Q. If there’s going to be a 20% reduction in management costs by reducing the number of directors, is this approach likely to be applied to all staff levels?
A. Our management cost allowance is being reduced by 20%, this is national policy. We have to consider management costs, both staffing and wider management costs when considering the new structures. So whilst we do know the overall reduction in a value we don’t yet know how that will translate to staff structures.

Q. Can I suggest that you check your calculations about the proposed reduction in the senior leadership structure? If the new structure “sees a net reduction in 4 posts” from an original number of 21, that works out as 19.05% (to 2 decimal places), which isn’t in line with management cost reduction targets of 20%. Doesn’t matter how many times you claim that’s 20%, it’s not.
A. We would ask that you consider the framing of your question to make this more professional and courteous to those responding to these questions. However, the Lay Members at joint Remuneration Committee received a paper considering the salaries and full costings of the new executive structure which shows an actual cost saving of 23%, this isn’t head count but management cost saving.

Q. Thanks for the answer about VSMs. But you didn't actually answer part of the question, which was 'at what monetary level does a VSM salary start'. You don't need to reveal at what %age level of Paul's salary they start, but it would be really helpful to know the amount at which they're going to start, just so we can all have an idea. How about you let us know?
A. We will not be sharing salaries with staff, this is personal information and will be considered and ratified through the formal committee structure.

Q. Thanks for agreeing that the question about the number of VSM salaries and the cost comparison with existing director salaries is a great question. How about answering it properly? It's not about a 20% reduction in capacity, it's questioning whether there's actually going to be any saving made at all.
A. The total cost of the new structure in comparison ti the current executive team structures, including posts that we have held as vacancies in the last 12 months, is a saving of 23.5%

Q. How are you going to make 20% cost savings in the executive team if you're going to pay VSM salaries to almost everyone at that level? Specifically, 20%? That's the magic number that's continually bandied about and used as the rationale when vacancies don't get filled, so is it possible to share the calculations with staff?
A. The actual cost saving of the new executive structure is 23.5%

Q. What percentage of the 20% overall savings have already been made from staff that have retired / handed in notices for permanent CCG posts, which have subsequently been positions that have not been re-recruited to since the freeze on jobs was announced?
A. As part of our review of the financial position of all our CCG’s we will be looking at this, this information is not currently available.

Q. Costs relating to contracted workers are extraordinarily high and unfair on substantive staff doing the same role. Whilst it has been made clear that the 20% reduction in management costs is greater than staffing costs, has thought been given to reducing the excessive use of agency workers, particularly in nursing roles?
A. Managers are encouraged to use Agency staff as a last resort, however, in order to maintain business as usual and ensure employed staff are protected as much as possible during the management of change process, the use of agency staff has been necessary.

Q. Is there a significant chance that at some point during the executive team recruitment process, it will be realised that the JDs are too much for any one individual director to deliver, and we'll magically find enough money to recruit a couple of people to each position?
A. At this stage there is no plan to add to the Executive Structure with additional posts to ensure that we are meeting the need to reduce management costs

Q. What exactly is a VSM salary? At what monetary level does it start? What additional benefits / perks will this entitle the Executive Team to claim / be paid in addition to their basic salary? Full details would be appreciated.
A. VSM stands for Very Senior Manager and has been established within the NHS since 2006. The VSM contract allows those on this contract to receive a basic salary which is a percentage of the Chief Accountable Officer’s basic pay. Staff on VSM contracts are also eligible for a performance bonus scheme in which Directors will need to demonstrate they have met their objectives. The bonus is non-pensionable. They do not receive cost of living pay awards or increment increase like staff on Agenda for Change contracts.

Q. Why are there no costings with the executive team structure? How can any assurance be given that 20% savings will be delivered if there's no details about the cost expectations of the executive team? Surely any expected savings will depend on factors such as potential redundancies, the level at which Very Senior Manager salaries are set, etc? The structure states that all but two directors will be paid at VSM level - how many staff in the organisations are paid at that level (pre-collaboration)? It's not open and transparent to claim that the number of directors will decrease by 20% (from a reported 21 down to 16) if the number of directors being paid VSM salaries increases. I know that's not a question but I would invite your response. How does the anticipated cost of director salaries (and when appointed, the known cost) compare with the combined salaries of the 21 current positions?
A. There have been 21 leadership roles across the four CCGs in 19/20 - not including clinical executive roles and one STP role. This new structure establishes 16 leadership roles in the CCG team plus 2 STP roles (PMO and Academy Director). The proposed senior leadership structure sees a net reduction in 4 posts which equates to a circa 20% reduction in senior leadership capacity and is therefore in line with management cost reduction targets. The Governing Body asked a similar question to gain assurance so this is a great question.

Q:  Is there an identified budget for the two new proposed office locations (New HQ and West Birmingham location)?
A:  As part of the estates review it is anticipated that there will be no additional costs in relation to a new HQ and office for West Birmingham colleagues, the estates review will seek to ensure buildings are used appropriately and fully utilised.

Q:  Why has the exec structure only resulted in a 20% reduction? There is a real opportunity to make further reductions in order to retain more operational staff.
A:  The executive team structure and staffing costs in general are only part of the overall management costs. The financial pressures have to be balanced with the deliverability of a large agenda and the complexity of our system – whilst considering changing the way we work and the ambition to make a real difference in the context of population health management.

Q:  Is there a 20% reduction in STAFF numbers or 20% reduction on the financial cost of the posts? As it feels like a lot of the top management will be benefiting quite well with the management of change?
A:  There is a requirement that CCGs reduce 20% of their management costs. Management costs are made up of a lot more than staff costs and we will be considering the financial pressures for all management costs. The senior team may be significantly affected by the proposed executive structure and some may not secure a role in the new structure, despite everyone wanting to be part of the new executive team.  This does not feel like top management will be benefiting well from the management of change but please contact HR or Paul if you would like to explore that further.