The consultant contract: marriage or divorce?

At the birth of the new millennium Britain's Labour government published a 10-year plan for modernising the National Health Service (NHS), placing great emphasis on new ways of working. As part of this process, and following extensive negotiation, general practitioners and hospital consultants were offered new contracts in 2003. This process highlighted the issues academic clinicians and managers face in dealing with the tensions inherent in delivering the tripartite mission of teaching, research and clinical service. Following a retrospective review of clinical academic appraisals, this paper considers new strategies for strengthening the relationship across the university and NHS interface and how this novel and strategic approach might be adopted in future health policy. These findings can be helpful for both UK colleagues and for a broader international audience by providing a pragmatic approach to increasing collaboration across the higher education and health service sectors.