Overview

• Senior NHS managers can earn bonuses of up to 10% of their salary for cutting waiting times and improving patient services, while underperformers may face pay cuts of up to £15,000.
• Executives taking roles in struggling trusts will receive temporary pay increases of 15%, potentially worth up to £45,000, to attract talent to challenging areas.
• The new framework applies to very senior managers across all 215 NHS trusts and 42 integrated care boards in England, including chief executives and other top-level roles.
• Health Secretary Wes Streeting emphasized the reforms aim to boost productivity, curb underperformance, and raise care standards, stating bonuses will be a 'reward, not a right.'
• Professional bodies, including NHS Providers and the Royal College of Nursing, have raised concerns about potential morale issues, equity, and unintended consequences of the measures.