Daily Insight: Nice work if you can find it

NHS managers who are “underperforming” should be “sacked” and the health service should reinvest some top salaries into the frontline, a new Department of Health and Social care adviser has said.

James Sunderland, a new parliamentary private secretary at DHSC, claimed at a Conservative party conference fringe event that some executives in the health service earn “the better part of £500k” – which he said is “absolutely ridiculous”.

He made the comments despite no substantive NHS executives having earned salaries approaching £500,000, according to annual reports. Chief executives of the largest trusts reported salaries under £300,000 in 2021-22.

However, some management consultancy firms, such as Test and Trace which was run by DHSC, are thought to have been paid day-rates reflecting around £500,000 in annual salary.

Mr Sunderland told the event that the NHS is now “better funded now than at any time in its history”.

He said: “The solution is not more money, it’s better managers. We need to get to grips with the senior management of the NHS. People not performing need to be sacked.

“We need to reinvest money spent on executives and management into the coalface. It’s about efficiency in how we do business.”

Mr Sunderland was not the only Conservative MP to criticise perceived high levels of NHS management at the party conference. Health committee member Marco Longhi told a separate fringe event that there is an “enormous amount of back office organisation” in the NHS and he was “not quite certain” about the value that brings to the front line.

Agencies’ income rockets

The income of two of the largest suppliers of agency staff to the NHS increased substantially year-on-year in 2021, their annual accounts reveal.

Acacium, which owns Independent Clinical Services, Pulse Healthcare and Thornbury Nursing, reported turnover of £748m from temporary staffing in its financial year ending December 2021. This is up from £175m in 2020 (although not all of this increased activity, some reflecting a shorter accounting period in 2020). 

A spokesperson for the Acacium Group said it had diversified into running the staff bank for some trusts.

Medacs, which claims to be the largest provider of locum doctors to the NHS, saw its income increase 75 per cent from £92m during the year ending December 2020 to £161m in 2021.

Medacs’ annual accounts said its performance was “driven from new significant staff bank and managed service provider contract wins across several hospital trusts”. Although it conceded that tighter margins had lowered its gross profit margin.

NHS England said it expected to see agency spend reduce by at least 10 per cent at each NHS provider in 2022-23.