Failing NHS bosses could have annual pay rises docked under tough new measures announced today.
The government said a "carrot and stick" approach will also see CEOs who cut waiting times and boost patient services rewarded with bonuses of up to 10%.
Health Secretary Wes Streeting said: “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.
"Our carrot and stick reforms will boost productivity, tackle underperformance and drive-up standards for patients.”
Under the measures chief executives that fail to deliver improvements or rack up debt could also have up to £15,000 docked from their pay packet.
The Department of Health and Social Care said the figure is based on last year's 5% pay rise and the highest current salary of a trust chief executive - just shy of £300,000.
Mr Streeting will also seek to recruit top talent for struggling trusts. Vacancies in badly performing areas will come with a temporary pay hike of 15%, which could be worth up to a maximum of £45,000.
Sir Jim Mackey, NHS England Chief Executive, said: “If we are to consistently reach the standards of care the public rightly expect, it is clear that we need to reward those who are delivering for patients.
“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."
The plans come after Mr Streeting pledged to sack failing NHS managers, telling trust leaders in November that there "will be no more rewards for failure".
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