The 10-year plan will reform the NHS focusing on 3 big shifts: from analogue to digital, hospital to community, and sickness to prevention.

To  this, this government believes that providers should be given greater freedom and flexibility to meet the needs of their patients and communities. We want to move to a system where freedom is the norm and central grip is the exception to challenge poor performance.

First-class system leadership will be essential in achieving this, and we will need to recruit and retain the very best to realise our ambitions. As Lord Darzi commented in his report: “The NHS has many strong and capable leaders. It needs more. Fortunately, leadership is not a quality that is simply endowed; it is a skill that can be learned. For the NHS to have more and better leaders, it needs to continue to invest in them.”

Accordingly, it is vital that we ensure the way we reward our very senior managers (VSMs) reflects the challenges they face and the responsibilities they carry while ensuring that we act where performance falls below our expectations.

VSMs play an essential role in delivering high-quality, compassionate care and ensuring value for money within their organisations. Improving services for patients should be rewarded.

But there will be no more rewards for failure. It is important that senior leaders in the NHS are held accountable for their performance in delivering high-quality healthcare and ensuring that hospital budgets are well-managed and financial rigour is effectively applied. This will ensure we deliver better outcomes for patients and better value for taxpayers’ money.

It is critical we can still attract the right candidates into the most challenged organisations; the framework provides us flexibility to do that.

This new pay framework for VSMs will bring together arrangements for trusts and integrated care boards (ICBs), creating greater consistency in the approach to pay across NHS organisations. In doing so, it removes the differentiation between different types of trusts and introduces pay benchmarks that account for organisational size and turnover more appropriately.

By introducing a greater focus on performance, this framework will ensure that pay is closely aligned with the delivery of outcomes and will incentivise improvements where these are needed most.

Overall, this new approach will place a renewed emphasis on accountability, transparency and performance of managers.

The new VSM framework is part of a broader package of reforms to ensure we support and invest in NHS managers.

This includes our commitments to introduce professional standards and regulate NHS managers, as well as establish a College of Executive and Clinical Leadership to help train and develop excellent NHS leaders. We have asked Sir Gordon Messenger to help identify how we can go further and faster in developing a strategic national approach to talent management in the NHS and attracting leadership talent into challenged parts of the system.

I look forward to seeing the leadership of the NHS rise to the challenge as we take the NHS from the worst crisis in its history and make it fit for the future.

Karin Smyth MP
Minister of State for Health

Publication reference: PRN01830i