s conduct or performance are upheld through disciplinary or professional fitness to practice proceedings; publish information on the distribution of each level of award and the names of award holders. 2.6 The local application of the clinical excellence awards scheme will take into account the latest guidance from the Advisory Committee on Clinical Excellence Awards (ACCEA) NHS Consultants Clinical Excellence Awards Scheme. The local CEA Scheme will also reflect the joint agreement between the Trust and the Local Negotiating Committee. 2.7 This agreement covers only the application of the local element of the Clinical Excellence Awards Scheme. It is intended as a means to ensure that the local elements of the ACCEA s scheme operate effectively and by agreement between the Trust and the consultant staff. Local awards can be made at levels 1-9 of the scheme at values set out annually by the Doctors and Dentists Review Body. 2.8 Eligible consultants can apply for national CEAs awarded by the ACCEA and its subcommittees at levels 9 (bronze), 10 (silver), 11 (gold) and 12 (platinum). If awarded, these will replace the local awards. Consultants are advised to refer to the ACCEA s guidelines on the scheme at https://www.gov.uk/government/organisations/advisory-committee-on-clinicalexcellence-awards for further details. 2.9 Each year the Trust will determine the budget for new CEAs to be awarded by the Employer Based Awards Committee (EBAC) with effect from the following Employer Based Clinical Excellence Awards Policy July 2015 4
1 April. This is calculated as 0.2 awards per eligible whole time equivalent consultant. 2.10 All consultants eligible to apply for local CEAs generate the calculation for the number of local CEAs to be awarded by the Trust. For the sake of clarity, this excludes those holding the maximum number of local CEA awards, distinction award holders, national CEA holders. 2.11 The value of awards granted to part-time consultants will be on a pro-rata basis. 2.12 Consultants can be awarded any level of CEA up to nine, as deemed appropriate by the Employer Based Award Committee (EBAC). 3. Eligible Consultants 3.1 Consultants must have been employed as a Consultant by the Trust for at least 12 full months 3.2 The Trust will provide a list of all eligible consultants for discussion and agreement with the LNC. 3.3 Consultants granted one CEA or more locally in one year would not normally be considered again locally the following year for a further award. Although this may be varied if there were circumstances warranting this in an individual case, this should be seen as exceptional and not normally applied. 4. Eligible Consultants under Investigation 4.1 If a consultant who is the subject of a formal investigation, including a professional advisory panel, chooses to submit an application for CEAs, his/her application will be considered in the usual way by the EBAC. Should that consultant following the EBAC meeting remain under investigation, then any CEA awards that were awarded during that EBAC meeting, will be withheld until such time as the formal investigation / process is completed. Neither the fact nor the details of the process will be disclosed to the EBAC. 4.2 Following completion of the formal investigation / process, the CEAs will either be awarded if no action is taken or may be withheld or withdrawn if action is taken, or withheld while a warning is extant. Any awards that are withheld will be made subsequently once the warning's time limit has lapsed. The fact that CEAs have been withheld will be disclosed to the Chair of the EBAC so that the next year's allocation may be properly verified. Employer Based Clinical Excellence Awards Policy July 2015 5
5. Consultants employed through alternative Trusts Consultants who are working at the Trust through a Service Level Agreement, or hold an honorary contract with the Trust and are employed by a different Trust, should apply for a local clinical excellence award directly from their employing Trust. A letter of support may be provided upon request in recognition for their contribution to the Trust; the request for the letter should be made to the EBAC panel and the decision to provide a letter will also be made by the EBAC panel. If the Consultant has been provided with a letter of support by the Trust and is successful in their application for an employer based clinical excellence award the Trust will organise to pay the employing institution directly for a percentage of the award, according to the programmed activities/sessions worked at the Trust. 