The NHS’s flagship pay reform, which increased its annual salary bill by £7.4bn, has been branded a failure by those it was meant to benefit according to an exclusive Nursing Times survey.
Agenda for Change was designed to bring better pay and conditions to 1.1m nurses and non-medical staff – but in a survey of more than 1,100 nurses, 61% said that it had failed to deliver a fair deal for NHS staff overall.
The revelations come after a critical National Audit Office report earlier this year, which revealed that the cost of the NHS pay system had increased from £20.8bn to £28.2bn since the introduction of AfC. The implementation costs of the new system were a further £239m.
Although 91% of respondents backed a national pay system, more than two-thirds (67%) said AfC was no improvement on the old Whitley pay scales, which it replaced.
AfC placed nurses and non-medical staff on one of eight pay bands. The majority (59%) of nurses who responded to the survey did not feel that they were on the correct pay band.
44% were worried that their employer would attempt to re-band their positions to cut costs during the recession.
There were also concerns about the way in which Agenda for Change had been implemented.
AfC differed from its predecessor in that pay was no longer based on job title but on work done – with most NHS posts evaluated against national jobs profiles or matched against guidelines on competencies.
However, a massive 80% of survey respondents thought that the job evaluation process was unfair.
Of the newly qualified nurses questioned, a staggering 92% had not received the mandatory pay increases agreed under the AfC system.
Nearly half (48%) said that Agenda for Change (AfC) had failed to achieve its goal of creating a system of equal pay for work of equal value.
Mike Travis, RCN steward at Alder Hey Children’s NHS Foundation Trust, said: ‘AfC is slowly deteriorating and falling apart. There are whole groups that have been downgraded from band 7 to 6 and from 6 to 5 – and most of that is done with finance in mind and not on an equal pay basis.’
Bindy Sumner, staff nurse at North Devon Healthcare NHS Trust, said that pay and conditions were worsening.
‘I think you will find a lot of nurses feel jobs are changing to get the maximum for the minimum. Everyone works more but they pay them the same,’ she said.
She reported that hospitals were abandoning family-friendly work practices and making nurses work longer shifts.
‘Things are going backwards because of hospitals introducing things like long days. Staff who can’t do nights are expected to do them even if they can’t arrange care for their children.
‘They are doing working months instead of working weeks, all for the sake of finance, which affect shift patterns and workload,’ she said.
However, Barrie Brown, Unite lead officer for nursing, defended AfC’s record on equal pay and on improving terms and conditions for nurses.
He said: ‘If people feel like they should go back to Whitley scales, that could not be supported. We had different pay structures for nurses, allied health professionals and pharmacists. That could not stand up to the rigour of the equal pay agenda.’
Mr Brown reminded nurses of the fact AfC had survived a legal challenge from lawyer Stefan Cross, which argued that it was sexist.
‘We have had the ruling of Hartley employment tribunal, which has established that AfC conforms to the equal pay agenda.’
He blamed employers for many of the problems reported in the survey.
‘There seem to be a lot of restructuring arrangements coming out which lead to the possibility of pay bandings being lowered. Bands 6 lowered to 5 is something we have seen,’ he said.
‘The concern is that employers are using AfC as part of a process to reduce costs. This was never the intention on the part of the unions or the Department of Health.’