• Pension tax issues mean trust can’t put on more clinics to clear a backlog of patients waiting over a year
  • Gastroenterology has nearly half of patients waiting over a year but consultants unwilling to take on more activity
  • Tapering of tax relief allowance an incentive for senior clinicians to work fewer hours

The pension tax has stopped a major London trust from dealing with the growing number of patients waiting over a year in one of its specialisms.

Capacity issues meant that Barking, Havering and Redbridge University Hospital Trust had 14 patients waiting more than 52 weeks in its gastroenterology service in April.

But the trust could not put on extra clinics to deal with this because consultants would not take on more work as the additional activity could affect the amount of tax they pay on their pension contributions.

The annual allowance taper restricts the amount of tax relief available on pension contributions for those who earn over a threshold of £110,000.

“The gastroenterology breaches were caused by capacity constraints that have been exacerbated by our inability to put on extra clinics across the service, as a result of the widely-reported pension tax issue affecting consultants,” the trust chief executive Chris Bown said in this month’s board papers.

“We are extending the use of locum and external consultants to supplement our core workforce to resolve the issue,” he added.

The gastroenterology backlog amounted to nearly half the trust’s 30 incidences of 52-week breaches in April, which had more than doubled from the 14 reported in March. It is the trust’s “greatest challenge,” Mr Bown said.

This year the government admitted its public sector pensions policy was acting as a “disincentive to take on additional work” for senior clinicians.

The British Medical Association produced guidance last month showing how some consultants could benefit from a larger pension if they reduced their hours.

The government has since announced it will launch a consultation at the end of this month on its plans to give senior doctors more flexibility over their pensions. It hopes to allow them to “freely take on additional shifts to reduce waiting lists, fill rota gaps or take on further supervisory responsibilities”.