6. Criteria 6.1 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. The format of applications will be that issued by the ACCEA. The scoring system will be the same as the ACCEA s system used in scoring of national awards 6.2 Assessment Criteria The decisions on level of award will be based on the following criteria:- Domain 1 delivering a high quality service Evidence of achievements in delivering a service which is safe, has measurably effective clinical outcomes, provides good patient experience, and where opportunities for improvement are consistently sought and implemented Domain 2 developing a high quality service Evidence of significantly enhancing clinical effectiveness (the quality, safety and cost effectiveness) of the local service(s) or related clinical services more widely within the NHS. Domain 3 leadership and managing a high quality service Evidence of having made a substantial personal contribution to leading and managing a local service, or national/international health policy development. Domain 4 research and innovation Evidence of having made a contribution to research or the evidence/evaluative base for quality or service innovation including the translation of evidence in to practice. Domain 5 teaching and training Evidence of how teaching and training forms a major part of the contribution applicants make to the NHS, over and above contractual obligations. Employer Based Clinical Excellence Awards Policy July 2015 6
7. Application Procedure 7.1 Each year Medical HR Lead will invite all eligible consultants to apply for clinical excellence awards at least four weeks in advance of the closing date. The invitation will include the application for a local CEA (Appendix A) and the web link to the ACCEA s guide. Eligible consultants will be sent a reminder seven days in advance of the closing date for applications. The application should be returned electronically to the Medical HR Lead. 7.2 Late entries will not be accepted under any circumstances. 7.3 Candidates for consideration for Clinical Excellence awards will be on a selfnominating basis only, by submitting a fully completed application form (Appendix A). 7.4 All applicants must have a citation from their Clinical Director (or equivalent). minating citations from third parties will not be referred to during the EBAC deliberations. There will be consistent application of this standard for all consultants. 7.5 The invitation letter will state that all applications will be acknowledged by email and that in the event of an applicant not receiving an acknowledgement he/she should assume that the application has not been received and contact the Medical HR Lead accordingly. The closing date and time will not be extended for this purpose. 7.6 The invitation letter will confirm that each application will be given to the Clinical Director for verification and a citation, if this has not already been requested. 7.7 The boxes on the application must not be enlarged and font size should not be less than 10. There is a maximum character count with spaces on 1350 per domain. Any text exceeding this will be excluded from consideration. 7.8 After the closing date for receipt of applications, a copy of each application will be given to the appropriate Clinical Director for verification and request a citation if this has not already been requested. An application from a Clinical Director will be sent to the Deputy Medical Director. 7.9 8. Employer Based Awards Committee (EBAC) 8.1 The function of the ACCEA EBAC is to review all eligible applications and 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 EBAC will use the scoring system as a guide and will allocate awards following a moderating discussion that takes into account information from citations and when previous awards were made. Employer Based Clinical Excellence Awards Policy July 2015 7
8.2 The EBAC will ensure that their decisions are properly documented and that their decision-making processes are transparent, fair and based on clear evidence. 8.3 The composition of the EBAC will be as follows (12 people): The chief executive of the Trust or nominated deputy The associate director of HR or nominated deputy The medical director or nominated deputy The chair of the local negotiating committee or nominated deputy The chair of the Management Advisory Group A non executive director At least one academic representative A member who is external to the Trust Four consultants who are not applying for CEAs. If possible, at least one should be newly appointed and not yet eligible At least six people in total must be consultants. At least three people must be lay, i.e. not medical doctors. 8.4 Members of the national ACCEA and its regional subcommittee will be eligible to attend meetings of the EBAC in an observer capacity. 8.5 The EBAC has responsibility to ensure no one with any of the nine protected characteristics is discriminated against (Equality Act 2010). 8.6 The chief executive of the Trust (or nominated deputy) will act as the Chair of the EBAC. 8.7 The HR representatives will not score the applicants. 8.8 The Medical HR Lead will: advise the EBAC of the total number of awards available for award; provide a spreadsheet showing all applicants including start date with the Trust and all CEAs awarded and the year in which they were awarded. be responsible for convening the meetings; be responsible for keeping the records of all scores and raw score sheets; be responsible for keeping notes of the meeting, together with a list of those attending; convey the results of the EBAC's deliberations to all consultants who have applied within two weeks of the meeting; convene and manage the appeals process; 8.9 Scoring shall be executed independently by EBAC members prior to the committee meeting. Employer Based Clinical Excellence Awards Policy July 2015 8
