October 2025

Dear colleagues,

In June we wrote to you confirming the VSM pay award outcome and asking you to refrain from applying the pay uplift before the NHS Oversight Framework (NOF) segmentation for your organisation was known during the Summer.

I now write to you following the launch of the new NHS Oversight Framework segmentation and league tables to confirm the next steps for implementing the VSM pay award for 2025/26.

Eligibility for the VSM pay framework

VSMs working in organisations that were in NOF segment 5 as of end of August 2025 when Q1 segmentation was published (see Annex 1: Recovery Support Programme) will not be eligible for the 2025/26 pay uplift unless they meet the requirements of an exemption (see section 3.3 of the VSM pay framework for exemption criteria).

Chief medical officer pay

Where a chief medical director is employed on a consultant contract, the medical pay award uplift and related back pay will have been applied in August’s pay.

Extra contractual payments pertaining to their role as a VSM will be subject to the eligibility criteria, with these payments not being uplifted where an individual is working in an organisation that is in RSP.

Approvals and next steps

Provider trusts and ICBs may now proceed to pay the VSM pay award unless:

• Their organisation is in the Recovery Support Programme / NOF segment 5
• Individual VSMs have failed to meet any local eligibility criteria

The new VSM framework sets out thresholds where you would need to submit a pay case to NHS England where a VSM’s proposed pay exceeds the agreed levels. As previously confirmed, pay cases are not required where the sole reason for pay going above the relevant threshold is due to implementing the SSRB’s pay recommendations. Should you have a case where a VSM’s pay is proposed for increase beyond the normal thresholds, and the reason is not solely related to the pay award, a pay case is still required.

Our team can guide you through any individual cases and can be contacted on england.vsmcases@nhs.net.

I would like to thank you again for your continued dedication to delivering exceptional patient care and the contribution you make to the NHS, as well as the support you provide to our staff.

Yours sincerely,

Jo Lenaghan
Interim Chief Workforce, Training and Education Officer
NHS England

Annex 1: Recovery Support Programme

Trusts in the Recovery Support Programme (NOF segment 5)

East of England

• Mid and South Essex NHS Foundation Trust. Entry date: 9 April 2024

London

• King’s College Hospital NHS Foundation Trust. Entry date: 9 April 2024

Midlands

• Shrewsbury and Telford Hospital NHS Trust. Entry date: 13 July 2021
• Nottingham University Hospital NHS Trust. Entry date: 14 September 2021
• Nottinghamshire Healthcare NHS Foundation Trust. Entry date: 27 February 2024

North West

• Greater Manchester Mental Health NHS Foundation Trust. Entry date: 8 November 2022
• Blackpool Teaching Hospitals NHS Foundation Trust. Entry date: 28 January 2025
• Lancashire Teaching Hospitals NHS Foundation Trust. Entry date: 28 January 2025
• East Lancashire Hospitals NHS Trust. Entry date: 28 January 2025

South East

• Medway NHS Foundation Trust. Entry date: 13 July 2021
• South Central Ambulance Service NHS Foundation Trust. Entry date: 27 September 2022
• Portsmouth Hospitals University NHS Trust. Entry date: 1 June 2023
• University Hospital Southampton NHS Foundation Trust. Entry date: 1 June 2023
• Isle of Wight NHS Trust. Entry date: 1 June 2023
• Hampshire Hospitals NHS Foundation Trust. Entry date: 1 June 2023
• Hampshire and Isle of Wight Healthcare NHS Foundation Trust*. Entry date: 1 June 2023

*Previously operating as Solent NHS Trust and Southern Health NHS Foundation Trust.

South West

• University Hospitals Plymouth NHS Trust. Entry date: 13 July 2021
• Torbay and South Devon NHS Foundation Trust. Entry date: 22 November 2022

Integrated care boards in the Recovery Support Programme

Midlands

• Shropshire, Telford and Wrekin Integrated Care Board. Entry date: 13 July 2021

South East

• Hampshire and Isle of Wight Integrated Care Board. Entry date: 1 June 2023

North West

• Lancashire and South Cumbria Integrated Care Board. Entry date: 28 January 2025