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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

ESM salary amounts
Role Grade 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 Pay Lead within the People and OD team, Head of HR, and are accurate as of August 2025

All ESM salaries are reviewed, agreed and approved by the Director of Human Resources and Organisation Development (HR & OD).

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 HR & OD team.

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