Making senior appointments in NHS trusts. Refreshed guidance to support your trust through the process.

This latest guidance sets out the process for all permanent or temporary appointments to chief executive or director posts in NHS trusts and the “key advisory role” NHS Improvement has in the selection process. The March 2017 guidance updates earlier guidance.

The guidance note sets out NHSI’s seven steps to the selection process from chairs initially discussing plans to recruit chief executives to reviewing and commenting on the advertisement and obtaining NHSI’s approval for the salary range. This process should be followed for all permanent appointments and fixed–term appointments of three months or longer whether on, or very exceptionally, off-pay roll. It also includes appointments where two or more trusts are combining executive teams, where at least one of these trusts is an NHS trust. In short, all these appointments must include discussions with NHSI given its newly defined role in the interview selection process.

These new requirements dovetail with NHSI’s recent guidance on pay for very senior managers in NHS trusts and foundation trusts. The VSM pay review process covers all on-payroll appointments both substantive and fixed term where the annual salary is £142,500 or above. All providers are advised to start the VSM pay process at the start of the recruitment process to help manage expectations at the outset. NHS Trusts are reminded that Treasury approval is required before appointments are confirmed – failure to obtain approval may be regarded as a breach of process with an associated fine.

As for off-payroll engagements and board office holders – HMRC has confirmed that all appointments to posts defined as “office holders” should be on payroll irrespective of the planned duration of the appointment. This includes virtually all VSMs and only a very limited exception is available.

Other changes of note include the re-appointment of chief executives or executive directors after taking pension benefits. In cases where executives plan to resign and take their pension benefits when they reach pensionable age and then return to work – NHS trusts should contact NHSI before any resignation, and seek approval from NHSI before authorising re-appointment.

Do get in touch if you would like support with your Trust’s senior management appointments – NHSI’s latest guidance has arrived with a number of other new employment related obligations for health and care providers engaging staff such as off-payroll working rules and the new immigration skills charge.

Jog Hundle, Partner

Stuart Craig, Partner

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