8.10 Scoring and ranking records must be maintained and made available as requested through the appeal process. Any applicant formally appealing against the decision of the EBAC will be given access to their records and anonymised summaries of the scoring. 8.11 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. 9. The process 9.1 All of the members of the EBAC attending this meeting will be given the applications for consideration at least two weeks before the meeting. Each individual member of the committee (scoring members) will independently score each of the applications at least two days before the meeting and the Medical HR Lead will be responsible for collating the information. 9.2 The Medical HR Lead will complete a composite score sheet, which shows the total score for all applicants. 9.3 The EBAC will meet and decide on the allocation of awards. 9.4 If any consultant on the EBAC has applied for a CEA, they will be required to step out of the room when their application is discussed. 9.5 The Medical HR Lead will write to all applicants within two weeks of the EBAC meeting informing them of the outcome. In the letter the Medical HR Lead will detail the process to be followed in the event of an appeal. 10. Appeal arrangements 10.1 If a consultant has grounds to believe that the process of awarding CEAs has not been carried out fairly, he/she will have the right to appeal to the Chair of the EBAC within one month from the date of receiving the results of the allocation of CEAs. Late applications will not normally be considered unless the applicant can show good reason for the delay, and it would be inequitable for the appeal not to proceed. The Medical Director will be responsible, with the help of the Medical HR Lead, for setting up the appeal. Prospective appellants may seek advice on an informal basis from the chair of the MAG prior to lodging an appeal. Any such consultation will be confidential and will not affect the time-scale. 10.2 Any consultant formally appealing will be granted access to copies of their scoring sheets and an anonymised summary of all scores. These will be confidential to the consultant and his/her advisors. In respect of sensitive or Employer Based Clinical Excellence Awards Policy July 2015 9
confidential information not relating to the applicant, that information will be removed. 10.3 All appeals should be heard within two months of the date of receipt. The grounds of appeal must be clearly stated by the applicant in his/her letter of appeal. Applicants will have a right to be represented by a working colleague or trade union representative not acting in a legal capacity. The appeals panel shall be comprised as follows: A n-executive Director of the Trust as Chair A further member of the Trust Board Two senior representatives of the Medical Staff Committee The Director of Workforce 10.4 The director of workforce or Medical HR Lead will convene and coordinate the appeals process. 10.5 An appropriate member of the appeals panel will advise the Board of the decisions of the results of any appeals decisions. 10.6 The appeal process may consider the validity of the claim under appeal. As part of this process the appellant may be asked to justify some of the contents of the CEA application form. The responsible clinical director will be asked to provide validation of the form s contents. Equally the appellant may supply additional information to support validation of what was already in his/her application, but not include new information. The appeal may not be upheld where validation fails to support the contents of the application form. 10.7 The appeal will not be upheld if it is found by the panel that the appellant s position in the rankings would have been above the lowest scoring consultant who received a CEA. 10.8 Following the appeal the appellant will be informed in writing 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. If successful, the appellant will receive the allocation of CEAs for the current year. 11. Review of Employer Based Awards 11.1 Employer Based Level 9 awards are subject to five-yearly reviews. It is the responsibility of the employer to ensure that level 9 awards are reviewed at the correct time. Employers should advise all award holders to whom this applies as soon as possible. 11.2 As much attention should be given to completing an application for a renewal of an award as would be given to submitting an application for a new award. An application for a renewal will be considered in the light of the standard of application for new awards at the relevant level, as well as previous Employer Based Clinical Excellence Awards Policy July 2015 10
