We welcome the opportunity to submit evidence to the Senior Salaries Review Body (SSRB) on behalf of NHS trusts and foundation trusts, to inform the 2024/25 pay round. The key messages from our submission are as follows:

• The 2024/25 pay round commences in very challenging operational and economic conditions. 95% of trust leaders responding to our annual ‘State of the Provider Sector’ survey said that they were concerned about the impact of seasonal pressures this winter on their trust and local area (with the most common reason for concerns relating to industrial action). 80% of trust leaders agreed that they believe this winter will be tougher than the last
• Industrial action has caused unprecedented disruption across frontline NHS services during the last year. In addition to the direct impact on patients, it has also limited trust leaders’ capacity for strategic planning, and made the delivery of key operational priorities much more difficult. While our members are fully aware that this will have a knock-on impact in the longer term, their immediate priority must be to safely manage strike action and navigate strained industrial relationships. With these factors in play, the resilience of NHS leaders is being challenged. It is essential that attention is now given to supporting, developing, and retaining NHS leaders so that the service can meet the challenges it is facing with the best possible people at its helm
• Turnover among the group covered by the SSRB remit remains high, with our remuneration survey finding that a third of executive directors have been appointed since the start of 2022, and nearly one in three chief executives were appointed that year (the same as in the previous year). Additionally, a majority (60%) of chief executives are in their first chief executive role, up from 53% in the previous year. There has also been a notable increase in the sharing of chief executive roles across trusts, with 14% shared in 2022/23 compared to zero in 2021/22
• It remains a priority for the new very senior manager (VSM) pay framework to be published. It is concerning that the version pending approval is now out of date and will require updating to be accurate. We ask that the SSRB raises this in its final report to government
• We are of the view that VSM pay is broadly appropriate and remain supportive of cost of living increases for trust leaders. We also continue to question the effectiveness of earn-back policies as a performance management tool. Trust leaders believe effective performance management is best delivered via robust appraisal processes and through the role non-executive directors (NEDs), chairs and NHS England’s (NHSE) regional and national teams play in ensuring accountability
• VSM roles are becoming more complex, due to system working and wider operational pressures. We would welcome the SSRB reflecting this in their pay recommendation for 2024/25 and would also welcome the delayed VSM pay framework acknowledging this
• The delayed announcement of all NHS pay awards continues to be damaging to staff morale and to trust financial planning. While we understand delays in pay review processes are not always in the control of individual review bodies, the 2023/24 pay uplifts being announced 18 weeks after the start of the 2023/24 financial year was unhelpful, and NHSE’s letter for enactment of the VSM uplift being sent to trusts in late October meant that the remit group did not receive their pay awards until November. We would be supportive of all efforts the SSRB can make to ensure that pay rounds are concluded by the start of each financial year. As a point of principle, all NHS staff deserve to go into each new financial year knowing their pay for that period
• Equality, diversity and inclusion (EDI) is essential to improved workplace cultures and leadership, enhanced recruitment and retention, and optimal patient care and outcomes. Our members have been consistently clear on this. We firmly reject the former secretary of state, Steve Barclay’s, messaging regarding EDI roles.