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Money, money, money: agenda for change

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Confused about how much money you can expect to make once you’re qualified? Agenda for Change does the penny-counting for you 

As the name indicates, Agenda for Change (AfC) was once a proposal for pay system reform in the NHS. Now that it has been accepted and put into place, AfC is the pay system under which nurses, midwifes and most other NHS employees are paid.

AfC sought to fix an out-dated system which decided salaries not by the amount of work someone carried out but by their job title.

Agenda for change aims to:

  • Make sure that employees with similar amounts of training and requirements receive similar paychecks
  • Link career progression and pay progression for employees
  • Address various other basic elements of employment like payment and sick leave

How does it work?

Employees in the NHS are divided into nine pay bands based on the amount and the difficulty of work their job requires.

Each pay band comprises a number of pay points.

The system is set up so that an employee will generally move up one pay point per year until he or she reaches the end of the pay band.

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Progress through the pay points is not always based on time, though. At two pay points called “gateway points” an employee must be able to demonstrate certain skills and knowledge to move forward.

Gaining experience and qualifications can help move you up to a higher band with a higher salary.

For example, in band 5, there are eight pay-points covering the salaries between £21,176 and £27,625. If you were to move from the third pay-point to the fourth, your salary would increase from £22,676 to £23,589. Once you reach the eighth pay-point, an increase in salary will only come with moving to the sixth band.

Taking it home to the bank

 A registered nurse begins their career at band 5 with the entry-level payment of £21,176.

While waiting for their NMC pins to arrive, some newly graduated nurses will choose to work as a healthcare assistant. This job is on band 3, and the entry-level payment is £15,860.

Changes for AfC

True to the name, AfC undergoes periodic review.

Currently, the 2012/3 Pay Review Board is considering increasing the salary of staff with a salary of £21,000 or less. But this proposal has not yet been accepted.

The latest pay scales are those from April 2011.


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