Potential changes to the current consultants’ contract are still being debated between the government and the BMA with a major focus on pay progression, clinical excellence awards and seven-day services.

Last year, the report on clinical excellence awards from the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) stated that consultant pay mechanisms and incentives ‘reward length of service more than performance’. It was suggested that in the future, pay and incentives for consultants should be more closely linked to “performance,” whatever this may mean in practice.

The DDRB proposed limiting ‘satisfactory’ consultants to the first five points of the pay scale (up to £83,829) and introducing a high paying ‘principal consultant’ grade for the top 10% of consultants. However, neither the BMA or NHS Employers has been particularly supportive of this recommendation, instead agreeing simply to ‘look at how to link pay progression with consultants’ contribution to the NHS, rather than their length of service, as well as to thrash out fair and objective job based criteria to judge the thresholds for pay progression.’

Critics have argued that linking pay with managerial targets could create a bank-like culture with a focus on how much money the organisation makes rather than on the quality of the service.

Despite many consultants reporting that they already provide an unofficial seven-day service, a new contract is likely to create key regulations for out-of-hours and premium time arrangements.

The BMA is hopeful of having a new contract on the table by the end of 2014.