Published: 06/10/2005 Volume 115 No. 5976 Page 29

Q: Because of tight budgets, some planned promotions for a couple of people are not going to happen - and will not happen for at least a year. How can I keep them motivated without promoting them and giving them a pay rise? These people need new challenges, but I want to avoid 'rewarding' them by just giving them more work without the benefits they deserve. How do you reward somebody not going anywhere and give them a sense of momentum?

A: Planned promotions suggest that you are interested in the development of your people. That is good news because it means you are on the right track.

Reward is a very broad concept and is about a lot more than money and promotion. It includes job satisfaction, constructive feedback, being treated with respect and given opportunities for training and development.

My guess is that your people will understand why the planned promotions are on hold. This is difficult and challenging time for the NHS. The need to tighten belts and balance the books is accepted by most people.

The first step is to be straight with them. do not invent elaborate excuses.

Just tell it like it is.

The second is to involve them in finding the solution. What would help them to keep their sense of momentum?

What about different work? Can you broaden their experience by job rotation or secondment? How about training and development? Your tight budgets will not allow for fancy options. Even a short exposure to something you are interested in can be refreshing and stimulating.

The third step is to treat them right.

Provide support, feedback and appreciation, and see what you can do to help with work-life balance.

A fourth idea is to see if you can give them the chance to develop other people - perhaps their eventual successors. They may get real satisfaction from this. And finally, help them to take a long-term view. The gathering storm of money and structural change will not last forever.

Ken Jarrold is former chief executive at County Durham and Tees Valley strategic health authority. If you have a query you want him to help with, e-mail in confidence to alexis. If we publish your question, you will win a copy of HSJ's Leadership at Every Level toolkit (normal price£95).