The NHS Pay Modernisation in England: Agenda for Change report also showed that nurses had received a lower pay rise than most other staff groups since 2003.
Although they have received an average pay rise of 18% since 2003, other groups have faired better, with unqualified and support staff receiving more than 30% and administrative staff receiving 27%.
The NAO estimated that the scheme has not run significantly over budget, with the new system costing the same as the previous Whitley NHS pay scales.
A key element of Agenda for Change, the Knowledge and Skills Framework staff development and training system, has not yet been fully implemented, the report said.
The NAO was also unable to find any real evidence that productivity of the NHS has been improved by Agenda for Change.
Edward Leigh, chairman of the influential House of Commons Public Accounts Committee, which works closely with the National Audit Office, said: ‘A fundamental element of Agenda for Change, the Knowledge and Skills Framework, has still not been implemented by many Trusts. Therefore, patients are not seeing the significant benefits that could be delivered by the Framework.’
Peter Carter, general secretary of the Royal College of Nursing, said: ‘Critics are wrong to say that these changes have failed to bring about increased productivity.’
Mike Jackson, Unison senior national officer, said: ‘Edward Leigh is wrong to suggest that Agenda for Change has not benefitted patients or patient care. It has been instrumental in cutting waiting lists to 18 weeks, patient satisfaction is at a high level and there has been a massive reduction in staff turnover.’
Related article on nursingtimes.net: Knowledge and Skills Framework: the bigger picture