{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:55:44Z","timestamp":1790618144803,"version":"4.1.0"},"reference-count":45,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"unspecified","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100022244","name":"National Institute for Health Research Applied Research Collaboration West","doi-asserted-by":"publisher","award":["N\/a"],"award-info":[{"award-number":["N\/a"]}],"id":[{"id":"10.13039\/501100022244","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,9,1]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore National Health Service (NHS) consultants\u2019 experiences and views of the local Clinical Excellence Award (CEA) scheme following changes to performance-related pay in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This was a qualitative study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>This study was set in one NHS Trust in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>20 NHS consultants took part in the study. Out of these, seven had successfully applied for performance pay and 13 had not applied for performance pay in 2023 (one of these had applied unsuccessfully in a previous year). The majority of participants were male (n=11) and of White British ethnicity (n=12), and the majority had been qualified as a consultant for 10 or more years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Interviews were conducted online, audio-recorded, transcribed verbatim and analysed thematically using both inductive and deductive coding. Data collection continued until thematic saturation was reached. The reporting of this qualitative study was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ) 32-item checklist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five key themes were identified: (1) motivations for engagement with the scheme, (2) experience of the application process, (3) perceptions of fairness and equity and (4) influence of organisational and contextual factors. Participants described challenges with defining \u2018excellence\u2019, time pressures and discomfort with self-promotion. While the revised CEA structure was generally welcomed, concerns remained about inequities, the separation of research from clinical work and cultural barriers to sustainable service development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Consultants\u2019 engagement with performance-related pay is shaped by personal, organisational and systemic factors. Although awards were valued as recognition and professional validation, performance pay was perceived to function more as symbolic recognition than as a motivator of performance. Findings highlight the need for transparent, equitable and team-oriented approaches to consultant recognition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-111699","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:00:28Z","timestamp":1790614828000},"page":"e111699","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["National Health Service consultants\u2019 experiences and views of performance pay in England: a qualitative interview study"],"prefix":"10.1136","volume":"16","author":[{"given":"Jo","family":"Parsons","sequence":"first","affiliation":[{"name":"Centre for Evidence and Implementation Science, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4791-7513","authenticated-orcid":false,"given":"Mark","family":"Exworthy","sequence":"additional","affiliation":[{"name":"Health Services Management Centre, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Murphy","sequence":"additional","affiliation":[{"name":"Department of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7835-0882","authenticated-orcid":false,"given":"Julia","family":"Gauly","sequence":"additional","affiliation":[{"name":"Centre for Evidence and Implementation Science, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"2026092810001366000_16.9.e111699.1","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1177\/0734371X17697248","article-title":"Building Evidence for Public Human Resource Management: Using Middle Range Theory to Link Theory and Data","volume":"37","author":"Abner","year":"2017","journal-title":"Review of Public Personnel Administration"},{"key":"2026092810001366000_16.9.e111699.2","doi-asserted-by":"publisher","DOI":"10.1258\/jrsm.2012.120035"},{"key":"2026092810001366000_16.9.e111699.3","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1080\/10967494.2024.2322139","article-title":"Back to the future revisited: A systematic literature review of performance-related pay in the public sector","volume":"27","author":"Ahmad","year":"2024","journal-title":"International Public Management Journal"},{"key":"2026092810001366000_16.9.e111699.4","doi-asserted-by":"crossref","unstructured":"Perry JL , Engbers TA , Jun SY , et al . 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