£190k salaries for leading trust operating officers and finance directors

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70 percent salary discrepancy expected between the chief operating officers of the largest and smallest acute trusts
Of all acute trust leadership roles, COOs are expected to see the biggest pay differentials between different sized acute providers
Finance directors also expected to see a 25 per cent salary difference between the trusts with the smallest and largest turnovers

Chief operating officers employed by the largest NHS acute trusts could receive almost 70 per cent higher pay than their colleagues working in smaller providers if NHS Improvement guidannce is followed.

The guidance includes indicative salaries for 10 very senior manager roles in acute, specialist, mental health, ambulance and community trusts. The salaries are grouped according to size of organisation and into lower quartile, median or upper quartiles bands.

Of all the 10 “established pay ranges” for each role, COOs have the biggest pay differential between those working in small and very large acute trusts.

The median salary for COOs working in the very largest trusts with a turnover of £500m or more is expected to be set at £190,000 compared to £122,500 at the smallest trust. For every step up in the size of the acute trust a COO manages there is approximately a 10 per cent pay increase.

However, once a COO works at a trust with a turnover higher than £500m, they can expect a 40 per cent pay rise compared to colleagues working for large trusts with a turnover between £400m and £500m.

While the £102,500 median salary for a COO at small mental health trust is set at £10,000 lower than the equivalent at a small acute trust, COOs of medium sized mental health trusts should see the reverse happening. Those working in these mental health trusts are in line to earn £132,000, which is almost £10,000 higher than that offered to a colleague at a medium sized acute trust.

NHS Improvement said the indicative salaries were being published ahead of a new very senior manager pay framework due to be drawn up by the DH. NHS trusts are expected to use the salaries as a guide when they seek approval from NHS Improvement for VSM pay. Foundation trusts are expected to have regard to the salary levels although they are free to set their own pay.

Finance directors working at the very largest acute trusts will also earn over 25 per cent more than peers working at the smallest trusts. The lower quartile salary figure for finance directors at the smallest trusts is £109,000 and the upper quartile figure for those at very large trusts is £190,000.

The differential between the median salaries at the largest and smallest acute trusts is set at 50 per cent for facilities or estates directors, 33 per cent for HR directors and 25 per cent for strategy directors.

The lowest paid role inclucded in the VSM pay guidance is directors of corporate affairs and goverenance. The median salary for the role at a very large trust is set at £105,000.

The regulator has also said that medium sized mental health trusts with high secure psychiatric hospitals can apply for a 10 per cent pay premium, while small and medium sized specialist trusts can apply for a 15 per cent salary bump.

Chief operatng officer salaries	Lower quartile	Median	Upper quartile
Small acute NHS trusts and foundation trusts (£0-£200m turnover)	£100,000	£112,500	£142,500
Medium acute NHS trusts and foundation trusts (£200m-400m)	£110,000	£122,500	£146,500
Large acute NHS trusts and foundation trusts (£400m-£500m)	£117,000	£136,000	£152,000
Very large acute NHS trusts and foundatin trusts (£500m+)	£141,000	£190,000	£198,000

Finance director salaries	Lower quartile	Median	Upper quartile
Small acute NHS trusts and foundation trusts (£0-£200m turnover)	£109,000	£125,000	£137,500
Medium acute NHS trusts and foundation trusts (£200m-400m)	£123,000	£135,000	£147,500
Large acute NHS trusts and foundation trusts (£400m-£500m)	£126,000	£140,000	£155,000
Very large acute NHS trusts and foundatin trusts (£500m+)	£148,500	£157,500	£190,000