Trust management failures impede consultant productivity
6 February 2013
The BMA is promoting effective job planning as a report says there is ‘significant room for improvement’ in how NHS trusts manage their consultants.
NAO (National Audit Office) report Managing NHS Hospital Consultants says many trusts in England are not implementing the good-practice job-planning guidance published jointly by the BMA and NHS Employers in 2011.
Although 97 per cent of consultants have job plans setting out their objectives, 16 per cent of these have not been reviewed in the past 12 months.
Trusts also reported that nearly a fifth of consultants had not had appraisals in the past 12 months.
BMA consultants committee chair Paul Flynn said: ‘We’re aware that job planning has not always been implemented by employers in an effective manner, and we’re working jointly with NHS Employers on improving training for consultants and their employers to get the most out of job planning.’
He added: ‘Measures of productivity for consultants are very crude, miss a lot of activity and shouldn’t be relied upon in considering the value of the consultant contract.’
The report says all the expected benefits of the consultant contract that could be measured have been either fully or partly achieved.
While indicators show that consultant productivity has continued to fall, the rate of decline has slowed.
The consultant participation rate (the ratio of full-time equivalent seniors to headcount) has also increased.
The report says the 2003 contract significantly increased the cost of employing consultants.
Between 2002/03 and 2003/04, total earnings per full-time consultant increased by 12 per cent in real terms.
However Dr Flynn said: ‘While the 2003 contract did improve pay for consultants, those improvements have been reversed with several below-inflation pay reviews and the pay freeze consultants have had.’
An NAO survey found only 41 per cent of consultants believed their employers motivated them to achieve trust objectives.
The survey also found that while most trusts monitored consultant performance, only 43 per cent of them and 27 per cent of consultants thought the information was good enough to assess individual performance.
NAO head Amyas Morse said: ‘Trusts need to get consultants strongly involved in achieving trust objectives [and] clinical goals.’