Executive Senior Managers (ESM), who used to be known as Very Senior Managers (VSM), use a different pay framework to Agenda for Change (AfC) which can be found below.

ESM pay framework

Role Grade Salary amounts
Minimum Operational max Exception Zone (Max)
1 £100,000 £113,625 £131,300
2 £131,301 £146,450 £161,600
3 £161,601 £176,750 £191,900
4 £191,901 £207,050 £222,200

The above amounts have been confirmed by the Department of Health and Social Care and are correct as of February 2021. 

All ESM and Senior Medical Leader salaries are reviewed, agreed and approved by the Director of Human Resources and Organisation Development (HR and OD) at NHS Improvement (NHSI). The Director of HR and OD holds a joint contract of employment for both NHS England (NHSE) and NHSI and therefore has the authority to sign the contracts on behalf of both organisations.


Bottom of the Band

The salary entered for ESM roles for the bottom of the band should be the specified minimum amount as displayed in the above table only. Using a range of salaries for these roles is not recommended.   

Exception Zone (Max)

This is the maximum the organisation can offer with Department of Health and Social Care approval.

Any queries regarding this should be directed to the NHSE Contact HR and OD Team.