The must-read stories and debate in health policy and leadership.

In a logical world, promotion comes with a pay rise. Not so in the NHS.

Instead, senior staff can actually end up losing money when they move up to band 8.

The issue is not a new one but has now been flagged by government pay advisers.

The independent pay review body, which has warned that the framework is acting as a “disincentive to promotion”, is pressing the government to fix the issue.

The problem stems from very low uplifts between bands 7 and 8, when rises can be as low as 1.8 per cent. Once unsociable hours payments and overtime are withdrawn, this can leave staff members out of pocket, despite them having more responsibilities.

There is little sympathy in the wider media for NHS managers. But the year-on-year squeezing of senior pay is having consequences for the health service.

Jon Restell, from the union Managers in Partnership, said employers were finding it “extremely difficult” to recruit band 8a staff from within the NHS, particularly in clinical careers. He said long waits for a pay rise once workers made it to band 8a were also a problem – with staff deciding it was “not worth sticking around for”.

The faulty 40

A watchdog has revealed today the government will not meet its pledge to build 40 “new hospitals” by 2030.

This may not come as a surprise to those who have been following the story, which has involved delays and rising costs.

But the National Audit Office also revealed the final list of schemes could have looked very different.

Seven trusts met the criteria for a new hospital shortlist in 2019 but did not make the final cut.

The NAO said there was a lack of documentation as to why.

Some of these unsuccessfully bid to join the New Hospital Programme later on. Doncaster and Bassetlaw’s bid said it was needed to “avoid further life-threatening infrastructure failures”.

On the other hand, the NAO said 14 trusts did not make the original shortlist for the health infrastructure plan in 2019, but ended up on it anyway. This final list turned into the New Hospital Programme the year after.

Also on today

In ImPatient, our columnist David Gilbert explains why it’s an exciting/ sad/ frustrating/ optimistic time for patient leadership. And in news we report the British Medical Association’s announcement that a second two-day walkout by NHS consultants will take place on Thursday 24 and Friday 25 August, unless the dispute is settled before then.