• Fifteen trusts applied for permission to pay an executive more than the prime minister
  • Providers must get Treasury approval for salaries above £142,500
  • NHS Improvement leaders say finding the right managers is biggest problem facing providers

Fifteen trusts have applied for permission to pay at least one board member more than the prime minister’s £142,500 annual salary, HSJ research reveals.

The news comes after the chief executive and chair of NHS Improvement said recruiting the right managers was the most difficult issue facing the provider sector.

In June, Jeremy Hunt wrote to trust chairs questioning whether board members should be paid more than the prime minister and said any new appointment above this level would have to be approved by the Treasury.

A Freedom of Information Act request to the Department of Health from HSJ reveals there were 17 applications from 15 trusts to appoint at least one person above this rate as of December (see box).

The trusts requesting directors get paid more than £142,500

  • Chelsea and Westminster Hospital FT – chief executive
  • Kings College Hospital FT – chief executive
  • Surrey and Borders Partnership FT – medical director
  • Northern Lincolnshire and Goole FT – medical director
  • Colchester University Hospitals FT – chief executive
  • Kent Community Health FT – chief executive
  • Birmingham and Solihull Mental Health FT – medical director
  • Birmingham Children’s Hospital FT – acting chief executive and chief medical officer
  • Sherwood Forest Hospitals FT – chief executive
  • Norfolk and Norwich University Hospitals FT – chief executive
  • East Kent University Hospitals FT – chief executive
  • St George’s University Hospitals FT – chief operating officer
  • Royal Surrey County Hospital FT – chief executive
  • South Staffordshire and Shropshire Healthcare FT – chief executive
  • Southern Health FT – nursing and therapies director; and operations director – mental health, learning disabilities and social care

The data shows a request for a salary of £225,000 for Mark Davies, chief executive at Norfolk and Norwich University Hospitals Foundation Trust. Chelsea and Westminster Hospital FT applied for a salary of £200,000 for its chief executive, who is now Lesley Watts.

NHS Improvement chief executive Jim Mackey last week identified the difficulty in recruiting to leadership positions in trusts as “the hardest part” of the situation faced by the provider sector.

Responding to a question from a non-executive director about pay for senior managers, Mr Mackey told the first joint meeting of the Monitor and NHS Trust Development Authority boards: “If we are honest… that is the hardest part of it at the moment, recruiting.”

Jim Mackey

Jim Mackey

Jim Mackey said in the short term ‘we can’t do anything about’ board level vacancies

He added that in “the short term, we can’t do anything about it”.

His comments were echoed by NHS Improvement chair Ed Smith, who said: “We are going to have to fix it at some stage. It’s a real challenge getting the right people in the system.”

Managers in Partnership chief executive Jon Restell told HSJ: “Executive pay is one part of the vacancy crisis on NHS boards. Pay for most directors has been frozen for five years. Poor tenure, over-regulation, public denigration, changes to pensions and redundancy terms are also in the mix.

“The Department of Health is pursuing a strategy based entirely on appeasing the media. It is failing and because stable leadership is a key ingredient of safe, compassionate healthcare, it is failing patients and frontline staff. The solution lies in encouraging a supply of permanent staff willing to do board jobs. That is a tough nut to crack but we need to make a start urgently.”

The health secretary has given conflicting messages to the NHS on how much people in top jobs should be paid.

In February 2014, Mr Hunt told HSJ he had no problem with managers being paid more than the prime minister if they were “outstanding” candidates.

In June 2015, he told The Daily Mail: “The NHS needs to make every penny count, so it is right to question why so many staff are paid more than the prime minister.

“I recognise that there are some great leaders in the NHS and people who do a good job for patients should be rewarded fairly. But the NHS is a public service and needs to show restraint on handing out generous pay packages as a matter of course.”