contributions of the award holder which led to the making of the original award. 11.3 The five year review ensures that the scheme only rewards consultants who continue to meet the performance standards required. In reaching a view on renewals, the Employer Based Awards Committee will also consider any adverse findings from complaints, disciplinary or professional proceedings. Where such proceedings are incomplete at the time of review they should either not be considered by the review committee or should renewal be agreed by the committee, may be made conditional on the satisfactory conclusion of those proceedings. 11.4 In submitting an application for review the locally agreed application will be used, setting out how they continue to meet the criteria for holding an award of that level. When applying for renewal they should demonstrate, by reference to any achievements since the original award or last review, how they continue to meet the criteria for the Scheme. 11.5 Applicants should focus on activity within the five year period leading up to the review. They should only include information on earlier activity to demonstrate how their contributions have evolved or been maintained. 11.6 If the evidence provided is deemed insufficient for a five year renewal, the award can be renewed for less than five years, giving the consultant another chance to demonstrate they still meet the relevant criteria for their award level. If the consultant still does not submit adequate evidence, the award may be downgraded or withdrawn. Consultants to whom this applies will be warned in writing that this recommendation is being made. Consultants who have been advised of the recommendation to withdraw or downgrade an award may appeal in writing to the Chief Executive within four weeks of receipt of the decision. The written appeal will be submitted for consideration by the EBAC or review committee and should contain details illustrating why the consultant should retain the award. The Chief Executive will reply within two weeks acknowledging receipt of the appeal; the appeal will be heard within one month and will follow the agreed CEA appeals procedure. 11.7 Where an award is downgraded or withdrawn together with its financial component the consultant concerned shall be eligible to apply for an award in the next and future awards rounds. Consultants will be ineligible to apply for further awards where the award was removed for substantiated gross dishonesty in the CEA application process or where the consultant has been convicted of a serious criminal offence leading to a period of imprisonment. 11.8 If a consultant s expected retirement date follows the five year review limit by only a short period (up to six months) the Trust may use its discretion to renew the award until that date, even if this results in an extension slightly beyond the limit. Employer Based Clinical Excellence Awards Policy July 2015 11
12 Annual Report 13 Review 12.7 The Medical HR Lead will produce an annual report for the Chief Executive and Medical Director. This annual report will list the members of the EBAC and will demonstrate that the process was completed fairly and in accordance with guidelines issued by ACCEA. The report must include: (a) The overall number of consultants eligible for consideration (i.e. those in post for at least 12 months) and the percentage of: Consultants in academic posts Female consultants Ethnic minority consultants Consultants in each specialty (b) The overall number of award holders and the percentage of: Consultants in academic posts Female consultants Ethnic minority consultants Awards to each specialty (c) The names of people allocated an award in the year under consideration. The Trust and the LNC may review this agreement annually in the light of experience and taking into account guidance from the Department of Health, ACCEA or BMA. Any local changes will only be made with the agreement of the LNC. 14 Timetable The local CEA process will follow this timetable: April Application Forms sent to eligible Consultants May Application deadline 4 weeks after request for applications is sent out and forms submitted to CEA Committee June EBAC meets to decide on allocation of awards. Applicants informed of outcome within two weeks. CEA awarded are backdated to 1 April. Signed by: Chair of LNC Date: Director of Workforce Date: Employer Based Clinical Excellence Awards Policy July 2015 12
Appendix 1 Equality Impact Assessment Tool Yes/ Comments 1. Does the policy/guidance affect one group less or more favourably than another on the basis of: Race Ethnic origins (including gypsies and travellers) Nationality Gender Culture Religion or belief Sexual orientation including lesbian, gay and bisexual people Age Disability - learning disabilities, physical disability, sensory impairment and mental health problems 2. Is there any evidence that some groups are affected differently? 3. If you have identified potential discrimination, are any exceptions valid, legal and/or justifiable? 4. Is the impact of the policy/guidance likely to be negative? 5. If so can the impact be avoided? 6. What alternatives are there to achieving the policy/guidance without the impact? 7. Can we reduce the impact by taking different action? N/A N/A N/A N/A Employer Based Clinical Excellence Awards Policy July 2015 13