NHS Pay Modernisation in England – Agenda for Change
Agenda for Change was implemented between December 2004 and
December 2006. It is the name given to the project for reforming
pay in the NHS for 1.1 million staff and in 2007-08 represented a
pay bill in excess of £28 billion.
Staff groups covered by Agenda for Change include nurses, other
healthcare professionals (e.g. occupational therapists,
radiographers) and infrastructure support. Doctors, dentists and
very senior managers in NHS organisations are not covered.
Before Agenda for Change was introduced there was widespread
agreement within the NHS that a new pay system was needed. Within
the old system there were numerous pay structures, allowances, and
terms and conditions for different staff groups. This had resulted
in barriers to developing new roles for staff and new ways of
working. Further, a lack of consistency in determining pay had led
to equal pay claims.
The key principle for Agenda for Change was to pay staff on a
consistent basis by reference to the work they do and the skills
and knowledge they apply. There were three main elements to the
programme:
- New harmonised terms and conditions and a simplified single pay
spine;
- A job evaluation scheme to assess the appropriate pay band for
each point; and
- A new competency based staff development framework (the
Knowledge and Skill Framework).
In developing a new pay system the Department of Health expected
that the NHS would improve productivity and efficiency by creating
new ways of working for staff.
Our report, NHS Pay Modernisation in
England – Agenda for Change, examines:
- the implementation and costs of Agenda for Change and the
Knowledge and Skills Framework; and
- whether the intended benefits have been achieved.