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National Clinical Excellence Awards - Reward, recognition and retention of highly-skilled doctors and dentists

 

Contents

Timetable and Budget

Please Note: To allow for emerging requirements the next steps in the commissioning process after submission of expressions of interest, will be considered by DHSC and NIHR when the quality, relevance and number of applications have been reviewed.

Deadline for outline applications: 26 January 2021
Notification of outcome of outline applications: February 2021
Budget: £125,000 (max) for one project
Expected duration: up to 12 months

Introduction

1.  The Department of Health and Social Care invites outline applications for a single research project to inform the development of the scoring system for a reformed national Clinical Excellence Awards scheme for consultant doctors and dentists and academic GPs. This is a significant opportunity to inform policy and practice for recognising outstanding contribution in these professions.

2.  It is vital that the way these awards are awarded is transparent, valid and robust, and that outcomes are fair. Funds of up to £125,000 over up to 12 months are available to support this research, with interim output required within six months of the start of the project. This work should contribute to knowledge about how to operate methods of professional peer reward in healthcare.

Background

3.  National Clinical Excellence Awards (CEAs) are financial bonuses available, via an annual competition, to consultant doctors and dentists and academic General Practitioners. The Advisory Committee on Clinical Excellence Awards (ACCEA) administers the competition on behalf of the Secretary of State and the Welsh Government. To achieve a CEA, an applicant must demonstrate achievements with national and international impact that are over-and-above what they would normally be expected to deliver in their role in the following ‘domains’:

• delivering a high-quality service; 
• developing a high-quality service; 
• leadership and managing a high-quality service; 
• research and innovation; and
• teaching and training.

4.  Normally, 300 CEAs are awarded in England each year at four different levels of progression (bronze, silver, gold, platinum). Awards last for five years, after which award holders can apply to renew their existing award. After three years at a certain level they can apply for a new award at the next level up. In 2019/20 the total value of national CEAs was around £132m and there were over 2,200 award holders.

5.  The scheme helps to make the NHS an attractive place to work when compared with competing industries, rewarding those senior clinicians who, in turn, help to attract and retain talent and investment in the NHS. National recognition is also a key motivator in continuing to drive and encourage clinical excellence. In addition, rewarding senior clinicians for investing in and partnering with the wider health economy encourages them to be ambitious and to spread their expertise beyond their employer. CEAs are an important mechanism for the NHS to maintain its reputation as a world leader in healthcare delivery and improve its efficiency and effectiveness.

6.  However, the current system can be improved, for example there are possible sources of bias resulting from time taken to progress through to higher levels of award, unrelated to merit (skewing against consultants who have taken career breaks, for example). There are therefore plans to reform the national Clinical Excellence Awards competition with a new scheme to be introduced from 2022. Proposals for the new system include: eliminating renewals; having a ‘single tier’ application system, where the relative strength of the application determines the level of the award; a possible increase in number of awards; and changes to the domains within which activities are assessed.

7.  The intention is that the new scheme should bring CEAs more in-line with modern performance bonus systems and improve accessibility of awards to currently under-represented groups.

The need for research

8.  We need research into scoring methodologies to inform decisions on the format and operation of the new scheme. This will include understanding how well the current scoring system is meeting ACCEA’s goals and how it can either be amended or replaced in the context of the proposed reforms outlined above to ensure:

  • reliable differentiation between closely performing applicants;
  • identification of true excellence in performance;
  • outcomes that reflect the right balance of breadth and depth of achievement across domains of professional activity;
  • fair and statistically robust outcomes that are not discriminatory;
  • it is understandable by both applicants and assessors; and
  • it is practical to administer.

Research required

9.  Possible approaches include analysis of data from the 5,000 applications for awards received since 2015, to model the implications for applicants of different scoring systems. There is also the possibility of using the 2021 award round to pilot a ‘shadow’ single tier scoring system to model the proposed reforms against the objectives of the new scheme.

10.  The prospective component of this research should start as soon as possible after April 2021 in order to inform implementation of the new scheme in 2022. Researchers would be expected to work closely alongside the ACCEA team to accomplish this, with output available by September 2021.

Applicants’ experience and expertise

11.  We invite outline applications from applicants who are able to demonstrate significant experience and understanding of medical and dental careers and especially of the value-adding activities that senior doctors and dentists undertake beyond their core role. Applicants should have an established track record in relevant data-modelling, and statistical analysis.

