DHSC is working closely with NHS England on the development of a new very senior manager ( VSM ) pay framework which will ensure that senior manager pay is set at the right level. The new framework aims to improve consistency and transparency of VSM pay setting processes and will be made publicly available. Local NHS trusts and ICBs will therefore be able to review the framework directly when deciding on individual pay proposals. This will enable trusts and ICBs to ensure that pay cases are compliant with the framework, thereby simplifying the approvals process for cases requiring DHSC oversight. Internal processes for official clearances have also been streamlined in order to improve approval times. We will continue to work with NHS England on this.