NHS consultant contract reviewed
Summary
This National Audit Office (NAO) Report
‘Pay
modernisation: a new contract for NHS consultants in England’ (HC 335)
examines the contract for NHS consultants agreed in 2003 and widely implemented
by April 2004.
The contract was needed to increase the size and
commitment of the consultant workforce if it was to deliver the NHS reform
agenda and comply with the requirements of the European Working Time Directive
to reduce consultants’ hours.
By the end of March 2006, the
Department of Health had spent £715m on the new consultant contract (27% more
than the original estimate of £565 million), partly because the government had
underestimated the amount of work consultants did.
In September 2005,
approximately 32,000 consultants worked for the NHS in England, primarily
within NHS acute and mental health hospitals, accounting for £3.8bn of NHS
expenditure in 2005-06.
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How does it affect
me?
If you work in or are a patient of the NHS, this affects you.
The National Audit Office concludes that the contract is not yet delivering
the full value for money to the NHS and patients that was expected.
The
contract has helped to align consultants’ pay levels with their contribution
to the NHS, but some consultants are actually working the same if not fewer
hours for more money. There is little evidence that ways of working have been
changed, and few trusts have used job planning as a lever for improving
participation or productivity.
The contract has delivered some benefits
in management of consultant time, prevention of an increase in private
practice, securing extra work at plain-time and increasing participation. The
contract has the capacity to provide some new levers for further enhancing
management control. There is scope for the NHS trusts to make much more of the
opportunity presented by the annual renegotiation of job plans to devise a set
of agreed job plans that will deliver more efficient and effective services to
patients.
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National Audit Office.
