Policy responses and statements

Name of organisation:

Department of Health, Social Services and Public Safety (DHSSPS)

Name of policy document:

Consultation on Northern Ireland Clinical Excellence Awards Scheme

Deadline for response:

29 February 2008

Background: The Department of Health, Social Services and Public Safety formally announced in October 2007 that a review had commenced of the Northern Ireland Clinical Excellence Awards scheme, introduced in 2005. A review group was established and a formal consultation paper was prepared. The College was invited to submit comments.

The key issues for the review are set out in paragraphs 18 to 21 of the paper, and questions included to help guide responses. The review in particular will focus on the arrangements for allocating lower clinical excellence awards, and paragraph 18 sets out 4 options for consideration.

COMMENTS ON
DEPARTMENT OF HEALTH, SOCIAL SERVICES AND PUBLIC SAFETY
CONSULTATION ON NORTHERN IRELAND CLINICAL EXCELLENCE AWARDS SCHEME

The Royal College of Physicians of Edinburgh is pleased to respond to the DHSSPS on the Consultation on Northern Ireland Clinical Excellence Awards Scheme.

The College believes that the DHSSPS should keep in mind the overall purpose of an excellence awards scheme ie to reward and encourage dedication and excellence.  The cost containing requirements of the current policy are very explicit within the document which is clear and helpful, but as the number of awards declines in Northern Ireland there will be a negative impact on morale and a failure to support/reward innovation and additional effort.

It is short-sighted of employers to ignore the current system and risks disenfranchising younger consultants by their failure to make any awards within those Trusts with many higher level awards holders.  The College recommends that NICEAC is given the authority to review the local awards process to ensure equity of opportunity for consultants for these lower, locally managed awards.  

Options on Lower Awards

• Option one is not an equitable system and results in a lottery according to the previous pattern of award decisions.  This will leave high performers in some Trusts unrewarded, regardless of excellence.
  
  
• Option two is preferable in that it is clearly more equitable.  Fellows in Northern Ireland do not understand why the system cannot mirror the approach in England with a formula based allocation and a shorter eligibility period.  This would guard against local parochialism.
  
  It is very clear that there has been a significant reduction in the number of lower awards under the new scheme and therefore consultants in Northern Ireland are missing out in comparison with English colleagues.

• Option three offers an opportunity to retain a formula based approach with regional variation regarding the level that could reflect affordability in Northern Ireland.  There would need to be discussion at a high level as to the formula employed to deliver a system that would drive excellence within the total funds available.
  
  
• Option four could provide a mechanism through which to offer growth in the level of awards to reflect the size of the consultant body and thus avoid some of the demotivating impact of the current system.

Eligibility

The College considers that it may be reasonable to apply a short experience-based criterion for new consultants, but this may disadvantage new employees who bring consultant level experience from previous posts.  It may also disadvantage “high fliers” and there should be some discretion for exceptional candidates.  This is particularly true for higher awards where clinicians of some distinction may not have had the opportunity to acquire lower awards and yet are performing at a high level in Northern Ireland.  This may apply particularly to local clinicians returning to Northern Ireland after a period of work/study/research at a prestigious centre overseas.

Openness and Transparency

The College supports strongly an awards system that is both open and transparent.  The system would also benefit from greater clarity over how points are allocated by the committee and definitions of “excellence”.  This would support and reassure applicants and be preferable to the open publication of CVs of previously successful applicants.

Levels of Awards

The College considers the scheme would benefit from an external perspective when determining step 9 awards.  This should be decided by the regional committee rather than employers, and the College could support such applications with external, independent references/citations.  

Copies of this response are available from:

Lesley Lockhart,
Royal College of Physicians of Edinburgh,
9 Queen Street,
Edinburgh,
EH2 1JQ.

Tel: 0131 225 7324 ext 608
Fax: 0131 220 3939

[29 February 2008]