APPENDIX 9
Memorandum by the NHS Executive, Department
of Health (CC1A)
TEMPORARY ADDITIONAL
NOTIONAL HALF
DAYS (TANHD'S)
1. Employers can also contact with consultants
for up to two, or exceptionally three, TANHD's to recognise work
undertaken outside their normal contractual duties. These extra
NHD's are paid at one eleventh of the whole-time salary.
2. Information collected in 1998 suggested
that 5,700 consultants in England (or 27 per cent) were receiving
one or more TANHD's, most commonly to recognise extra clinical
duties, onerous on-call commitments and heavy non-clinical workload,
particularly management responsibilities. Some 70 per cent of
clinical directors and almost 80 per cent of medical directors
received TANHD's in respect of the additional responsibilities
on these activities, whereas 15 per cent of other consultants
received TANHD's in respect of activities other than clinical
or medical directors. The annual cost is around £50 million.
CONSULTANTS' DISCRETIONARY
POINTS
3. Discretionary Points (DP) are consolidated
payments in addition to the maximum of the consultant's salary
scale, paid at the discretion of employers. The DP scheme was
introduced in 1996. Until 1 April 2000, the DP scale consisted
of five points of equal value. However, there are now eight points
available, worth about £2,500 each. These are uprated from
time to time in light of recommendations of the Review Body on
Doctors' and Dentists' Remuneration (DDRB).
4. Discretionary Points are not seniority
payments, nor automatic annual increments. To warrant award, consultants
are expected to demonstrate above average contributions in respect
of one or more of service to patients, teaching, research, and
management and development of the service. Progression up the
DP scale reflects the continuing quality and range of the contribution
made by consultants. To attain the maximum of the scale they will
be expected to have demonstrated an outstanding contribution to
services.
5. The criteria for payment of DP were also
changed from 1 April 2000, to allow greater recognition of service
achievement (highlighted in italics below). The criteria allow
for contributions made in the following areas to be taken into
account:
(i) professional excellence, including;
(ii) significant contribution towards the
achievement of local NHS service priorities;
(iii) undertaking recognised significant
heavy workload or responsibilities in pursuit of local NHS service
goals;
(iv) contribution to professional and multidisciplinary
teamworking;
(v) research, innovation and improvement
in the service;
(vii) administrative or NHS management contributions;
(viii) teaching and training, including;
— training of junior staff;
— involvement in undergraduate or postgraduate
teaching;
— public education and health problems;
— contribution to training of other staff;
(ix) Wider contribution to the work of the
NHS nationally.
6. Consultants must have reached the maximum
of their basic salary scale to be eligible for consideration for
a DP. Consultants who have been awarded a Distinction Award are
not eligible.
7. NHS and Health Authorities are required
to award each year 0.35 new points for each eligible consultant.
About 34 per cent of Consultants (about 7,500) in England in 1999
were in receipt of one or more DP, at an annual cost of around
£60 million.
MAXIMUM PART-TIME
CONTRACTS
8. There were 22,020 hospital medical consultants
in England as at 30 September 1999, according to the NHS Executive's
annual census of Trusts and Health Authorities, 25 per cent of
these were on maximum part-time contracts, as shawn in the following
table (which also shows a breakdown by speciality group).
HOSPITAL MEDICAL CONSULTANTS BY TYPE OF CONTRACT
AND SPECIALTY GROUP
England: 30 September 1999
|
| percentage
|
| All
| Whole time | Max Part-Time
| Part-Time | Honorary
|
|
| All Specialties | 100
| 58 | 25
| 11 | 5
|
| Accident & emergency | 100
| 88 | 7
| 5 | 0
|
| Anaesthetics | 100
| 56 | 35
| 8 | 2
|
| Clinical oncology | 100
| 57 | 25
| 12 | 7
|
| General medicine | 100
| 58 | 20
| 12 | 10
|
| Obs & Gynae | 100
| 42 | 42
| 10 | 6
|
| Paediatric group | 100
| 78 | 4
| 12 | 8
|
| Pathology group | 100
| 84 | 14
| 10 | 12
|
| Psychiatry group | 100
| 73 | 4
| 17 | 6
|
| Radiology group | 100
| 46 | 37
| 14 | 2
|
| Surgical group | 100
| 46 | 43
| 8 | 3
|
|
Source: NHS Executive medical and dental workforce
census
9. Within the surgical group, there are variations in the
percentage of maximum part-time contract holders by individual
specialty, as shown below.
HOSPITAL MEDICAL CONSULTANTS IN THE SURGICAL GROUP: BY
TYPE OF CONTRACT AND SPECIALTY
England: 30 September 1999
|
| percentage
|
| All
| Whole time | Max Part-Time
| Part-Time | Honorary
|
|
| Surgical Group | 100
| 46 | 43
| 8 | 3
|
| Cardio-thoracic surgery | 100
| 51 | 36
| 9 | 3
|
| General surgery | 100
| 47 | 43
| 6 | 4
|
| Neurosurgery | 100
| 63 | 29
| 4 | 4
|
| Ophthalmology | 100
| 42 | 40
| 15 | 3
|
| Otolaryngology | 100
| 38 | 49
| 10 | 3
|
| Paediatric surgery | 100
| 77 | 9
| 8 | 6
|
| Plastic surgery | 100
| 46 | 39
| 14 | 1
|
| Trauma + Orthop | 100
| 45 | 45
| 7 | 2
|
| Urology | 100
| 46 | 45
| 7 | 2
|
|
Source: NHS Executive medical and dental workforce
census
DATA ON
NHS AND PRIVATE
PATIENTS
10. The Health Select Committee asked whether any exercise
had been undertaken in respect of evaluating the operating lists,
the use of individual theatres used for NHS and private patients
and the clinical needs of those patients; and whether the NHS
shared data with the private sector.
11. The Committee may wish to refer to the study by Professor
Brian Williams, published in Volume 29, No 1 of the 1997 edition
of Health Trends: Utilisation of NHS hospital beds in England
by private patients. This used Hospital Episode Statistics
data from 1989-90 to 1994-95 to compare NHS patients treated in
NHS hospitals with private patients treated in NHS hospitals.
12. We do not at present share data with the private
sector. We know that the private sector have detailed information
on the treatment of patients, but this is sensitive information
and is not published. We will be exploring, as part of the concordat
development, the opportunities for sharing information between
the NHS and the private sector, both at local and national level.
However, we are only at the early stages of this work and we will
need to pay particular attention to confidentiality issues.
June 2000
| 
