The NHS trust in charge of Norfolk's biggest hospital is facing a backlash over its decision to appoint a new boss who will do the job part-time while running two other hospitals.
Nick Hulme has been named the new chief executive of the Norfolk and Norwich University Hospital (NNUH).
But the appointment is under growing scrutiny because he will continue to run another NHS trust and two other hospitals at the same time.
Critics have asked how the new boss - who has been dubbed 'Two Jobs' - will be able to address the challenges at the N&N, while also leading the East Suffolk and North Essex NHS Foundation Trust (ESNEFT), which runs hospitals in Ipswich and Colchester.
His appointment comes at a time when more than 8,000 of the N&N's patients are on waiting lists of more than a year for treatment.
Meanwhile, staff including junior doctors continue to take industrial action over pay and the hospital has a number of major infrastructure projects under way - including a new orthopaedic unit.
The hospital also continues to fight through a backlog of more than 20,000 patients awaiting elective surgery.
Mr Hulme has only been appointed on an interim basis, until February, when a permanent replacement will be in place.
But critics have questioned why, if the permanent role will be full-time, it can be filled on a part-time basis for more than six months.
Fran Whymark, who chairs the Norfolk health scrutiny committee, said: "It certainly sounds quite a task for one person - the N&N on its own would be testing, let alone two other hospitals.
"Patients need to be given assurances that he will have a strong team around him to pick up the slack when he isn't there - one person cannot do everything."
Mr Whymark added he had concerns that the temporary period includes the winter - when hospitals are at their busiest.
Trade union Unison has also criticised the appointment.
Caroline Hennessy, who represents the union, said: “NHS nurses, porters, cleaners and call handlers are well used to covering multiple roles after years of declining pay and underinvestment has left them stretched to the limit — but they don’t get six-figure sums for the privilege.
“But just as staff shortages on the hospital floor are hitting patient care, there are questions as to whether one CEO will be able to deliver for patients and staff in Norwich, Ipswich and Colchester."
The two trusts which employ Mr Hulme have declined to explain exactly how his time will be split between them.
His other hospitals, in Ipswich and Colchester, face challenges of their own and are currently rated as 'requiring improvement' by the Care Quality Commission - the same as the N&N.
The Suffolk and Essex role pays up to £200,000 per year - a figure that was reduced by £50,000 just over a year ago.
The Norfolk one also pays a base salary of between £95,000 and £100,000 - but pension benefits and expenses take this up to the £200,000 mark too.
The trusts have confirmed Mr Hulme will not be paid two full-time salaries, with his pay instead split between the two organisations.
Mr Hulme's appointment comes following the departure of current N&N boss Sam Higginson, who is leaving the hospital to take on a senior post at NHS England.
A spokesman on behalf of both trusts said: "An independent remuneration committee of both organisations have agreed the terms and conditions related to the joint appointment of the chief executive between ESNEFT and NNUH.
"Mr Hulme will be dividing his time between both organisations and has put in place management arrangements at ESNEFT for the days that he is working at NNUH and members of the executive team will be deputising when he’s not at NNUH."
Analysis
Running a hospital is no mean feat - particularly the biggest one in the county.
The N&N is one of Norfolk's largest organisations, treating more than 100,000 patients every year from all corners of the county.
It employs more than 7,000 people making it one of the largest employers in the region to boot.
It is therefore concerning to learn that for the next seven months it will share its chief executive with another NHS trust.
Even with this only being a temporary measure, one has to question the practicality of this arrangement.
The hospital has many challenges facing it as it continues to feel the aftermath of the Covid pandemic.
Its waiting list for elective surgery has surpassed 20,000 people, it has a number of major infrastructure projects under way and it continues to be rated as requiring improvement.
Circumnavigating these choppy waters desperately needs a strong, focussed pair of hands at the helm.
While Nick Hulme's level of experience is not questioned - he has been a mainstay in the NHS for more than 40 years - he is still only one person.
Patients using the hospital have to be given assurances that he will be able to provide the N&N with the level of focus it deserves.
The trust he is already in charge of runs two other hospitals, Ipswich and Colchester, which are facing similar challenges to the N&N.
All three hospitals can not afford to suffer because Mr Hulme is spreading himself too thin - which people may be fearing.
When so many lives - and livelihoods - rely on the hospital, it surely can not afford to be led by a part-time chief.
If this job is so important, then it deserves someone doing it full-time. If it doesn't, then the hospital should admit that and make sure that someone part-time - and on a lower salary - takes on the job in February.
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