No pay rises for failing NHS leaders, pledges Streeting
Trust and system leaders who fail to meet performance or financial targets will not receive pay rises, Wes Streeting will tell the NHS Providers conference this week.
The health and social care secretary will vow that NHS leaders “who run big deficits or poor services” will face “financial implications”, according to a government announcement entitled: “Failing NHS managers’ pay clampdown”.
The DHSC said a new pay framework for very senior managers would be published before April. The framework will “clamp down on poor performance, while rewarding senior leaders who are successfully turning their services around”, according to the announcement.
The move comes despite the fact it was criticised by the senior salaries review body in the summer (see below).
According to the department, the framework will be part of a “package of radical and tough reforms” the health and social care secretary will announce at the NHS Providers annual conference in Liverpool on Wednesday.
Appearing to blame system leaders for overspending against their financial plans so far this year, the DHSC’s announcement said: “NHS integrated care systems had built up deficits totalling £2bn in just the first four months of this financial year, leaving the incoming government with a financial black hole which had to be dealt with at the budget.”
Mr Streeting was also keen to stress that he “prepared to pay for the best” NHS leaders. He said: “I will defend financial incentives to attract and keep talented people in the NHS. It’s a big organisation that should be competing with global businesses for the best talent. We have got to get a grip on runaway spending and make sure every penny going to the NHS benefits patient — changes will not be popular but it’s a case of reform or die.”
The current trust CEO pay framework was criticised in Lord Ara Darzi’s review of NHS performance in September. He said “incentives for individual trust leaders are blunt” and noted: “The only criteria by which trust chief executive pay is set is the turnover of the organisation. Neither the timeliness of access nor the quality of care are routinely factored into pay. This encourages organisations to grow their revenue rather than to improve operational performance.”
The introduction of a new VSM framework has been promised for several years and delayed.
‘Extensive oversight’
The independent senior salaries pay review body criticised the latest proposals, which were shared with it, as including too much “detailed prescription” and “extensive regulatory oversight”.
Noting the idea of using “premia to attract able leaders to the most challenged organisations” the SSRB said it was “not sure that the uplifts planned… will provide sufficient incentive for leaders to move to these organisations”.
The SSRB also pointed out very high vacancy rates and turnover among NHS very senior managers, “difficulties [which] particularly affect challenged trusts”.
It continued: “Trusts rated ‘inadequate’ by the Care Quality Commission have vacancy rates and proportions of executives in their first year, which are several times higher than those of ‘outstanding’ trusts”, and added: “Some do not see promotion to senior leadership as attractive, given the increased responsibility and loss of entitlements such as payments for overtime and being on-call.”