HSJ Health Check Why some NHS staff are facing a pay cut
May 30, 2025
Nick Cattuno and Henry Anderson, both HSJ journalists, unravel the government’s new pay framework for senior NHS managers, exposing looming real-term pay cuts and the challenge of recruitment amid high turnover. They delve into the impact of performance-linked pay while highlighting the disparities in earnings among executives. The duo also discusses the implications of the upcoming NHS spending review, focusing on funding challenges and potential shifts in priority areas like digital infrastructure and mental health.
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NHS Senior Manager Pay Framework
- The new NHS pay framework for very senior managers (VSMs) introduces a carrot and stick approach.
- Underperformance can lead to no pay rise or reduced incremental pay increases, while good performance can be rewarded with bonuses.
Pay Gap Between ICB and Trust Chiefs
- Integrated Care Board (ICB) chief executives earn more than trust chief executives under the new NHS pay framework.
- This pay difference may reflect government's view of ICBs' system-level importance.
Challenges in NHS Executive Recruitment
- NHS trusts face challenges recruiting executives, with fewer applications and high turnover.
- Continuous scrutiny and pay restraints make executive roles less attractive, risking leadership instability.