Call For NHS Consultant Management Improvements

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.

According to the National Audit Office, there is still significant room for improvement in how trusts manage their consultants.

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. Consultants' private practice work has not increased, pay progression has slowed and 97 per cent now have a job plan setting out their objectives, although 16 per cent of these have not been reviewed in the last 12 months.

While indicators show that consultant productivity has continued to fall, the rate of decline has slowed significantly. The consultant participation rate (the ratio of full-time equivalent consultants to headcount) has also increased although it remains unclear to what extent this has resulted in consultants doing more actual work for the NHS.

"NHS consultants play a key role in the NHS. Given the size of the pay increase given to consultants under the 2003 contract, it is reasonable to expect Trusts to have made more progress in improving how consultants are managed and realizing the expected benefits of the contract.

"Trusts need to get consultants strongly involved in achieving the trusts' objectives as well as their own clinical goals."

(GK)