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Fair Pay: Fixing 17 Years of Growth, Outdated Systems, and Pay Variations

Challenge

Our customer is a leading healthcare group in the UK. They deliver high standards of care to insured, self-pay and NHS patients, running 39 hospitals and over 50 clinics, medical centres and consulting rooms.

They provide diagnostics, inpatient, day case and outpatient care in areas including orthopedics, gynecology, cardiology, neurology, oncology and general surgery. They also provide a private GPs service, deliver private, NHS and corporate mental health, dermatological and musculoskeletal services, and provide occupational health services to 800 corporate clients. Working in partnership with 8,650 experienced consultants, they have delivered tailored, personalised care to over one million people in one year.

Approach

A UK leading healthcare group wished to introduce a Salary Framework across its hospitals and Central Functions team. Over the past 17 years of growth, hospitals had been acquired, others built, and historically Hospital Directors had significant levels of autonomy to optimise salaries, overtime, on-call and other variable pay elements for their local market. For variable pay alone, this had led to over 1,000 different variations across the Group. In addition, the job-related fields in their core HR system had not kept pace with the local variations, and the job title field was a free text field, leading to many thousands of variations.

Collectively this had led to some pay disparity, a highly complex variable pay system that couldn’t realistically be automated, and uncertainty as to what job people performed based on the system data. The intent was to address these issues by developing a Salary Framework.

Outcome

Work initially started on a Salary Framework, but once the job data structure and data quality were better understood, focus shifted to developing a Job Framework. Having a great understanding and having previously worked with the customer, we re–deployed a team to provide project management and solution design support to the Group Reward team.

Collaborating with the relevant “Heads of” each functional domain, a series of “core roles” were developed. These represented the strategically significant roles within each functional domain, to which multiple existing job titles could be mapped to. Each core role was defined using a common set of descriptors, reviewed and signed off by the functional “Head of”.

In parallel, different job levels were developed from Senior Leader to Team Member. These two aspects were then combined to create a grid that featured on the Y axis the job levels, on the X axis the functional domains, and the core roles were then added into the relevant cell within the grid.

Throughout this process we provided a combination of project management, process design, and solution design expertise, supporting the Group Reward team. With the grid of core roles developed, more of the teams focus shifted to defining salary ranges and target salaries for each core role.

A logistically challenging process was then designed and executed to map over 10,000 staff working in over 40 locations to the appropriate core role, confirm the local enhanced pay rules, and calculate any material remuneration differences against the salary range and target salary.

Given the significant influence that the NHS has on the UK healthcare market, their approach needed to be considered whilst also identifying ways in which the organisation can offer a competitive alternative.

Throughout this entire process, a carefully constructed stakeholder engagement plan was executed, with the stakeholders including a Working Group and the Executive Committee.

Following many months of work, complex analysis, and stakeholder engagement, the Job Framework and Salary Framework were signed off and various pay changes were made across the Group, which are expected to reduce attrition due to reward and increase the number of applicants to open roles.

As expected, the Job Framework also provided a strong foundation upon which to improve the granularity of training allocation (generating material time savings), career path discussions, induction and onboarding, system access rules. The improved clarity as to how many people were performing each role, in each location was also welcomed by the senior leadership.

Project One value Add: