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Fresh threat to national pay framework emerges


The long-term future of a national pay deal for nurses has been thrown into fresh doubt, as a landmark agreement on changes to terms and conditions is set to go ahead.

A deal on proposals to amend the national Agenda for Change pay framework will be discussed by unions and employers at the NHS Staff Council this Tuesday. Nursing Times understands it will almost certainly be approved.

The deal, which has been the subject of long-term negotiations, would see a range of terms and conditions for NHS staff diluted or altered, as health service managers seek to make savings.

But ahead of the deal being rubberstamped, calls have already been made for a debate about whether AfC should be ripped up and replaced by locally negotiated pay and terms and conditions – with the likely outcome that nurses and other NHS staff would be worse off in many parts of the country as a result.

The head of the Foundation Trust Network has told Nursing Times he cannot see how a national deal can survive in the long-term. The network represents trusts given greater freedoms by gaining foundation status.

FTN chief executive Chris Hopson said a debate was needed about the best way forward for the NHS, given the continuing tough financial climate predicted for the next five years.

“It is difficult to see how we can stay with the current arrangements, taking a five year view, with the financial pressures and the need to improve the service,” he told Nursing Times.

Mr Hopson said the network “unequivocally” supported the new AfC deal on the table. But he added: “We need a debate about terms and conditions. Are they right or are they not and what is the best way of negotiating?

“With 10 years of flat cash at best, the NHS needs to take a long hard look at this,” he said, stressing that the network had no pre-decided position on the issue at present.

Christina McAnea, health of health at Unison and chair of the staff side of the NHS Staff Council, emphasised that unions only negotiated changes to AfC with NHS Employers. “We don’t negotiate terms and conditions with the FTN,” she said.

The current proposed changes to AfC have been accepted in consultation exercises by the two largest health unions, Unison and the Royal College of Nursing, suggesting they are unlikely to be stopped – despite opposition from another union Unite.  

The Royal College of Midwives, the Chartered Society of Physiotherapists and the British Association of Occupational Therapists have also accepted the proposals.

The proposals would see automatic incremental pay rise scrapped, with staff expected to meet performance criteria to receive increments.

They would also see the end of enhanced out of hours sick pay, and bring an end to band 5 nurses receiving two increment rises during their first year after qualification.

Senior staff on higher pay bands could also be removed from Agenda for Change entirely and paid an individual spot salary.

The changes have proven controversial coming at a time when NHS staff have been hit with two years of a pay freeze, increased pension contributions and major re-organisation.

Attempts to bring in localised pay deals have also emerged in the past year, most notably in the South West where 19 trusts – including 13 foundation trusts – formed a “cartel” to try and significantly reduce pay across the region.

The South West Pay, Terms and Conditions Consortium is due to announce whether it will proceed with its plans once the NHS Staff Council’s decision on the AfC deal is known. However, separate government proposals for regional pay were dropped by the Treasury in December.  

Ms McAnea said any trust that attempted to impose local pay would be strongly opposed. She said: “Where we have a local trust trying to forge ahead with breaking away from the national agreement, unions will be putting all our effort and resources into stopping that from happening.”

Dean Royles, director of the NHS Employers, the body which negotiates with unions on behalf of health service organisations, said: “I know from my meetings with employers up and down the country they need Agenda for Change to be fit for purpose. This deal will reassure them.”

He said it was important unions were seen to be willing to negotiate if they wished to retain national deals, adding: “I know it’s difficult but this is about mature partnership working in the most challenging of financial environments.

“Get it right and we can start to support employers with the challenging task of implementation. Get it wrong and fragmentation becomes inevitable,” he warned.


Readers' comments (10)

  • How many of the organizations above could be scrapped? How many of these managers are going to change their working conditions for the worst?

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  • From the feeling of various closures (eg A&E), streamlining + consolidation of resources, reduction of duplication and having centres of excellence, how about managing all NHS trusts at a regional level. Scrap all that duplication of purchasing, management infrastructures, along with all the bureaucracies of different policies, procedures + practices of different organizations. We are there to deliver excellent healthcare, which can only happen if staff aren't stressed out with resource issues. Besides a lot of the staff who aren't covering 24/7 are probably not needed anyway ;)
    In London, there's downgrading plans for 6-10 A&Es into Urgent Care Centres. If there's enough resistance, the change will just happen more subtly. The ambulance service will be directing the more serious cases to the 4 trauma centres (like they do now) and the remaining A&Es. Afterall in event of very serious emergencies, it is better where there are more consultants, medics + nurses 24/7. With the breakup of a certain trust, some non-clinical staff were told to be flexible in applying for positions within the London region. It looks like frontline nurses are relatively safe, as there isn't enough in the first place, and coping as well as expected so far.
    If the cartel trusts breaks away from AfC a sabbatical / career break might look good. Commuting to a non cartel trust maybe an option to consider. A colleague commuted about 8 years, with 3 days b+b and return train tickets from Yorkshire to London every week, though tough on family was financially much better off and in stable employment. Yes this was an extreme case.

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  • Have I been asleep for the past few months? The two year pay freeze has now expired. I thought unions were negotiating a new 'deal' for 2013? The last I read, and this came from Camerons mouth, was that a small increase - around 1% was affordable and had been factored in by the goverment. Not heard anything since from either the pay review body or the RCN/Unison on this. Have I missed something?

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  • Why don't they just go the whole way and stop paying us all together, as nurses are just such an unnecessary overhead!!!!

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  • With the centre of workforce intelligence indication that there is a national shortage of registered nurses looming. Combined with the model of care being nurse led in the community. This is madness, nursing agencies will start raking in the profets just like they did in the early 90s - all at the expense of patient care.

    the FTN knows the price of everything and the value of nothing. Unions get real with this network of CEOs who are if they are lucky only in post for a max of 1 year.

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  • There have been reports of some areas in the south-west struggling to recruit good staff to the area. That was with just consultations about local pay. Some areas like London and other conurbations are likely to have real issues with escalation of salaries to attract and retain staff in specialist or unpopular specialties particularly.
    Some really isolated areas may manage to retain staff in the short term but will struggle to attract staff from other areas which give the mix of skills and experience so critical to improve care for patients.

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  • Anonymous | 26-Feb-2013 11:59 am

    Have I been asleep for the past few months? The two year pay freeze has now expired. I thought unions were negotiating a new 'deal' for 2013? The last I read, and this came from Camerons mouth, was that a small increase - around 1% was affordable and had been factored in by the goverment. Not heard anything since from either the pay review body or the RCN/Unison on this. Have I missed something?

    Yes, a 1% 'rise' represents a 14% pay cut in real terms in the last 3 years! Other than that - spot on!

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  • These proposed changes aren't really about economics, rather they are about the Conservative Party's social engineering to make sure all hands-on health care workers - except doctors - are lowly paid again and kept in our place.

    Pay 'restraint' is not just for the next five - and last two - years; it is forever...

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  • Bob on there John Tallon - couldn't agree more with that analysis. In fact if they could weed out the male nurses (the only male staff in a hospital should be the orderlies, porters and the doctors). Stamp out this outrageous idea of the married nurse. Ensure all nurses 'live in'. Allow one half-day off a week. You get the gist.

    Let's get back to hands on nursing being an alternative domestic service!

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  • Anon 8.26pm
    Perhaps they could give the male nurses all the management jobs and make all the women the domestics instead.

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