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Half of nurses say Agenda for Change has failed


Nearly one-half of nurses think that Agenda for Change, the system brought in five years ago to harmonise pay across the NHS, has failed, according to an exclusive survey by Nursing Times.

Of more than 1,140 nurses who responded to the survey, 48% said that AfC had been a failure overall, and 61% said that it had failed to deliver a fair deal for NHS staff.

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.

The majority (59%) of nurses who responded to the survey did not feel that they were on the correct pay band and as many as 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 – about one in 12 (8%) were demoted or were put on pay protection as a result of AfC.

Trusts failing to honour preceptorship payments, an issue highlighted by Nursing Times in February this year, continued to be a problem, the survey found.

Of the newly qualified nurses questioned, a staggering 92% had not received preceptorship payments – mandatory pay increases agreed under the AfC system.

The system for on-call payments was also unpopular, with nearly three-quarters (73%) describing it as unfair.

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 by nurses 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.’

He referred to the low rate – 8% – of pay protection reported in the survey. ‘This means 92% have had a pay increase attributable to Agenda for Change,’ he said.                                          


Readers' comments (15)

  • It was obvious from the earliest days of AfC that it was going to be used as a management tool to save money by not paying nurses what they were worth. AfC was the primary reason I left the NHS and earn a very nice salary in the the private sector where I am valued. I am sure many other nurses probably did the same thing. I expect others will accuse nurses like me of abandoning the NHS, but believe me, the NHS had plenty of free hours and dedication from me over the years.

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  • Compared to the car industry we got a cost of living allowance this year- we are in jobs final salary pensions so stop moaning and get on with the summer- yes we could be teachers but we are not- we are lucky

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  • Sorry, Jane, but the auto industry suffers from the effect of consumer demand and overpricing, in addition to which (not to decry the work that its employees do or their responsibility to keep the wolf from the door) this is a production-line, set value job and to ascribe these qualities to dealing with the human animal - in all its glorious diversity - is an invalid comparison. As to our (admittedly good) pension scheme, this too is gradually being eroded.
    I'm sure that all those who found themselves 'downgraded' or paid at less than their evaluation actually warrants, even after appeal, may find your comments less than supportive.

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  • Yes Jane we did not choose to make cars,but we are or should be teachers. Teaching is a key part of of the nursing profession. You are missing the point. A nationally agreed pay structure should do what it claims to do. A4C is not the problem. Corrupt employers / managers are stealing from the majority of the workforce, by not implementing the system fairly. Unsupportive comments like Jane's wil maintain that corruption. Comment 1 (Diana) describes the result. Experienced nurses are leaving in droves.A profession that values itself is entitled to equal pay for equal work. Kathleen White

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  • For those of you who have worked in the profession for years, I have heard many people say that you have seen AFC used unfairly and your roles rebanded or numerous other unfair practices used to stop you getting the pay that you as nurses deserve.

    For myself just starting out in the profession I have all this ahead of me, with little or no chance of getting up to band 6 or higher anytime soon without really struggling for it (despite increasingly taking on the roles and jobs entailed in what band 6 is), more work and more hours for less pay, and the added threat of greatly reduced or no pension at the end of it.

    And people wonder why I have decided to get the hell out to Australia or Canada just as soon as I can get my Visa through.

    And to Diana Davies: Others will probably accuse me of abandoning the NHS too, but you know what? I don't care any more. I struggled and sacrificed for years to get my pin and continue to do so to work for an employer (the NHS) that does not deserve my loyalty. The NHS and its penny pinching managers and paymasters in government are systematically destroying the NHS, and now they are even eroding the goodwill of nurses. I'm looking after myself as much as I will look after others now, why shouldn't I?

    This is the legacy AFC will leave.

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  • It is good to hear Mike Travis of the RCN acknowledging the farce of AfC.How disappointing to hear Barry Brown ,the UNITE lead officer for nursing, regurgitate the drivle that employers want to hear by defending AfC. Has he read the results of this NT survey? Perhap those surveyed dont recognise the equal pay & improved conditions that AfC has bestowed upon them!!!.
    To recognise the outcome of the Hartley tribunal over this survey outcome is an insult to nurses.The Hartley tribunal would have no way of knowing what happens on the frontline,unless of course our unions submitted that information. No one has suggested a return to Whitley.The rhetoric of AfC is sound. The implementation is shown to be otherwise. Barry Brown & spokespeople like him do not appear to understand this. But then it is difficult to understand such things if your cosy position & future career depends on not understanding. Why alienate yourself from the powerbase.
    Dishonest implementation is driving experienced nurses out of the NHS & deterring quality applicants from joining.The Unions who signed up to AfC in our name have a responsibility to address the fraud involved.

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  • If we keep on neglecting our nurses, we will lost them and in the end, we find ourselves having more problem than ever.
    Treating them fairly and keeping them are the best and wise thing to do than adding more problems in the future! Sometimes, we need to put ourselves in their shoe in order to understand what they going through. Cutting expenses is not always the best solutions to problems but learning how to budget and use money correctly in a right way and eliminate unnecessary expenses!

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  • It's 5 years on, and as a former employee, I'm STILL waiting for Glasgow to Job Match my last 'F' Grade job. Come on! Who is kiding who about this pay scam!

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  • Overall A4C has been fair and as a charge nurse I am now being paid far more than what I would have been on Whitley, and I'd have been stuck by now on my top increment of a G Grade. On A4C I still have a few to go. However, for a relative minority of NHS staff who work an on-call system, having now waited for coming up on 5 years back-pay for on call work already done, is totally unacceptable, holding on to a considerable sum of money because of lack of budget to pay out what they owe and what we have worked for, in my case often 18-24 hours in theatre. They continue to misuse taxpayers money creating new administrative and nurse director posts with made-up job titles, instead of putting Band 5 and 6 clinical nurses on the floor to provide actual care. Junior staff under A4C are paid their proper hourly rate on-call, while we seniors who assimilated from Whitley are now getting around £4.20 less per hour worked on-call than our A4C hourly rate. It amounts to a lot of money and it's time we stood together to get it sorted, (Unions are worse than useless and have done nothing here in Scotland). Instead of fleeing the country to Oz or Canada (who have their own issues), do something about it and stop having managers, administrators, accountants and politicians dictating how to run the NHS when they have never set foot in a clinical area to appreciate the quantity and quality of work done there.

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  • I am surprised by the issue of pay and that agenda for change was considered to be a forward step. For me I just see it as an exercise to pay less and get more. Most of the RGN's on the whitley scales ended up worst off except of course grade 'g' and above and what a surprise that was .........
    How can it be justified to pay a midwife on band 5. Or a well experienced RGN on band 5. This is rubbish and it is no wonder that nurses and midwives leave this country, but there will always be plenty of nurses or midwives who cannot speak understandable english who will come in and take their place, so is it really an issue, when our pay structure is better than theirs.
    The solution, who knows ...... perhaps less chiefs and more indians.
    May I just mention midwives often do on calls for less than the above mentioned wonderful rate of £4 per hour.

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