New scheme for rewarding NHS staff is a missed opportunity to design a fairer system

The new national scheme for rewarding clinical excellence in the NHS is a missed opportunity to design a fairer system and one that recognizes the collective effort of teams over individuals, according to a new article.

Writing in the Journal of the Royal Society of Medicine, a group of academics says the new National Clinical Impact Awards (NCIAs) (formerly the Clinical Excellence Awards (CEAs)), which are awarded to individual physicians, are insensitive to the needs of the wider NHS staff. Now more than ever, healthcare and innovation in the NHS depend on teamwork, and this should have been reflected in the design of the new scheme, they say.

Launched in January 2022, the NCIAs have made several changes to broaden access, make it simpler, fairer and more inclusive, and reward a wider spectrum of work and behavior.

Precursors to the current scheme have been criticized for, among other things, inequalities between race, gender and between specialties, with female and ethnic minority candidates being underrepresented at all price levels. For example, the Department of Health and Social Care’s Mend the Gap report for 2020 found that the KEAs contributed to the wider gender pay gap in medicine.

These concerns are likely to persist, the researchers say, from a range of institutions across England. While they welcome changes such as increasing the number of awards, the provision of “improved guidance materials, in addition to a communication strategy to increase awareness of the scheme” and improved data reporting, they are skeptical that they are making firm commitments or targets. represent longstanding gender and ethnic differences. They also remain unconvinced that this arrangement will have an impact on patient care, or that these changes provide an objective measure of the impact applicable to the diversity of medical specialties and outputs.

They call for more research into the effectiveness of such schemes and say there is currently little evidence to support their continued use and effectiveness. They conclude that the NCIA reforms seem symbolic and represent a missed opportunity to abolish this scheme and introduce a fairer wage scheme for all.


Royal Society of Medicine

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