The end of local clinical excellence awards

The news that consultants have accepted the government’s pay offer marks an important moment in British health policy, signalling the end of local clinical excellence awards (LCEAs) in England and Wales.1The NHS has had a form of performance related pay for consultants since its inception. The 2003 consultant contract included the provision of locally administered awards for the delivery of “clinical excellence.” It was meant to reward activity “over and above” basic contractual requirements.2Criticisms of the system relate to fairness and transparency. It was considered exclusionary, as applicants had to have evidence of management and research activity. It was seen as contributing to the gender and ethnicity pay gaps and lacked value for money.345 In 2018 the consultant contract was amended with the aim to reform LCEAs. Negotiations failed, and since the pandemic equal distribution of LCEA funding to all consultants has largely continued across NHS trusts, although the national…
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