The total wage bill for managers at NHS Wiltshire is one of the highest among health trusts in the South West.

In 2007/8 the trust spent £11.2 million on management costs, which is equivalent to £28.69 per head of population. The average among health trusts in the South West was £21.71, making Wiltshire the third highest.

In 2008/9 Wiltshire is set to be the second highest with an estimated cost of £31.25 per head.

NHS Wiltshire’s chief executive Jeff James, who in 2007/8 earned between £135,000 and £140,000, said the increased costs were due to filling vacant posts in the senior management team.

He added: “We employ 370 people in our headquarters, few of whom are senior managers. One of the reasons for our comparatively high management costs is that we provide a wider range of community services ourselves than most Primary Care Trusts. Effective management makes a difference by contibuting to properly organised healthcare. We are always concerned to put as much of our money as possible into front line services. Next year’s budget includes a target to reduce our management costs and put more money into front line care.”

In 2007/8 the trust employed 1,557 full time staff and had a wage bill of £55 million. Of this it employed 63 managers and senior managers for which the wage bill was £5.2 million. Figures for December 2008 show the trust employed 77 managers and senior managers against a budgeted total of 86.

NHS Wiltshire is also considering saving money by changing the timing of assessments on patients who may need long term health care. The trust may assess while patients in hospital instead of waiting until they have been discharged.

The NHS pays for care until an assessment is carried out. The health trust is predicting an overspend of over £5 million on continuing health care in Wiltshire by the end of March.

The assessments determine whether a person requires free health care.

Despite getting through a backlog of more than 100 patients by the end of November, the winter weather has meant staff have had to look after other priority patients and there are a number of people waiting.