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NHS employs more than 2,000 managers on six-figure salaries

Nurses
Nurses

More than 2,000 NHS trust managers are taking home six-figure salaries amid soaring pay, an investigation reveals.

The figures, which come as nurses prepare for national strikes for the first time, show a 15 per cent rise in NHS pay at the highest levels in 12 months, with more than 600 people earning over £200,000.

Think tanks demanded an “urgent focus” on executive pay on Sunday, urging health chiefs to “show some restraint” at a time when patients are facing increasingly long waits, and struggling to access care.

Ministers have just ordered a review of NHS efficiency, which aims to reduce spending on administration, in an attempt to ensure that record spending is not “squandered on ever-expanding layers of management”.

The Telegraph analysis reveals that the total number of NHS managers at local hospitals and commissioning bodies earning at least £100,000 has reached 2,056.

The best-paid received £300,000 in 2020/21, almost twice the salary of the Prime Minister.

In just 12 months, there has been a 15 per cent rise in the number of NHS board members earning at least £200,000, taking the total on such earnings to 632.

Meanwhile, 1,305 received salaries of at least £150,000, with the number in this bracket surging by 12 per cent.

In addition, more than 500 senior officials at NHS England, the Department of Health and its associated quangos are on such salaries.

At NHS trusts, the best-paid was Dr Bruno Holthof, chief executive at Oxford University Hospitals NHS Foundation Trust, on a package of between £295,000 to £300,000.

The trust has an overall rating of “requires improvement” with problems identified in safety, leadership, urgent and emergency services, surgery and maternity, following inspections by the Care Quality Commission (CQC). Performance against the four-hour A&E target is just 61 per cent, against the national average of 71 per cent.

Mr Holthof was chief executive from 2015 until he stepped down in June, and was paid a salary of £285,000 to £290,000, plus a “life assurance and income protection premium” worth £8,500, the records show. The previous year he received a total package of £485,000 to £490,000, which included £187,500 in lieu of five years’ outstanding pensions contributions.

Prof Clive Kay, chief executive at King's College Hospital NHS Foundation Trust, was paid £285,000 to £290,000. Mr Kay has led the trust, which also has a “requires improvement” rating, since 2019.

Latest CQC ratings deem the trust as “inadequate” for use of resources, with improvements required in safety, effectiveness, leadership and responsiveness.

Government pay submissions drawn up earlier this year show a 65 per cent rise in pay for NHS senior managers over the last decade. This is more than three times the rise seen by workers across the rest of the economy.

The increase also far exceeds rises given to the rest of the NHS workforce, with average pay increases of 35 per cent over the period, the documents show.

The pay figures for 2020/21 cover 215 NHS trusts and more than 100 clinical commissioning groups (CCGs) across England. Since then, CCGs have merged into larger organisations, bringing still higher senior salaries.

Pay levels are set locally, under guidance from NHS England, but all salaries over £150,000 have to be signed off by ministers.

The analysis covers only board positions, excluding thousands more medics, with hospital consultants on average annual earnings of £123,000, and average pay for GP partners now at £142,000.

In addition, there are 529 senior officials at NHS England, the Department of Health and associated quangos on six figures. NHS England is currently drawing up plans to cut its workforce of 22,000 by up to half.

Strike will mean 'bank holiday' service

It comes as nurses prepare to strike on December 15 and 20, leaving hospitals operating a “bank holiday” service stripped back to emergency and urgent care.

Rishi Sunak has said demands by the Royal College of Nursing (RCN) for a 19 per cent pay rise are “obviously unaffordable”.

Tensions are escalating, with Steve Barclay, the Health Secretary, accusing the RCN of risking patient safety, by refusing to attend a key meeting to decide which services will be exempt from strike action.

In an exchange of furious letters over the weekend, Pat Cullen, the union’s general secretary, said members were open to pay negotiations “or nothing,” after Mr Barclay urged the union to return for talks about working conditions.

Dr Jim McConalogue, chief executive of Civitas, a think tank, said: “The government urgently needs to get a grip on pay – some of these NHS bosses will be the best paid people in their area, an absurd situation to be in and all for hard working taxpayers who are struggling to pay higher taxes to fund lavish pay for NHS execs.

“The NHS is now doing less for more and globally our health service is one of the worst for keeping people alive. Now we discover we are paying huge salaries for a poorer service.

“Politicians tell us we need to pay more in tax for the health service only for voters to discover that top bosses are raking in huge six-figure salaries off the back of these tax rises."

Earlier this year a report by Civitas found UK health spending was costing around £10,000 per household, with the third highest share of GDP in Europe. The study also calculated that almost 50,000 people a year are dying in the UK for want of effective medical intervention.

'Restraint' urged on top-level pay

John O'Connell, chief executive of the TaxPayers' Alliance, said: "Taxpayers are sick of seeing high-level officials receive bumper pay rises, while nurses struggle and services suffer. Households are told again and again to stump up more cash for the health service, yet salaries for upper executives are hitting new heights.”

"It's long past time for NHS bosses to put their money where their mouth is and show restraint on top-level pay,” he added.

Sean Phillips, research fellow at the think tank Policy Exchange, said: "High-quality management is essential to improving NHS performance, but these striking figures force us to question whether such a disproportionate rise in the pay and quantity of senior managers – compared to frontline staff – is justifiable in the current climate.

“Earlier this year, Policy Exchange found there had been a 130 per cent increase in the number of senior roles at NHS England over just two years. An urgent focus is needed to reverse the tendency to over-centralise and to ensure the highest-performing managers can make a difference to the new integrated care systems, where they are most needed."

A Department of Health and Social Care spokesman said: “We recognise that NHS senior pay needs to be set at a level that enables employers to recruit, retain and motivate talented individuals to executive board level roles, while ensuring value for money for the taxpayer.

“The Health and Social Care Secretary is focused on ensuring resources are targeted on improving care for patients,  funding is directed to frontline services and the NHS operates as effectively and efficiently as possible.”