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NHS bosses could get pay boosts under reform plans, with ministers urging a former defence chief to consider the incentives needed to attract the “best leaders”.
Sir Gordon Messenger, a former vice chief of the defence staff, has been appointed by Sajid Javid, the Health Secretary, to lead an overhaul of NHS management. He has been asked to “look at how we can support leaders to drive up efficiency and give staff the space to focus on delivering care for patients”.
The terms of reference of the review, published on Tuesday, suggest higher pay rates may be recommended in order to attract the highest performers or persuade them to take on the toughest jobs.
Sir Gordon has been asked to consider “the drivers of performance and the standards expected of good leaders and leadership teams”. This should result in “proposals for ensuring the right incentives for the best leaders and leadership teams to take on the most difficult leadership challenges”, the terms of reference say.
He is being asked “whether the right pay and incentives are in place to foster good and excellent performance and recruit and retain the best leaders from start of career to retirement”.
Ministers have also requested that he consider what “further powers” might be needed to drive change amid frustration in Whitehall over a lack of drivers to tackle failing hospitals or replace leadership teams.
Important to look at risk/reward equation
On Tuesday night, Chris Hopson, the chief executive of NHS Providers, which represents hospitals, said those taking on the most challenging organisations should be offered similar rewards to those running school academies.
Those leading large chains have attracted salaries as high as £450,000, with average rates of more than £230,000 at the largest academies. Currently, the highest paid hospital chief executives are earning £300,000, while the NHS is in the process of hiring 42 new executives on salaries of up to £270,000 to run integrated care systems.
Mr Hopson said: “I think it’s important to look at the risk/reward equation. If you are trying to encourage people into the most difficult jobs, you need to have the right incentives – not just pay but also support and realistic timeframes to deliver changes.”
The review was announced by Mr Javid at the Conservative Party conference last month, when it was described as “the most far-reaching” overhaul of NHS leadership since the 1980s.
‘Watchful for waste or wokery’
It came after the Health Secretary told MPs he would be “watchful for any waste or wokery” in the NHS after it was awarded a record funding boost.
This led to speculation that there could be a cut in the number of well-paid managers, meaning more money goes directly to patient care.
Sir Gordon, who will be supported by Dame Linda Pollard, who chairs the Leeds Teaching Hospital Trust, has been given four months to draw up plans for “driving up efficiency”.
He has been asked to examine whether the findings of previous reports on leadership have been delivered and what their impact has been.
As health secretary, Jeremy Hunt commissioned a review by Sir Stuart Rose, the former chief executive of Marks and Spencer, which was published in 2015. This concluded that the NHS was “drowning in bureaucracy” and had a chronic shortage of good leaders to apply “common sense”.
Meanwhile, a review has recommended that waiting lists should be cleared by sending patients around the country for treatment and scrapping follow-up outpatient appointments for certain procedures.
Mr Javid instructed NHS England to produce a plan to tackle the backlog and the review – led by Sir Jim Mackey, the head of Northumbria Healthcare NHS Foundation Trust – has been seen by The Times and will recommend sending patients outside of their area.