Guidance

ACCEA newsletter April 2015

Updated 10 July 2015

2014 Round: New awards

In England and Wales there were 1539 applications for new awards. As in recent years 300 new awards were made in England and 18 in Wales. The success rate at the four levels was broadly similar, 19.8% for Bronze, 20.93% for Silver, 23% for Gold and 21.43% for Platinum.

2014 Round: Renewals

• After receiving notifications of forthcoming retirements ACCEA had to take decisions on 353 renewal applications.
• Towards half of these (164) met the renewal standard i.e. their regional score was at least as good as the lowest successful score for a new award at that level in that region. These applicants were given a 5 year renewal.
• 42 of the applicants fell well short of the standard required (more than 15% below the lowest relevant score). 37 of these applicants have now lost their awards.
• From 2014 ACCEA is applying a new policy whereby individuals losing a higher award at Silver, Gold or Platinum level can be renewed at a lower level if their score justifies it. Five of the 42 had their awards renewed at a lower level based upon the aggregate score that they achieved. Unfortunately it has not proved possible to make the same provision in respect of Bronze award renewals.
• 147 applicants scored less than the lowest successful score for a new award at that level in that region, but within 15% of the lowest relevant successful score. The Main Committee of ACCEA noted that consultants making a renewal application now faced a more substantial challenge given that the renewal standard has increased over the last few years and has been accompanied by the introduction of scoring of renewals. It was also noted that the impact of this may not have been fully appreciated by many applicants for renewal.
• On this basis ACCEA decided that these 147 consultants should be given a one year extension to their award with continued payment of the financial element and be asked to submit a renewal application in the 2015 Round. As such those applicants have every opportunity in 2015 to provide evidence of their achievements and obtain support from their employer and nominating bodies.
• However, ACCEA also made it clear that with effect from the 2015 round and without exception all applications for renewal of an award will be measured against the lowest aggregate score of required for a new award in that award category and region. Those who do not may be renewed at a lower award level or not at all consistent with their aggregate score.

2015 Round

• ACCEA launched the 2015 awards round on 14 April 2015. As in recent years there will be 300 new awards in England and the pro rata equivalent in Wales (circa 17 or 18).
• The Round will also be open for renewal applications from (i) the 147 individuals who were given one year extensions in 2014 (ii) consultants who are in any event due for renewal in 2015 (typically those who received their awards in 2011, 2006, 2001 or 1996) (iii) those asked to renew in 2015 because of changed circumstances.
• The online system for application will close on 17 June 2015. It will be followed by scoring by assessors and meetings of the regional sub-committees.
• It is planned that ACCEA will announce the results of the 2015 round in December 2015. As usual new awards will be backdated to 1 April 2015. Renewals will be from 1 April 2016. Any loses of the awards will be as from 31 March 2016.
• In the interest of transparency the full application for successful new applicants and successful renewals will be published from the 2015 Round.
• The 2015 Guidance will make it abundantly clear that to be successful renewal applications must meet the standard for new awards at that level and in that region.

Changes of circumstances

• Current award holders are reminded that they must notify the ACCEA secretariat as soon as possible of changes to their circumstances. The implications of these changes will be considered on a case by case basis. Failure to notify changes could lead to the retention of the award being questioned

Applications welcomed for membership of regional sub-committees

• From time to time ACCEA needs to fill vacancies for members of its 13 regional sub-committees in England. These sub-committees are a mixture of medical / professional members, employers and lay members. If you would like to be considered for a vacancy which might arise in your region. More details can be found on our web page

Advisory Committee on Clinical Excellence Awards

This annex provides a brief summary of the ACCEA system. More detail can be found in the published guidance. It also contains some contextual information about important issues.

Annex

This annex provides a brief summary of the ACCEA system. More detail can be found in the published Guidance. It also contains some contextual information about key issues.

