More than 1,500 NHS bosses earn over six figures
26 May 2025, 12:42 | Updated: 26 May 2025, 12:45
1,557 senior NHS managers received a six-figure salary in the year 2023-24, including many in charge of failing hospitals.
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The highest paid executive, Ann James, former chief executive of University Hospitals Plymouth, earned £397,500, despite the trust ranking 95th out of 136 trusts in England for A&E waiting times.
Eight managers in East Cheshire - which ranked bottom of the A&E waiting times league table with just half of A&E patients seen within four hours - earned six figure salaries, including the director of people and culture, Rachel Charlton, who received an eye-watering £367,500.
The chief executive of Queen Victoria Hospital in East Grinstead, West Sussex, which ranked top of the table, did not receive more than £100,000 in remuneration.
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279 managers receive between £200,000 and £300,000, according to analysis by the TaxPayers' Alliance.
Taking into account expenses, benefits, bonuses and pension contributions, 1,694 managers earned a total remuneration package of more than £100,000.
Fewer than 1,000 NHS managers earned six-figure salaries in 2014.
NHS spending has increased 24.5% in the last decade. Waiting times have also increased.
The NHS operational standard, introduced in 2010, states that no more than 5% of patients should wait more than four hours between arrival and admission, transfer or discharge at A&E.
In 2010, 8% of patients waited more than four hours. By December 2023, this figure had risen to 45%.
Shimeon Lee, policy analyst at the TaxPayers’ Alliance, said: “Taxpayers will be appalled that while NHS patients face prolonged waiting lists and dismal A&E performance, hundreds of senior managers are pocketing six-figure pay packets."
"No one disputes that frontline staff deserve decent pay, but this rich list shows that there are sky-high salaries for senior bureaucrats, many in underachieving trusts, that are impossible to justify.”
Earlier this month, Health Secretary Wes Streeting announced a performance-based NHS pay reform.
He described the approach as "carrot and stick", saying that NHS Chief Executives who deliver measurable improvements will be reward with bonuses and pay rises, while those in charge of failing trusts may see their pay docked.
Streeting said: "Some of the best businesses and most effective organisations across Britain and the world reward their top talent so they can keep on delivering. There’s no reason why we shouldn’t do the same in our NHS”, he said.
He continued: “We will reward leaders who are cutting waiting times and making sure patients get better services."
"But bonuses and pay rises will be a reward and not a right – because I’m determined that every penny we invest through our Plan for Change is money well spent.”
Sir Jim Mackey, Chief Executive of NHS England, backed the reforms. He said: "An important element of driving improvements must be strengthening the link between pay and operational performance at a very senior level – this happens in almost every other sector, and there is no reason for the NHS to shy away from it, particularly when we rely on money that comes directly from taxpayers’ pockets.”
Some NHS organisations warned the reforms could be seen as "punishing" NHS leaders and may deter talented managers from working in struggling trusts.
A spokesperson for Department of Health said the figures related to the previous government’s term in office: “This government is introducing tough new measures in relation to senior managers’ pay, to drive progress on cutting waiting lists."
"The NHS should pay to attract top talent, but there can be no more rewards to failure. Under our new ‘carrot and stick’ approach, we will offer incentives to recruit top talent to struggling trusts, while leaders who fail to cut waiting times will have their pay docked.”