Budget and Duration and Specific Assessment Criteria

12.  The maximum budget is £125,000, for research taking up to 12 months to complete, with interim required within six months of commencement. Proposals which enable a timely start to research will be favoured. Outputs should include:

a. Published papers in peer-reviewed academic journals
b. Draft and interim reports, as agreed at project scoping
c. Final publishable report with lay summary and executive summary
d. Presentation(s) of findings to key stakeholders
e. Policy briefings for circulation through the duration of the project.

Governance

13.  A research advisory group will be established including: ACCEA’s Medical Director, Government analysts, ACCEA scoring sub-committee members, applicant representatives and representatives from relevant stakeholder groups as appropriate. The advisory group will provide guidance for the research, meeting regularly over the lifetime of the research. The successful bidders for this research should be prepared to review research objectives with the advisory group, and to share emerging findings. They will be expected to:

a.  Provide regular feedback on progress
b.  Produce timely reports to the advisory group
c.  Produce a final report for sign off
d.  Take advice from the advisory group about dissemination

14.  Successful bidders will be expected to work with nominated officials in DHSC, its partners and the NIHR Central Commissioning Facility. Key documents including, for example, research protocols, research instruments and reports must be provided to DHSC in draft form allowing sufficient time for review (minimum of 2 weeks).

15.  A final report is required within a maximum of 12 months of commencement of the project. The final report, with accessible executive summary, will be peer reviewed and circulated to policy makers in DHSC and a summary placed in the public domain. Outputs resulting from expenditure of public funds are made available for public scrutiny and so should be fully understandable to the lay reader with plain language summaries.

16.  Applicants should consider the full range of audiences and ensure a plan for dissemination and, if appropriate, implementation into policy and practice. Key stakeholders include policy makers and analysts in DHSC, members of ACCEA’s scoring sub-committees and members of ACCEA’s Main Committee (which includes the Chief Medical Officer for England, the National Medical Director of NHS England and Improvement and the Chair of the Academy of Medical Royal Colleges).

Standard Information for Applicants

General comments about applications

17.  Applications will be considered from other UK countries (Scotland, Wales and Northern Ireland) provided they address the priority areas in a way that is relevant to the DHSC (England) and meet all other selection criteria.

18.  Applicants are encouraged to submit multidisciplinary applications

19.  Applicants are encouraged to submit applications with evidence of coproduction with education and training providers in the NHS and third sector.

20.  Applicants must provide details of the pathway to impact. These should include plans for engaging relevant stakeholders to ensure beneficial research knowledge is translated into policy and practice. Monitoring and evaluation plans should be developed to determine the extent to how the activities proposed will deliverable measurable benefits to patients and public.

21.  It will be important to communicate research findings directly to policy makers, practitioners and users, as well as through traditional communication routes. This requirement will need to be reflected in work programmes and dissemination plans. HEE expects that research data will be made available for analysis and re-use.

22.  Applicants should consider the full range of potential audiences and describe how the research findings could be disseminated most effectively to ensure that the lessons from this research impact on policy and practice.

Research Management

23.  Day-to-day management of this research will be provided by the principal investigator. They and their employers should ensure that they identify, and are able to discharge effectively, their respective responsibilities under the Department of Health and Social Care (DHSC) Research Governance Framework for Health and Social Care, which sets out the broad principles of good research governance.

24.  All successful research involving National Health Service (NHS) and social care users, carers, staff, data and/or premises must be approved by the appropriate research ethics committee (REC) or social care research ethics committee (SCREC). For further information on RECs, please visit the Health Research Authority website: http://www.hra.nhs.uk/.

25.  The successful research team must be compliant with the General Data Protection Regulations (GDPR).

Risk Management

26.  Applicants should submit, as part of their proposal, a summary explaining what they believe will be the key risks to delivering their research, and what contingencies they will put in place to deal with them.

27.  A risk is defined as any factor which may delay, disrupt or prevent the full achievement of a project objective. All risks should be identified. The summary should include an assessment of each risk, together with a rating of the risks likelihood and its impact on a project objective (using a high, medium or low classification for both). The risk assessment should also identify appropriate actions that would reduce or eliminate each risk, or its impact.

28.  Typical areas of risk for a research study of this nature might include ethical approval, site variation in data gathering, staffing, resource constraints, technical constraints, data access and quality, timing, management and operational issues; however, please note this is not an exhaustive list.

