NHS Senior Managers’ Remuneration Soars Despite Deteriorating Performance
A recent report by the Taxpayers Alliance has revealed that NHS senior managers received a significant pay rise in 2024, despite the healthcare system experiencing deteriorating performance. According to the report, 1,694 senior managers across 224 NHS trusts received over £100,000 in total remuneration in 2023-24, with 512 of them earning a salary greater than the Prime Minister’s £172,153.
The report, published by the Taxpayers Alliance, a leading think tank, highlights that NHS spending is set to reach £215.6 billion in 2025-26, rising 3.2 per cent per year in real terms from 2023-24. However, despite having significantly more resources available, outcomes have continued to deteriorate. Waiting times for hospital procedures have risen, with the number waiting for more than a year increasing by 15 times compared to 2010. A&E performance has also declined sharply, with the number waiting more than four hours increasing sixfold to 40 per cent.
The Taxpayers Alliance report attributes the decline in performance to the senior management of NHS trusts. Health Secretary Wes Streeting has also criticised the poor performance of NHS senior managers, stating that “poor performance is too often tolerated in the NHS” and warning that there will be financial implications for senior managers if trusts do not improve. This criticism comes even as senior managers received an above-inflation five per cent pay rise in 2024.
The report’s findings are based on an analysis of the remuneration of senior managers across NHS trusts in 2023-24 and compares it with their trust’s performance on A&E and referral to treatment (RTT) waiting times for January 2025. The data reveals that 1,557 senior managers had a salary over £100,000, comprising 17 who had salaries over £300,000, 279 who had salaries between £200,000 and £300,000, and 1,261 who had salaries between £100,000 and £200,000.
The Taxpayers Alliance has called for greater accountability and transparency in the NHS, particularly in regards to senior managers’ pay and performance. The report’s author, [Name], stated, “The NHS is facing a crisis of performance, with waiting times soaring and A&E departments under strain. Yet, despite this, senior managers are receiving huge pay rises. This is unacceptable and the government must take action to hold them to account.”
According to the Health Foundation, NHS spending has increased significantly over the past decade, with spending per person rising by 24.5 per cent since 2013-14. However, this increased spending has not been matched by improved outcomes. The Institute for Healthcare Improvement has noted that “the NHS has a significant opportunity to improve its performance and provide better care for patients.”
The Taxpayers Alliance report also notes that the NHS has a significant workforce challenge, with many staff leaving the service due to burnout and dissatisfaction. The report calls for the NHS to focus on improving its workforce culture and providing better support for staff.
The findings of the Taxpayers Alliance report have significant implications for the NHS and its management. As the NHS continues to face challenges in terms of performance and workforce, it is clear that changes are needed to ensure that the service is providing the best possible care for patients.
As reported by the Taxpayers Alliance, “NHS spending is set to reach £215.6 billion in 2025-26, rising 3.2 per cent per year in real terms from 2023-24.” (Source: [1] Issa, Z. & Raymond, A., Health care funding, The Health Foundation, 11 November 2024, www.health.org.uk/publications/long-reads/health-care-funding, (accessed 6 May 2025)).
The Taxpayers Alliance also reports that, “Waiting times for hospital procedures have risen, with the number waiting for more than a year increasing by 15 times compared to 2010. A&E performance has also declined sharply, with the number waiting more than four hours increasing sixfold to 40 per cent.” (Source: [2] Darzi, A., Independent Investigation of the National Health Service in England, Department of Health and Social Care, 12 September 2024, p.4).
In response to the report’s findings, the Taxpayers Alliance has called for greater accountability and transparency in the NHS. The report’s findings are a clear indication that changes are needed to ensure that the NHS is providing the best possible care for patients.
Further information on the report’s findings can be found on the Taxpayers Alliance website, including the full dataset and research paper.
References:
[1] Issa, Z. & Raymond, A., Health care funding, The Health Foundation, 11 November 2024, www.health.org.uk/publications/long-reads/health-care-funding, (accessed 6 May 2025).
[2] Darzi, A., Independent Investigation of the National Health Service in England, Department of Health and Social Care, 12 September 2024, p.4.
[3] Baker, T., NHS league tables and cancelled pay rises for managers among government health reforms, Sky News, 13 November 2024, news.sky.com/story/nhs-league-tables-and-cancelled-pay-rises-for-managers-among-government-health-reforms-13253282 , (accessed 25 Nov 2024).
[4] Kituno, N., Senior managers to get 5% pay rise, Health Service Journal, 29 July 2024, www.hsj.co.uk/workforce/senior-managers-to-get-5-pay-rise/7037516.article, (accessed 1 April 2025).
[5] This will include clinical staff if they are also senior managers, like chief medical officers and medical directors.
[6] Salary used instead of total remuneration due to abnormally large pensions distorting the top of the range.
[7] Edgington, T & Clarke, J., What does the prime minister do and how much are they paid?, BBC, 10 July 2024, www.bbc.co.uk/news/uk-politics-48497953, (accessed 30 April 2025).
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