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

Interim pay back in the headlines

Positions just below board level have proved to be very attractive to interim managers over the last couple of years.

Many have been named (if not shamed) in the media in the past for their “excessive” costs – a consequence of some diligent digging into annual reports by hacks where board level remuneration has to be stated. Non-board positions like transformation director and financial improvement director don’t have to be reported in this way and therefore enable them to keep a lower profile.

So, it was a bit of a surprise when Ian Miller’s £311,000 pay packet (covering six months work) popped up in East Sussex Healthcare Trust’s annual report. Mr Miller has a track record of earning similar sums as an interim finance director: on this occasion he had been financial improvement director. He was, however, on payroll rather than employed through a consultancy – so will have been paying PAYE and NI.

Intriguingly, NHS Improvement says it did not approve Mr Miller’s salary – despite him taking up the position six months after it was announced it would instigate an approval process for interims paid over £750 a day. It also seemed slightly surprised at how much he had earned.

Mr Miller is unlikely to be alone in earning what looks like a shedload compared with average NHS wages. Many trusts have had financial improvement directors or similar since the financial special measures regime was introduced in 2016. NHSI is closely involved in these appointments.

NHSI’s comments suggest there is a going rate for the job. Although it did not specify this, it’s hard to imagine it is much below £1750-£2000 a day. After several years of NHS agency staff seeing their rates squeezed, many will wonder how much effort NHSI has really put into bringing down interim managers’ pay.

Sir David does the double

Salford Royal Foundation Trust is celebrating after being rated outstanding for the second time by the Care Quality Commission who specifically praised the trust’s integration of health and social care services. All this while the trust leadership has been actively working to improve the performance of Pennine Acute Hospitals Trust.

Sir David Dalton spoke to HSJ about the trust’s success and raised the suggestion that the NHS could make better use of successful organisations in helping those with persistent issues. He specifically cited the use by NHS Improvement of management consultants to turnaround trusts at great expense.

Quite rightly, Sir David highlighted that in many cases these consultants don’t actually have the experience of making their vision work and he believes the NHS would be better off finding a way to reward trusts like Salford Royal and Frimley Park to act almost as consultancies themselves to partner with other organisations to try and graft their proven methodologies onto the less successful organisation.

It’s an intriguing idea and one that sits uncomfortably with our other headline of the day and the egregious spending on some interim managers.