Agenda for Change

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Agenda for Change (AfC) is the current NHS grading and pay system for all NHS staff, with the exception of doctors, dentists and some senior managers. It covers more than 1 million people and harmonises their pay scales and career progression arrangements across traditionally separate pay groups, in the most radical change since the NHS was founded.

It was agreed 1 December 2004, by unions, employers and government, but it is not yet fully implemented nationwide. All the signatory organisations have agreed to implement it through a partnership approach.

AfC assimilates staff to a new salary according to an evaluation of their job weight under an NHS Job Evaluation Scheme. There are nine new numbered pay bands subdivided into points, similar to the old alphabetic Whitley Council 'grades' pay scales. A set of national job profiles has been agreed to assist in the process of matching posts to pay bands. All staff will either be matched to a national job profile, or their job will be evaluated locally.

Under AfC, all staff will have annual development reviews against the NHS Knowledge and Skills Framework (KSF). Normal pay progression is one point a year, but pay progression at specified 'gateway' points in each pay band will depend on how the individual matches the KSF outline for their post.

[edit] The history of Agenda for Change

After five years of negotiations Agenda for Change (AfC) is now a reality - but how did it all begin? When the NHS was established in 1948 it adopted the Whitley industrial relations system, which was used in the civil service and local government. The system stemmed from work done by J S Whitley in 1916 and provided a framework for pay, terms and conditions.

The NHS Whitley system has essentially been unaltered since its inception, although there have been some changes. Nevertheless, it has been heavily criticised for decades. These criticisms centred on its structure, complexity, over centralisation, lack of flexibility and equal value.

Negotiations on a new system began in February 1999 when the four health departments of England, Northern Ireland, Scotland and Wales published the Agenda for Change White Paper. It aimed to address the issues of the Whitley system and highlighted the need for a change of pay, career structures and terms and conditions of employment within the NHS. It stated that any new pay system must deliver equal pay for work of equal value.

A number of organisations were involved in the discussions and negotiations including:

Four UK Health Departments The NHS Confederation - which represents NHS employers 20 trade unions and representative bodies. Nurses are the largest occupational group in the NHS, so the RCN was at the forefront of the discussions and negotiations.

Talks came to an end in November 2002, and the Government published a set of proposals in January 2003. After looking closely at the AfC proposals, RCN Council recommended the package to members, on the basis that it would bring significant improvements to nurses' pay, professional development and career opportunities.

[edit] Bands

1 - Catering, domestic, admin, porterage staff
2 - Clinical support workers, pharmacy assistant, patient transport, cook, admin
3 - Microbiology assistant, secretaries, security
4 - Mortuary, radiography or occupational therapy assistant, operating department practitioner
5 - Nurse & midwife entry level, dietician, occupational therapist, physiotherapist, paramedic
6 - Art therapist, health visitor, nurse specialist, pharmacist
7 - Management - clinical & admin, psychologist
8 - Nurse & midwife consultants, higher management - psychology, therapists, clinical & admin
9 - Psychologist consultant

Pay varies, at 2006 rates, from £11,782 to £88,397 across all bands, with extra allowances for London, being on call and leading.