The long-term future of a national pay deal for nurses has been thrown into fresh doubt, as a landmark agreement on changes to terms and conditions is set to go ahead.
A deal on proposals to amend the national Agenda for Change pay framework will be discussed by unions and employers at the NHS Staff Council this Tuesday. Nursing Times understands it will almost certainly be approved.
The deal, which has been the subject of long-term negotiations, would see a range of terms and conditions for NHS staff diluted or altered, as health service managers seek to make savings.
But ahead of the deal being rubberstamped, calls have already been made for a debate about whether AfC should be ripped up and replaced by locally negotiated pay and terms and conditions – with the likely outcome that nurses and other NHS staff would be worse off in many parts of the country as a result.
The head of the Foundation Trust Network has told Nursing Times he cannot see how a national deal can survive in the long-term. The network represents trusts given greater freedoms by gaining foundation status.
FTN chief executive Chris Hopson said a debate was needed about the best way forward for the NHS, given the continuing tough financial climate predicted for the next five years.
“It is difficult to see how we can stay with the current arrangements, taking a five year view, with the financial pressures and the need to improve the service,” he told Nursing Times.
Mr Hopson said the network “unequivocally” supported the new AfC deal on the table. But he added: “We need a debate about terms and conditions. Are they right or are they not and what is the best way of negotiating?
“With 10 years of flat cash at best, the NHS needs to take a long hard look at this,” he said, stressing that the network had no pre-decided position on the issue at present.
Christina McAnea, health of health at Unison and chair of the staff side of the NHS Staff Council, emphasised that unions only negotiated changes to AfC with NHS Employers. “We don’t negotiate terms and conditions with the FTN,” she said.
The current proposed changes to AfC have been accepted in consultation exercises by the two largest health unions, Unison and the Royal College of Nursing, suggesting they are unlikely to be stopped – despite opposition from another union Unite.
The Royal College of Midwives, the Chartered Society of Physiotherapists and the British Association of Occupational Therapists have also accepted the proposals.
The proposals would see automatic incremental pay rise scrapped, with staff expected to meet performance criteria to receive increments.
They would also see the end of enhanced out of hours sick pay, and bring an end to band 5 nurses receiving two increment rises during their first year after qualification.
Senior staff on higher pay bands could also be removed from Agenda for Change entirely and paid an individual spot salary.
The changes have proven controversial coming at a time when NHS staff have been hit with two years of a pay freeze, increased pension contributions and major re-organisation.
Attempts to bring in localised pay deals have also emerged in the past year, most notably in the South West where 19 trusts – including 13 foundation trusts – formed a “cartel” to try and significantly reduce pay across the region.
The South West Pay, Terms and Conditions Consortium is due to announce whether it will proceed with its plans once the NHS Staff Council’s decision on the AfC deal is known. However, separate government proposals for regional pay were dropped by the Treasury in December.
Ms McAnea said any trust that attempted to impose local pay would be strongly opposed. She said: “Where we have a local trust trying to forge ahead with breaking away from the national agreement, unions will be putting all our effort and resources into stopping that from happening.”
Dean Royles, director of the NHS Employers, the body which negotiates with unions on behalf of health service organisations, said: “I know from my meetings with employers up and down the country they need Agenda for Change to be fit for purpose. This deal will reassure them.”
He said it was important unions were seen to be willing to negotiate if they wished to retain national deals, adding: “I know it’s difficult but this is about mature partnership working in the most challenging of financial environments.
“Get it right and we can start to support employers with the challenging task of implementation. Get it wrong and fragmentation becomes inevitable,” he warned.