Several trust chief executives were paid more than £300,000 in 2022-23, including adjustments for previous underpayments, pay in lieu of pension contributions, and redundancy packages. 

In 2021-22, only one chief executive, David Loughton, was paid more than £300,000, for leading Royal Wolverhampton Trust and Walsall Healthcare Trust.

Trust accounts also show several CEOs were paid at least £20,000 more in 2022-23 than in the previous year – well over the 3.5 per cent government recommended rise. These rises did not always reflect an increase in core salary.

According to the 2022-23 accounts, five trust CEOs were paid more than £300,000. These were:

• Mr Loughton, whose pay remained £305,000. The trust said it reflected “his long and distinguished career, which amounts to almost 40 years in the NHS. He is also group chief executive for two trusts which… brings additional responsibilities”. He is due to retire in March;
• King’s College Hospital FT’s Clive Kay, whose pay went from £300,000 to £305,000;
• Sir Jim Mackey, whose pay at Northumbria Healthcare FT went from £300,000 to £315,000. The trust said his actual pay increase in 2022-23 was 3.5 per cent, as recommended nationally, and that the £315,000 included adjustments for deduction errors in previous years. Trust accounts said part of his pay included £18,000 for work carried out as chair of the NHS Customer Board for Procurement and Supply, and that part of his salary had been paid by NHS England for his role as national elective care director. Sir Jim has since moved from Northumbria to Newcastle Hospitals FT; 
• St George’s Hospitals CEO Jacqueline Totterdell received at least £308,000 in 2022-23, up significantly from the previous year. This increase reflected the fact she also became CEO of Epsom and St Helier in August 2021. The trusts said her 2022-23 annual salary was £262,650, but that she also received £9,355 due to underpayments in previous years, and £36,919 lieu of pension; and
• North Tees And Hartlepool FT’s Julie Gillon was paid at least £390,000 in 2022-23, but this included £160,000 in redundancy and £11,000 in training and legal fees. The trust said she had 40 years continuous service with the NHS and that national guidelines were followed when calculating her redundancy package.

Some CEO payments included pay in lieu of pensions, adjustments for previous underpayments, and redundancy payments, in addition to their core salary (see HSJ's full story for details and trusts' comments) Hover over the blue dots for more details of those who received £250k or more.

Many large increases in the annual remuneration of CEOs reflected their decision to exit the NHS pension scheme. The greatest increases were seen by the following chief executives:

• Barnet, Enfield and Haringey Mental Health Trust’s Jinjer Kandola. The amount she was paid increased by at least £95,000, from at most £135,000 to at least £230,000. She took on responsibility for a second trust – Camden and Islington FT during the period. The trusts say that this included £15,000 backpay relating to the period between October 2021 and April 2022 after she took on Camden and Islington.
• Portsmouth Hospitals Trust’s Penny Emerit saw her annual salary go from at the most £205,000 to at least £235,000. Ms Emerit went from interim to substantive CEO in September 2022. Portsmouth said the increase included a Treasury-approved pay increase to £219,500 and six months of pay in lieu of pension contributions.
• Great Ormond Street Hospital for Children FT’s Matthew Shaw’s pay went from at most £225,000 to at least £250,000. GOSH said the increase was due to payments in lieu of pension contributions plus the 3 per cent pay rise.
• The salary of Royal United Hospital Bath FT’s Cara Charles-Barks went from at most £195,000 to at least £220,000. RUH said it adhered to NHSE guidance and used benchmarking data to bring salaries in line. 
• Midland Partnership FT’s Neil Carr experienced a pay increase from at most £185,000 to at least £210,000. His trust said performance-related pay was absorbed into Mr Carr’s base salary in 2022-23 and that his previous year’s bonus was paid during 2022-23.
• The Royal Marsden FT’s Dame Cally Palmer was paid £295,000 in 2022-23, an increase of at least £20,000. Dame Cally is also NHSE’s national cancer director. The Royal Marsden said Dame Cally has held a dual role as its chief executive and as NHSE’s national cancer director since 2015 and her overall remuneration reflected this.
• Cambridge University Hospitals FT’s Roland Sinker also saw his pay go from at most £275,000 to at least £295,000. The trust said Mr Sinker was given the same level of bonus awarded to Agenda for Change staff;
• Maidstone & Tunbridge Wells Trust’s Miles Scott’s went from at most £230,000 to at least £250,000. MTW said the increase reflected payment in lieu of pension contributions.
• Herefordshire and Worcestershire Health and Care Trust’s Sarah Dugan’s pay went from at most £160,000 to at least £195,000. Ms Dugan has since announced her retirement. The trust said performance-related pay had been incorporated into base pay, and that backpay for 2021-22 was included in the 2022-23 total.
• Gloucestershire Hospitals FT CEO Deborah Lee’s salary went from at most £250,000 to at least £270,000. Ms Lee also has since announced her retirement. Gloucestershire said much of the increase was due to the full effect of receiving payment in lieu of pension contributions of £37,000. Ms Lee also received a slightly increased recruitment and retention premium and the trust argued, when these factors were taken into account, her basic salary had not changed.

Some trusts explained the pay rises given in excess of the 3.5 per cent recommended by the senior salaries review board were to bring salaries in line with peers and had been approved by NHSE and, in some cases, the Treasury and ministers.

Miriam Deakin, NHS Providers’ director of policy and strategy, said: “Given the complexity and size of the services, budgets and workforces that trust board directors oversee, these rates of pay are both appropriate and competitive given the wider economic environment.

“It is vital that salaries remain competitive enough to attract and retain talented and inclusive leaders, given the worryingly high rate of turnover amongst very senior managers in the NHS… [and] it is essential that attention is given to all levers that support, develop, and retain NHS leaders so that the service can meet the challenges it is facing with the best possible people at its helm.”

NHSE publishes “established” pay ranges for chief executives in both acute NHS trusts and foundation trusts. The top salary it suggests for those running “supra large” trusts with £750m plus turnover is £265,000. Although many chief executives were paid more than the suggested rates, NHSE did not respond when HSJ asked if the tables were up to date.

When calculating pay rises, HSJ  has looked at only chief executives who have led the same trust, either as interim or substantive, for all of 2021-22 and 2022-23 and taken account of base pay only. As CEO pay is given in £5,000 bands, HSJ  has used the smallest possible difference when calculating pay rises.

Update: This article has been updated to include details of Jinjer Kandola’s £15,000 backpay after taking on the Camden and Islington role.