MiP has warned the government to “get senior staff on board” after executive-level NHS managers in England were given a lower pay rise than other health service staff.

The UK government accepted the 3.25% pay award recommended by the Senior Salaries Review Body (SSRB) for very senior managers in providers and ICBs, and executive senior managers (ESMs) in arm’s length bodies. The award is below those given to colleagues on Agenda for Change (3.6%) and to doctors and dentists (4%).

MiP chief executive Jon Restell warned the lower award, following years in which executive managers were sometimes given no pay rise at all, would exacerbate existing pay overlap issues—where some executives are paid less than Agenda for Change staff they manage.

“There has to be a long term solution to this or it will continue to get worse. If the government is serious about its NHS reform agenda then it must get senior managers on board,” he said.

The SSRB again recommended using an extra 0.5% of each employer’s pay bill to tackle these pay overlap issues, but the proposal was rejected by health secretary Wes Streeting, who said the additional money “has not seen widespread use by employers” in previous years. He promised to report back on the review body’s recommendation to withdraw the ESM framework once the winding up of NHS England—where three quarters of ESMs work—is complete.

Restell said MiP “understood the government’s reluctance” to commit extra money but the pay overlap issue still needed to be resolved. “In MiP’s own conversations with senior manager members we found no evidence this pot of money was ever being used. This doesn’t mean the government is off the hook — it’s up to them to explore other avenues to deal with this problem,” he said.

The new pay framework for very senior managers (VSMs), published in May, attempts to link executive pay to performance. Annual pay rises will be withheld from executives in trusts which fail to meet performance targets, while remuneration committees will be able to award VSMs one-off bonus payments of up to 10% of basic pay in “recognition of exceptional contribution”.

To encourage VSMs to take on struggling organisations, the new framework also allows employers to pay managers an additional 15% of their base pay while working at an organisation deemed as “challenging”.

“MiP is not convinced that linking senior manager pay to performance, especially while organisations are making significant cuts to running costs and staff numbers, is the right approach,” said Restell. It will likely prove counterproductive to the health secretary’s admirable aim of getting the best leaders to take on struggling trusts.”