Patient and Public Involvement and Engagement (PPIE)

29.  HEE expects the active involvement and engagement of patients and the public (e.g. service users and carers) in the research that it supports, where appropriate. However, the nature and extent of patient and public involvement and engagement (PPIE) is likely to vary depending on the context of the study. Applicants should describe how the issue of PPIE will be addressed throughout the research process. For example, this could include patient and public involvement and engagement in refining research questions, designing research instruments, advising on approaches to recruitment, assisting in the collection and analysis of data, participation or chairing advisory and steering groups, and in the dissemination of research findings.

30.  Applicants are required to detail what active involvement is planned, how it will benefit the research and the rationale for their approach. PPIE needs to be undertaken in a manner that acknowledges that some people may need additional support, or to acquire new knowledge or skills to enable them to become involved effectively (see INVOLVE publications for guides for researchers). Applicants should therefore provide information on arrangements for training and support. In addition, applicants should note that a budget line for the costs of PPIE is included in the finance form. Where no PPIE is proposed, a rationale for this decision must be given.

31.  For further information and guidance about PPI, please visit the INVOLVE website: http://www.invo.org.uk/.

Outputs and Reporting Arrangements

32.  The research team will be expected to provide regular progress reports over the lifetime of the research and will be provided with a progress report template to complete at regular intervals. In addition to describing progress, these reports will allow researchers to indicate any significant changes to the agreed protocol, as well as setting down milestones for the next reporting period, giving an update on PPIE and any publications or other outputs. Information on emergent findings that can feed more immediately into policy development will be encouraged and should be made available as appropriate.

33.  A final report on the research, with an accessible executive summary, will be required within one month following completion of the research. The report will be peer reviewed and may be circulated among relevant stakeholders within the Department of Health and Social Care and its partners. Once the study is completed, a summary of the final report will be placed in the public domain. This is where the outputs resulting from expenditure of public funds are made available for public scrutiny so it is important that the summary of your final report is easily accessible to the lay reader.

34.  The successful applicants are obliged to give at least 28 days’ notice before submission of any publication arising from research. In this instance, ‘publication’ concerns any presentation, paper, press release, report or other output for public dissemination arising from this research funding. The successful applicants remain under an obligation to provide notice even after the contract has ended. Publication of this research is subject to prior consent of the Secretary of State, which will not be withheld unreasonably and cannot be withheld for more than three months from the time the publication is submitted.

Finance

35.  The duration of the research and individual projects within the contract will be no longer than is consistent with a high-quality study meeting the objectives set out above in paragraphs 8-10. In assessing proposals, the Department will be seeking value for money as well as scientific excellence and, in particular, the potential for impact on education and training practice, which is key.

36.  Applicants are asked to address the timing and nature of deliverables, maximising staff resources and other options for interim reporting in their proposals.

37.  Applicants should always provide an indicative budget for the planned research.

38.  Costings can include up to 100% full economic costing (FEC) but should exclude output VAT. Applicants are advised that value for money is one of the key criteria that peer reviewers and commissioning committee members will assess applications against.

39.  All applications are expected to start within 2 months of funding being agreed, subject to pre-contract negotiations and specific requirements.

Dissemination

40.  Applicants should describe how the research findings could be disseminated most effectively, ensuring that results of this research impact on policy and practice in the NHS, HEE, DHSC, NGOs and others, as appropriate.

41.  Publication of scientifically robust research results is encouraged. This could include plans to submit papers to peer reviewed journals, national and regional conferences aimed at service providers, professional bodies and professional leaders. It might also include distribution of executive summaries and newsletters. Less traditional dissemination routes are also welcomed for consideration.

Transparency

42.  In line with the government’s transparency agenda, any contract resulting from this tender may be published in its entirety to the general public. Further information on the transparency agenda is at: https://www.gov.uk/government/publications/procurement-and-contracting-transparency-requirements-guidance.

Selection Criteria

43.  The commissioning committee members will consider applications against the criteria in the research specification, as well as:

a.  Relevance to research specification;
b.  An awareness of the customer’s organisational needs;
c.  Capacity of the team/organisation to access the required range of methodological expertise needed to deliver the proposed work;
d.  A previous successful track record in delivering similar work;
e.  Previous successful collaborations or liaisons with relevant policy makers;
f.  An awareness or ability to identify potential risks and challenges in delivering this type of work;
g.  Value for money (justification of costs);
h.  Appropriate involvement of patients and the public.

Contacts

General enquiries regarding the application and commissioning process can be directed to NIHR Central Commissioning Facility in the first instance at prp@nihr.ac.uk.