From discretionary points to local clinical excellence awards
January 2006
Background
In some trusts in England, the implementation of the new clinical excellence awards (CEA) scheme from April 2004 has caused some problems because the value of CEAs is different to that of discretionary points (DPs).
This guidance suggests one way of understanding and managing the transition from the “old” DP system to the “new” CEA scheme, which will take several years as DP holders gradually succeed in obtaining CEAs. It complements, but does not supersede, change, replace or contradict previous CCSC guidance. It is intended to provide an alternative means for checking that an appropriate number of CEAs were given for April 2004 and April 2005 (where this has already been done) or are given (where the process has not yet been completed).
It will also be relevant for some years to come, as consultants with DPs are gradually assimilated into the CEA scheme.
Fractional awards in the 2004 round
The problem for which this guidance is designed to assist is that the receipt of a local CEA by any consultant who already holds DPs will inevitably result in a fractional CEA allocation.
Value of DPs and CEAs, 2004-2005
| DPs | CEAs | ||
| 1 | £2,927 | 1 | £2,702 |
| 2 | £5,854 | 2 | £5,404 |
| 3 | £8,781 | 3 | £8,106 |
| 4 | £11,708 | 4 | £10,808 |
| 5 | £14,635 | 5 | £13,510 |
| 6 | £17,562 | 6 | £16,212 |
| 7 | £20,489 | 7 | £21,616 |
| 8 | £23,416 | 8 | £27,020 |
| 9 (Bronze) | £32,424 |
It is easy to see that moving from any level of DP to the next numerical level of CEA results in the award of a salary increase which is not equal to a full CEA (£2,702 at levels 1 to 6 and £5,404 at levels 7, 8 and 9) and is always a fraction.
How to summate fractional awards
It can readily be seen that while the value of a DP is £2,927, the value of the first 6 CEAs is £2,702. CEAs from level 7 involve a double quantum but still only count as a single award.
It is easy to see that moving from 1 DP to level 2 CEA is a rise of £2,477. This is (£2,477/£2,702) =0.917 of a full CEA.
The following table shows all such fractional CEA awards:
| DP Level | Value |
Next CEA | Value | Rise | CEA Fraction |
| 1 | £2,927 | 2 | £5,404 | £2,477 | 0.917 |
| 2 | £5,854 | 3 | £8,106 | £2,252 | 0.833 |
| 3 | £8,781 | 4 | £10,808 | £2,027 | 0.750 |
| 4 | £11,708 | 5 | £13,510 | £1,802 | 0.667 |
| 5 | £14,635 | 6 | £16,212 | £1,577 | 0.584 |
| 6 | £17,562 | 7 | £21,616 | £4,054 | 0.750* |
| 7 | £20,489 | 7 | £21,616 | £1,127 | 0.209* |
| 8 | £23,416 | 8 | £27,020 | £3,604 | 0.667* |
* This figure indicates that at the higher levels, the higher value of CEAs has, of course, been used. There is nothing in any documentation either discussed or agreed with the BMA, or issued unilaterally by the Department of Health, to suggest that higher CEAs should count as two awards. They are worth more than the equivalent DP level (and twice as much as the lower levels); just as the first 6 DPs are worth 8.3% more than the first 6 CEA levels.
The process
The first step is therefore to agree the list of eligible consultants. An eligible consultant is defined as one who has been in post for one year on April 1st of the relevant year.
The next step is to agree the total number of awards to allocate in the trust. Each LNC needs to negotiate with trust management partners how many CEAs will be awarded. The minimum is 0.35 per eligible consultant. There is no maximum.
Once the total number of CEAs has been agreed with the LNC, the next task is for the local CEA committee to allocate the quantum of awards. This should be done with reference to the above table.
Of course, if a consultant progresses by more than the minimum step, this will involve a fraction and a whole number. For example, moving from 5 DPs to level 7 CEA would be 1.584 CEAs.
The local CEA committee must keep a “running total” of awards made, to include fractional and whole awards. In order to fulfil their responsibilities, they must continue awarding fractional and whole awards until at least the minimum allocation is reached.
The BMA’s consultants committee would like to be informed of the final outcome in your trust and we would be grateful if you could send this information to us at email address - info.ccsc@bma.org.uk. Please let us know the details of your trust, the number of eligible consultants and the number of awards made.
Update for April 2005 round
| DP level | Value | Next CEA | Value | Rise | CEA Fraction |
| 1 | £3,021 | 2 | £5,578 | £2,557 | 0.917 |
| 2 | £6,042 | 3 | £8,367 | £2,325 | 0.833 |
| 3 | £9,063 | 4 | £11,156 | £2,093 | 0.750 |
| 4 | £12,084 | 5 | £13,945 | £1,861 | 0.667 |
| 5 | £15,105 | 6 | £16,734 | £1,629 | 0.584 |
| 6 | £18,126 | 7 | £22,312 | £4,186 | 0.750* |
| 7 | £21,147 | 7 | £22,312 | £1,165 | 0.209* |
| 8 | £24,168 | 8 | £27,890 | £3,722 | 0.667* |
It can be seen that the fractions are the same. This is because the DDRB award for April 2005 increased DPs and CEAs by the same percentage, so the percentage difference is unchanged.
"Update for April 2006 round
The DDRB made the same recommended percentage increase for DPs and CEAs. While the Governement phased the implementation of the award, this was done to the same extent for DPs and CEAs, so the above table of fractions of awards remains valid for the April 2006 local awards round."