Future pay-offs to senior managers who leave under a cloud may have to be approved by the Treasury. It follows the furore over severance pay to former Maidstone and Tunbridge Wells trust chief executive Rose Gibb.

Health Secretary Alan Johnson said pay-offs needed 'to protect public confidence in the NHS' during a visit to Maidstone Hospital, part of the trust where 90 patients are believed to have died of Clostridium difficile infections.

Mr Johnson also said Maidstone and Tunbridge Wells trust had probably acted unlawfully in agreeing a six-figure pay-off to Ms Gibb and it would not go ahead at the moment.

'Legal advice I have received shows that the trust did not follow due process in getting all the necessary approvals it required for Rose Gibb's severance package,' he said. 'The trust has now referred all the relevant papers to its external auditors to review and is considering the potential next steps.'

Former trust chair James Lee said he was 'very surprised' by the move. Jon Restell, chief executive of union Managers in Partnership, which is representing Ms Gibb, said: 'We understand any severance payment for Rose Gibb was lawful and can be paid in due course.'

HSJ has been told the severance pay was agreed by the trust's remuneration committee and the strategic health authority had been kept informed throughout the process.

NHS chief executive David Nicholson has now written to all trusts clarifying the approvals they must seek before making any severance payments to senior managers.

Any payments outside of contracts will have to be referred to SHA remuneration committees, as well as trust remuneration committees and auditors, and potentially also to the Treasury if they are 'novel and unusual'. The Department of Health says the approval process should already be in place.

Mr Johnson also wants notice periods of no more than six months in new contracts to limit the amount paid if chief executives leave.

NHS Employers deputy director Sian Thomas said SHAs would play a key role in advising remuneration committees. However, it was 'slightly unclear' how the Treasury's involvement would work.

During his visit to Maidstone, Mr Johnson said the trust would be one of the first to get funding under the 'deep clean' programme. Some of the£350,000 will be spent on buying decontamination equipment to allow ultrasound cleaning of wheelchairs and commodes.

Mr Johnson also said construction of a hospital to replace two ageing facilities in the Tunbridge Wells area may start in the new year.

Equion has been selected as the preferred bidder to build the£228m private finance initiative scheme. The hospital in Pembury will include more than 500 ensuite bedrooms and be the first in England where every patient has their own room.

  • A second senior manager has left the trust after the C difficile scandal. Bernard Place was director of nursing and patient experience, as well as director of infection control at the time of the outbreak. He has left by mutual agreement without any pay-off outside his contract. The trust said he recognised 'his position had become untenable'.

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