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Friday 20th April 2018

Agenda for Change

9th March 2006

27022006_a4c1L.jpgWhat is the history of Agenda for Change?

Agenda for Change applies to over one million NHS staff with the exception of doctors and dentists - covered by the Doctors’ and Dentists’ Pay Review Body, and the most senior managers. It represents the biggest overhaul of NHS pay, terms and conditions in over 50 years. It is a pay and reform package that was designed to ensure that people who work in the NHS are paid on the basis of equal pay for work of equal value, with a clearer system for career progression.

The Agenda for Change (AfC) White Paper was published by the four health departments of England, Northern Ireland, Scotland and Wales in February 1999.  It highlighted the need for a change of pay, career structures and terms and conditions of employment within the NHS, and stated that any new pay system must deliver equal pay for work of equal value.  Talks concluded in November 2002 and the Government published the AfC proposals in January 2003.  From June 2003 12 English trusts and four project site in Scotland tested the new system.  A review of early implementation was conducted by the NHS staff Council during the autumn of 2004 and was favourable in the main. In early November 2004 both UNISON and Amicus members voted in favour of Agenda for Change, following on from earlier endorsement from other organisations including the Royal College of Nursing (RCN), the Royal College of Midwives, GMB and the Chartered Society of Physiotherapists. The national rollout of Agenda for Change commenced on 1 December 2004. A target of having all staff, except those who wish to remain on local contracts, assimilated into the scheme by the end of September 2005 was set, but this was not achieved and some trusts are continuing this process into 2006.

What is Agenda for Change?

The initiative is a high profile attempt to improve recruitment, retention and motivation of staff and to facilitate new ways of working, through harmonising conditions of service and providing more transparent rewards for flexible working. Jobs are assessed to provide national and local consistency - equal work for equal pay - and assigned to one of 8 Pay Bands.  Arrangements for hours, annual leave and overtime pay are standardised.

To support personal development and career progression, there is the NHS Knowledge and Skills Framework(KSF), linked to annual development reviews and personal development plans. The system is designed to replace outdated demarcations and allows staff to progress by taking on new responsibilities. The Knowledge and Skills Framework was implemented with the rest of AfC on 1 December 2004, but it will not have an impact on pay until October 2006.  The aim is to help development of knowledge and skills appropriate to the level of responsibility, and to help identify and develop knowledge and skills that will support career progression. The KSF has 22 dimensions which form the basis for development reviews, identification of training needs and progression through the two 'gateways' in the Pay Bands.

How are jobs assessed in the Agenda for Change process?

The NHS job evaluation system is designed to assess all jobs consistently across an organisation.  Jobs are scored against 16 job evaluation factors and placed on a pay band according to their score.  The job will, in the first instance, be matched against one of a number of national job profiles.  If a job is not matched against a profile, an evaluation panel will use the job description, a job evaluation questionnaire, person specification and any other additional information to assess the job against the job evaluation factors.  In the job evaluation points are awarded for the skills, effort and knowledge needed to carry out a job.  Further points are awarded for the responsibility staff carry and the conditions under which they work. The post will be assigned to one of the 8 Pay Bands.

What are the potential benefits of Agenda for Change?

There are potential short and longer term benefits of Agenda for Change, with opportunities for increasing efficiency and productivity, for example;

  • jobs designed around the needs of patients rather than around grading definitions
  • employers can define the core skills and knowledge they want staff to develop in each job, so that staff and services can be developed in tandem
  • recruitment and retention difficulties can be addressed through extra pay (retention and recruitment premia)
  • a system that is fair and transparent
  • recognition and reward for the skills and competencies staff acquire throughout their career
  • greater support for team working through harmonised conditions, replacing disparate Whitley and local contracts 
  • an easier system to administer
  • a system that should improve recruitment and retention with a higher minimum wage and access to higher maximum pay rates for the majority of staff

What are the risks that the potential benefits of Agenda for Change will not be realised?

There is a risk identified that potential AfC benefits may not be realised; for example organisations may see pay reform as essentially a transactional move to new pay system; as simply an HR activity; may not link pay reform to wider corporate development objectives or potential service improvement opportunities; may not have put in place the necessary high level leadership and accountability to support benefits realisation; or do not see how pay and workforce reform can act as a driver for increased organisational efficiency and productivity.

What are the future developments in Agenda for Change?

Looking to the future in October 2005 it was announced that within 12 months contractors providing cleaners, caterers, porters and other ‘soft facilities’ management staff to the NHS will be required to employ staff on terms no less favourable than the Agenda for Change equivalent, and also introduce systems for job evaluation and staff development. During 2006 The King's Fund are due to carry out an evaluation looking at early cost and benefits for Agenda for Change for staff, patients and organisations based on case studies taken from across England. Full implementation of the KSF will be in place by October 2006, with quarterly returns on progress from March 2006.






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