New NHS bodies face recruitment challenge, government told
National bodies being set up as part of the government’s NHS reforms risk being unable to attract good enough leaders due to declining pay, terms and conditions, experts have warned.
VSMs include chief executives and the board directors they line manage - other than medical directors - in primary care trusts, strategic health authorities, special health authorities and ambulance trusts.
From next year they are expected to include senior leaders in new arm’s length bodies such as the NHS Commissioning Board, Health Education England and the Trust Development Authority.
The review body’s latest report published last week says VSMs’ average take-home pay has dropped by 12 per cent since 2009-10, from £55,843 to £48,860, due to inflation, tax changes and the pay freeze – which started a year earlier than for the rest of the NHS.
It also highlights declining morale and says that “if it becomes widely perceived that terms and conditions…are persistently declining, then it is very likely that there will be a fall in the quality – and possibly the numbers – of recruits, together with problems in retaining the best people.”
Currently, VSMs fall under a strict pay system that sets chiefs’ salaries according to the population size their organisation covers and ensures directors earn a percentage of their leaders’ salary.
The Department of Health commissioned PricewaterhouseCooopers in March 2010 to devise a job evaluation system for VSMs aimed at addressing fears of a widening boardroom pay gap between PCTs and foundation trusts, which have the freedom to offer more attractive salaries.
The new system is awaiting ministerial sign-off. But, ahead of its publication, the review body states: “We have learned that the DH intends to control closely the pay of the VSMs covered by us and in that respect the framework may remain fairly rigid…Therefore we question whether NHS ALBs will be able to compete with foundation trusts to recruit and retain suitably able and qualified managers.”
Managers in Partnership has been involved in developing the framework. MiP chief executive Jon Restell partly welcomed it but said there were a number of potential pay problems it did not fully tackle. He said: “If we want a level playing field between the commissioning and provider sectors then we have got to level the terms and conditions because that’s the only way we’re going to recruit. I don’t think what we’ve got in the new framework necessarily deals with that.”
He also expressed concern that clinical commissioning groups would not face the same restrictions as other bodies, making it easier for them to recruit.
He said there was a risk that senior jobs in the commissioning board’s 50 local offices would be made unattractive by offering salaries lower than those of former PCT chief executives, on the basis that the jobs were further down the management chain.
However, leaders may welcome the new framework’s expected removal of the blanket rule that high-performing VSMs cannot receive a bonus if their organisation has missed its financial targets.