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The success and importance of integrated care systems will depend to a large extent on how senior leaders view and engage with the new entities.

NHS England clearly wants them to be taken seriously, and is looking to achieve this by attracting the best people it can to lead them.

It is understood salaries of around £250,000 are being considered for the larger ICSs, which would be more than many trust bosses.

This will be controversial in some quarters, due to uncertainty about the levels of accountability these leaders will hold.

One HSJ reader commented: “Unless NHS England/NHS Improvement and CQC oversight/scrutiny changes to be more system-focused, this disparity in pay will cause conflict.

“You cannot be paid more than provider CEOs yet dodge the scrutiny when parts of the system need help or are challenged. Too many ICS leaders currently point the finger at ‘failing’ parts of the system as if they have no role to play. That needs to change if we are to truly embed the ICS framework.”

Another said: “This needs to be looked at very carefully, in some regions these are big jobs worthy of larger salaries but in others they are pretty insignificant.”

‘Peremptory and unreasonable’

Two trust directors have found themselves on the receiving end of an employment tribunal’s criticism over how they handled disciplinary proceedings.

The Newcastle upon Tyne Hospitals Foundation Trust was found to have unfairly sacked consultant healthcare scientist Hanan Zaitoun in May 2019 over accusations she had misused its IT systems.

The judgment described the proceedings as “peremptory and unreasonable”. It singled out finance director Angela Dragone and non-executive director Jonathan Jowett as being “improperly influenced” by the trust’s HR department’s views.

However, it also took issue with Ms Zaitoun’s behaviour and said her conduct “contributed to her own dismissal”.

Ms Zaitoun was suspended, and subsequently dismissed, after an investigation found 90 emails containing patient identifiable information had been sent from her NHS email account to her personal Hotmail address and one belonging to a former trust employee. This contravened the trust’s IT policies and the Caldicott principles.

A separate probe was launched into her storing £144,000 in cash and £250,000 worth of jewellery in a filing cabinet. She claimed she had put them there after being burgled three times, with enquiries establishing they were her property. No charges were filed.