How different attraction factors can be used to enhance the NHS consultant package

The NHS offers a progressive career path for Clinical consultants and is frequently the first stop for a clinician seeking a new appointment. That being said, their pay scales have a degree of grey-ness at certain levels. Between salary points 4-7 for example, the level of pay is the same. Essentially, a clinical consultant who has been practicing for a few years less than his peer could be on the same level of take-home pay. This is great for the less experienced clinician, but understandably less than appealing for the one with the greater wealth of experience. So what can be done to entice consultants towards these positions, and how can the controversial salary brackets be worked in the favour of the consultant?

Discretionary pay

The NHS guidelines are just that, a guideline. If a highly specialised clinician who would ordinarily be entering on, for example, the level 4 pay scale, were to request their salary be set at the level 8 payscale, this is entirely possible. The final decision lays in the hands of the trust, but the employer does have the ability to grant the increased salary at their discretion.

Extra Programmed Activities (PAs)

While 10 PAs a week is the accepted norm, this too is negotiable. Research has shown that most new consultants request around (12 – 14) PAs per week, and it’s easy to see why. If one PA effectively counts as approximately a tenth of your salary, adding 3 PAs can increase your overall salary by 30%. For a consultant on a hypothetic salary of £100k per annum, this could mean an increase to £130k. It’s certainly not an insignificant figure! Junior consultants in particular are in a great position to request extra PAs. As with salary decisions, these are entirely at the discretion of the employer and they much be justified, but for ambitious consultants looking to advance their careers, it’s relatively straightforward to justify extra PAs to be put towards research hours and Continual Professional Development (CPD) time.

Recruiting Premiums / ‘Golden Hello’s’

Once again, the trust has the power to make a consultants’ package more appealing than it first looks. Discretionary upfront payments, or ‘Golden Hello’s can be offered as an enticement into a role where the trust feels the consultant would be of great benefit. These typically include a few conditions, such as a minimum time to be spent in that role before seeking a change in employment, and if you leave before that date you could be liable to pay the welcome bonus back, but for those confident that they are willing and able to stay put for a set time frame, this can be a great introduction and a further way to make the overall package more appealing.