NHS bosses could get pay rises in bid to attract the ‘best leaders’

NHS bosses could get a pay boost under reform plans, as a former defence chief leading a review of NHS management has been urged to consider the incentives needed to attract the "best leaders".

Sir Gordon Messenger, former Vice Chief of the Defence Staff, has been appointed to lead the “most far-reaching review” of NHS management in 40 years.

The general, who led the Royal Marines’ invasion of Iraq, 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”.

This has led to speculation that it could see a cut in the number of well-paid managers so more money goes directly to patient care. 

However, the terms of reference of the review, published on Tuesday, suggest that higher pay rates may be needed to attract the highest performers, or persuade them to take on the toughest jobs. 

‘The right incentives for the best leaders’

In the terms, Sir Gordon is 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 state. 

He is also 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”.

The review is due to report in four months, with officials promising a delivery plan for implementation.

Plans for ‘driving up efficiency’

The former army chief has been asked to draw up plans for “driving up efficiency”.

The terms say this means supporting leaders, managers, clinicians and wider staff in creating the space and time for them to focus on delivering for patients and care users.

The review was announced by Sajid Javid, the Health Secretary, at the Conservative Party conference last month, when it was described as the “most far-reaching review” of NHS leadership since the 1980s. 

However, there have been many reviews since the 1980s, and questions remain about what difference they have made. 

Sir Gordon has been asked to examine whether the findings of previous reports on leadership have been delivered and what their impact has been. 

Sir Gordon will be supported by Leeds Teaching Hospital Trust chair Dame Linda Pollard.

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