The very senior managers (VSM) pay framework is designed to support the NHS in securing the best senior leaders, with the right skills and experience, to deliver exceptional care and services for patients and their local communities.

The framework applies to all integrated care boards (ICBs) and NHS provider trusts and seeks to strengthen the link between reward and performance outcomes, increase transparency and offer flexibility to attract talented candidates to the most challenging roles.

The VSM pay framework has been jointly produced by NHS England and the Department of Health and Social Care (DHSC), with the policy owned by DHSC as instructed by the Secretary of State for Health and Social Care.

• The very senior managers pay framework – ministerial foreword
• The very senior managers pay framework
• The very senior managers pay framework – operational guidance
• The very senior managers pay framework – NHS provider and integrated care board pay ranges (02/2025)
  • The NHS very senior managers pay framework – NHS provider and integrated care board pay ranges (01/2025)
• The very senior managers pay framework – pay case and justification form
• The very senior managers pay framework – question and answers
• Very senior managers pay framework – pay circular 2025/26