Surgeons may get operation bonuses

10:36pm Saturday 19th July 2008

Surgeons could receive performance-related bonuses for their operating work under plans being drawn up for the NHS.

The largest hospital trust in the country said it plans to run a pilot scheme in which doctors are rewarded financially for operations that are particularly successful.

Imperial College Healthcare Trust in London is currently discussing the proposal with the surgical team responsible, for a specific operation that lends itself to clear assessment of the clinical outcome for patients, with a view to introducing it in the next few months.

"We are looking at a pilot scheme for a particular operation which will measure the improved functionality of the patient and we are looking at linking certain performance-related bonuses to that," a spokesman for the trust said. "At the moment we are in discussions with the surgical team."

The spokesman would not say which operation the scheme would apply to, but said it was chosen because it had "very clearly defined" indicators that made it suitable for testing the approach.

Similar schemes were used in other countries, the spokesman said, and the trust was keen to test the approach as a means of raising standards. "It's about rewarding excellence," he said.

The Government paved the way for extending cash incentives based on measures such as post-operative mobility in the recently-published NHS Next Stage Review.

It stated that the current Clinical Excellence Awards Scheme, which gives consultants financial rewards for excellence, would be strengthened to reinforce quality improvement.

According to the review, new awards, and the renewal of existing awards, will become more conditional on clinical activity and quality indicators.

A Department of Health spokesman said: "The Advisory Committee on Clinical Excellence Awards makes recommendations for awards on the basis of applications from consultants, who are required to produce objective evidence of excellence. Quality indicators such as complication rates and patient feedback are already used in specialties where they are available. As such measures become more widespread and robust, they will become increasingly influential in determining who gets awards."

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