Assessment process

This is summarised in the following diagram:

Regional sub-committees

• The members of the 13 regional sub-committees come from a wide range of backgrounds. 50% are medical (professional), 25% are lay members and 25% are employers.
• Care is taken to try to ensure that a good cross section of clinical specialities are present on each sub-committee but it is not practicable to ensure that all specialities are included. It is also important to note that individual members of sub-committees are not appointed to represent their particular specialty but to objectively score the evidence provided by applicants in a consistent manner and in line with ACCEA guidance.
• The meetings of the regional sub-committees are well attended. The most important point about their work is that a very high number of members score applications. The aggregate score obtained by applicants is the key means of determining which applications for both new awards and renewals will be submitted for consideration at national level.

National rescoring of applications

• National rescoring of applications by a broadly based group with representatives from all the regions is undertaken for NRES and Platinum.
• Marginal cases for new awards are rescored (NRES) i.e. those just below the successful cut off score for a new score for that region.
• Additionally, the Chair and Medical Director may, after discussion with the relevant regional sub-committee, decide to refer an applicant to the NRES process who has achieved an aggregate score that is significantly above the cut-off point where in their opinion the evidence submitted does not merit the score. They may also decide to refer an applicant who has scored significantly below the cut-off point where they judge that the evidence merits a higher score that would place them above the cut-off point.
• In 2014 around 70 such applications were rescored in order to determine which ones should be included in the final list of recommendations.
• Platinum applications are scored twice. First by the regional sub-committees and then by a national sub-committee comprised of regional representatives. The scores are then reviewed by the Platinum sub-committee of the Main Committee. The Main Committee then makes recommendations to the Minister.

Domain structure

The ACCEA Domain structure is used equally and consistently for all applicants. NHS consultants from particular backgrounds from time to time assert that the Domain structure does not work well for them. For example consultants who excel in service delivery, development and leadership often complain that they are not in a position to score highly on domains 4 and 5. By the same token academics who may score highly in domains 4 and 5 often refer to the difficulties that they face in scoring well in domains 1 and 2. These views are inevitable in a system that covers all NHS consultants, with the very wide variety of their circumstances and roles. The key point is that the system is the same for all applicants and is applied equally. Gender equality

ACCEA takes the issue of gender equality very seriously, and has undertaken specific analyses on the application rates and success rates of women over a number of years. These data are published in the annual reports and are shown in the table below. The data demonstrates that whilst women are overall much less likely to apply for an award, but when they do apply they are generally as competitive and successful as men.

England	2007	2008	2009	2010	2011	2012	2013	2014
Total no. of applicants	1944	1889	1773	1980	1908	1813	1682	1404
No. of women applicants	320	301	305	366	358	311	320	270
No. of male applicants	1624	1588	1468	1614	1550	1502	1362	1134
Total no. of awards	531	544	566	300	300	300	300	300
No. of women new awards	100	93	107	59	73	49	53	46
No. of male new awards	431	451	459	241	227	251	247	254
Success rate male[footnote 1]	26.54%	28.40%	31.06%	14.93%	14.65%	16.71%	18.13%	22.40%
Success rate women[footnote 1]	31.25%	30.90%	35.08%	16.12%	20.39%	15.76%	16.56%	17.04%

Applications from BME consultants

• The table on the following page shows that the percentage of applications from BME consultants has steadily increased over the last eight years, while the total number of applications has been declining.
• The success rate of BME consultants varies from year to year. It was slightly higher in 2013 and slightly lower in 2014. However, based upon the scoring pattern that is regularly monitored by ACCEA, there is no reason to suspect a systemic problem in ensuring that all applications from BME consultants are assessed as fairly and objectively as all other applications.

	2007	2008	2009	2010	2011	2012	2013	2014
Total number of applicants	1944	1889	1773	1980	1908	1813	1682	1404
No. of BME applicants (% of total applicants)	252 (12.96%)	253 (13.39%)	263 (14.83%)	298 (15.05%)	274 (14.36%)	299 (16.49%)	311 (18.49%)	282 (20.09%)
Total awards	565	544	566	300	300	301	300	300
No. of awards to BME consultants (% of total awards)	67 (11.86%)	66 (12.13%)	82 (14.49%)	46 (15.33%)	42 (14%)	41 (13.62%)	51 (17%)	37 (12.33%)

1. success rate of new awards compared to number of male/female applicants. ↩ ↩²