The NHS is moving away from an era of managerialism towards clinical leadership. It now widely recognised that close working between managers and clinical leaders is the most effective arrangement to improve the performance and quality of NHS organisations.
In order to effectively make the jump from consultant to leadership roles, clinicians are rightly advised to take on leadership training. The NHS Leadership Academy provides excellent training through degree courses, which is done as additional work to the day job, i.e. outside of work hours and at the cost of family and social activity. In the future, clinical leadership roles would only be offered to clinicians who have undertaken relevant training - in order to ensure they are effective.
The work pressures in the NHS are such that clinical colleagues often take on these leadership roles on top of their clinical roles, again at cost to themselves and their families.
The current perverse and overly complex pension rules are acting as a significant disincentive to those wishing to lead and make a difference in this way. Why would you take on the burden of further training to be an effective leader if you are going to find yourself with an unexpected large tax bill related to the pensions allowance? If it were possible to adjust pension contributions so that the tax allowance was not breached, then that might be enough of a move to remove this disincentive; however this is not possible and the system means that doctors do not know they are going to breach until it is too late.
For those already in leadership roles, the options are to pay large sums for accountants to decipher the situation, and then either remove themselves from NHS pensions, or step down and thus remove the benefits to the NHS of the experience and training they have sweated to gain.
Clearly the system needs changing, and changing quickly.
Competing interests:
I am personally affected by the current pension rules
Rapid Response:
Clinical Leadership
Dear Editor
The NHS is moving away from an era of managerialism towards clinical leadership. It now widely recognised that close working between managers and clinical leaders is the most effective arrangement to improve the performance and quality of NHS organisations.
In order to effectively make the jump from consultant to leadership roles, clinicians are rightly advised to take on leadership training. The NHS Leadership Academy provides excellent training through degree courses, which is done as additional work to the day job, i.e. outside of work hours and at the cost of family and social activity. In the future, clinical leadership roles would only be offered to clinicians who have undertaken relevant training - in order to ensure they are effective.
The work pressures in the NHS are such that clinical colleagues often take on these leadership roles on top of their clinical roles, again at cost to themselves and their families.
The current perverse and overly complex pension rules are acting as a significant disincentive to those wishing to lead and make a difference in this way. Why would you take on the burden of further training to be an effective leader if you are going to find yourself with an unexpected large tax bill related to the pensions allowance? If it were possible to adjust pension contributions so that the tax allowance was not breached, then that might be enough of a move to remove this disincentive; however this is not possible and the system means that doctors do not know they are going to breach until it is too late.
For those already in leadership roles, the options are to pay large sums for accountants to decipher the situation, and then either remove themselves from NHS pensions, or step down and thus remove the benefits to the NHS of the experience and training they have sweated to gain.
Clearly the system needs changing, and changing quickly.
Competing interests: I am personally affected by the current pension rules