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'Agreeing national changes is crucial to the survival of AfC'


Across the country, employers are discussing the financial challenge facing them in partnership with their staff and trade unions.

They are involving staff in the complex task of adapting service provision to patient needs, maximising efficiency and improving the quality of care through recognising and rewarding innovation and good practice.

With the pay bill making up around 70% of the average NHS organisation’s costs, it’s no surprise that staff terms and conditions are being widely discussed.

We know there are lots of support and ideas from staff on reducing costs and that they are keen to do so in the context of a national pay and conditions framework.

People also recognise that pay systems adapt over time, in light of changing circumstances. Indeed, throughout the history of Agenda for Change, there have been a number of revisions to the system, most often enhancing conditions for staff.

What is less publicly known is the very real commitment employers have to their staff. In particular, they want to use the new local education and training boards to invest in staff training and development. They genuinely want to improve the health and wellbeing of their staff and they want the flexibility to do this.

Pledges to staff are embedded in the NHS Constitution, as is a commitment to involve staff  in decisions that affect them. Employers know that, to meet significant challenges ahead, staff engagement will be crucial. We have some difficult conversations ahead and being open is more likely to lead to solutions.

For some time, NHS Employers has been engaged in discussions with the NHS Staff Council about the changes needed to AfC to keep the framework sustainable for the future. The national staff side organisations are now consulting on employer proposals and this consultation is due to close at the end of July.

We welcome this important conversation with staff. It is vital that employers continue to engage with staff and local unions about the financial and productivity challenges facing them and the need for a pay framework that provides greater flexibility to help meet these.

Our proposals provide a clearer link between pay progression and performance – which is what staff tell us they want to see. They also ensure that staff are recognised and rewarded for their hard work and make adjustments to remove the unsocial hours payment that some staff receive during sickness absence. Our aim is to allow employers more scope to better reward good performance, productivity and contributions to the delivery of high standards of patient care.

Employers and trade unions in the NHS have a long track record of working together in partnership. The financial and quality challenges facing the NHS are widely understood by staff and their managers.

We all know that these are very sensitive issues for nurses, midwives and their unions and we know we have to talk about them. We hope that taking this constructive and transparent approach will enable a national agreement to be reached that is good for patients as well as staff and their employers.

It remains our view that local action outside a revised AfC framework is unnecessary. We believe that  the best way of retaining the benefits of the national pay system is for the NHS Staff Council to agree changes to the national agreement along the lines of our proposals. The future of a national Agenda for Change agreement depends upon it.

  • What do you think of the changes to Agenda for Change proposed by NHS Employers? Have your say at nursingtimes.

Dean Royles is director of NHS Employers



Readers' comments (22)

  • What about your pay and conditions then Dean? Produce and publish a report on how NHS Employees are going to reduce their wages from the board down, and include in this every Chief Executive and Board member of every trust in the land ( Cue argument used by the higher-ups that they need suitable renumeration to attract the best candidates. Does this arguement not cover EVERYONE working in the NHS?)

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  • Seconded redpaddys

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  • I would also add that unsocial ooh payments were crucial to me financially in my previous post, as it was solely ooh. So no I disagree on that alone, and I haven't read the rest of your proposals yet.
    Maybe a link to the horse's mouth NT?

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  • I would also like to see how Chief Execs (especially the ones who have taken it upon themselves to join the cartel in the South west) plan to cut their pay bill.
    Look forward to a brain drain of our best Nurses and Doctors because that's what I foresee.

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  • This whole article amounts to "Management Speak" waffle!

    Make no mistake the "managers" have a hidden agenda the aim of which is to massively reduce the NURSING component of the AfC pay bill!

    The Staff side should refuse any contact with management until the whole agenda is revealed.

    Once the complete management "AGENDA" is revealed then the staff side must respond by demanding that nurse staffing levels/skill mix issues are placed at the top of the agenda for discussion.

    If this is not done the profession will be presented with a Fait Accompli involving further skill/mix dilution. In addition the removal of unsocial hours payments can be expected together with a reduction in sick pay entitlement.

    Pay(Band) scale advancement will cease to be automatic and instead be based on some hair brained scheme involving productivity and be in the gift of local managers who will seek to obstruct advancement.

    A consortium of Trust Chief Executives in the South West is , quite openly, seeking to subvert any national negotiation and all of the issues I mention above are on their their agenda (which was leaked ).

    The time for whining is over!

    Nurses must demand (and actively support) effective representation form their Trade Unions/Profession Organisation.

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  • I have always worked really hard, and left at the end of the day, after staying late, feeling exhausted and not able to offer much more. I know there are loads of stories published about nurses not appearing to work that hard on the wards but they must be the minority. The majority of my colleagues over the years have worked just as hard. When this level of activity is expected as the baseline norm, how is a pay system that 'rewards staff who work hard' going to work, when we literally cannot do any more in a day? It just means that the pay will decrease. And this is why I am so upset by the government's stance about health care professionals as we do work bloody hard and they seem to think we sit on our backsides doing nothing all day.
    Unless we get the same or more money and conditions these pay changes will not be seen positively. I am one of those nurses that have started seriously thinking about moving abroad where the quality of life overall will be better. (Does anyone else have moments of madness and wonder whether it's possible that David Cameron also has control over the weather?)

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  • cut the pay bill of all chief execs within the nhs...lead by example..No thought not!!

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  • And if you need the staff, and you need good staff, you have to pay them and find the money to pay them, rather than expecting to be able to pay less for the same amount of work just because there are large number of them (which are needed, and are in fact not enough in number for the work that needs doing).

    Just because we need loads of nurses and other healthcare staff it isn't a reason not to pay us what we are worth.
    Not sure if I am making sense - I know what I mean :-(.

    Maybe we need to turn it round, and find a miraculous way to get people to take more care of their health so that there is not the demand on services. Maybe Public Health England can help to acheive that...

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  • tinkerbell

    Jenny Jones | 25-Jul-2012 3:58 am

    totally agree. Unfortunatley i think it is all an attempt to undo any achievements that have been made to nursing pay and working conditions and make more cuts and savings at the cost of nurses pay, conditions and providing any quality care.

    They just want to provide a minimum standard of care at the cheapest possible price.

    Our only weapon against changes to our pay and conditions that are also threatening patient care is to say 'NO' loud and clear and be united, but so far this has not happened.

    They realise that nurses are mostly too scared to do anything about it and they can do whatever they like.

    Our unit manager has offered to come in an work a shift with us so it will save me the energy of having to explain what i mean. A picture paints a thousand words. I realise this is a token gesture on his behalf to shut us all up, but still glad that he is volunteering to do it, i hope i am on the shift he works. He'll be run ragged bless him and then hopefully will see that we are only able to provide basic care with our staffing levels. Will it make any difference to our staffing levels? Probably not as his hands are also tied by upper management and budgets, but at least he will understand, if only for one shift why we are all so exhausted and that we work bloody hard for the money.

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  • tinkerbell

    'unit manager' should read 'services manager'.

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