Great Britain: National Audit Office
Published: 2013-02-06
Total Pages: 56
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A new contract for hospital consultants, introduced in October 2003, delivered many of the expected benefits. This was in exchange for a significant increase in consultants' pay. By 2011-12, there were around 40,000 hospital consultants employed at a cost to the NHS of £5.6 billion, 97 per cent of whom were on the 2003 contract. Of the expected benefits that could be measured, all have been either fully or partly achieved. More could be done, however, to achieve better value for money by fully realising the benefits set out in the Department's business case. Despite, for example, the contract providing a clear structure for paying for additional work at contractual rates, most trusts still use locally agreed rates of pay for additional work outside job plans, which ranges from £48 to £200 per hour. Pay progression is also the norm and not linked to consultant performance. According to an NAO survey, only 41 per cent of consultants thought that their trust motivated them to achieve the trust's objectives. While most trusts monitor consultant performance, only 43 per cent of trusts (27 per cent of consultants) thought that information was good enough to assess individual consultant performance. Trusts also reported that nearly a fifth of consultants have not had an appraisal in the last 12 months. Many trusts are not implementing the good practice job planning guidance published jointly by NHS Employers and the British Medical Association in 2011.