62:'grades' pay scales. A set of national job profiles has been agreed to assist in the process of matching posts to pay bands. All staff will either be matched to a national job profile, or their job will be evaluated locally. In theory, AfC is designed to evaluate the job rather than the person in it, and to ensure equity between similar posts in different areas. In reality it has been implemented differently in different places, and some posts have been graded very differently from similar jobs elsewhere, despite the supposedly tighter definitions. Around 5% of staff appealed their initial banding, but again the appeals process varies from site to site. Current indications suggest that lower bandings are being used in London and Scotland than elsewhere in the country.
230:(sub divided into 4 bands - a, b, c, d) Deputy Associate Director/ Associate Director, Senior Nurse Manager/ Matron, Advanced Pharmacist, Dietitian Manager, Superintendent Radiographer (Diagnostic/Therapeutic), Senior Chief Highly Specialist Clinical/Counselling/Forensic Physiologist, Senior Physician Associate, Chief Biomedical Scientist, Consultant Paramedic, Consultant Social Worker/ Team Manager, Approved Mental Health Professional Manager
66:
onto a different band has become very difficult, as the post would need to have changed substantially in order to be re-graded (even if the person in the post has developed and become more experienced or taken on more responsibilities this would not be seen as a good enough reason to re-band a post). The full implementation of KSF has been slow.
218:
Office
Manager/ Junior Manager, Staff Nurse, Midwife (Newly Qualified), Diagnostic/Therapeutic Radiographer, Dietitian, Emergency Medical Technician, Senior Pharmacy Technician, Occupational Therapist, Physiotherapist, Clinical Physiologist, Operating Department Practitioner (Newly Qualified), Speech
174:, NHS pay was frozen in 2011 for two years, followed by increases capped at 1 per cent. In March 2017 the National Health Service Pay Review Body (NHSPRB), the independent body who advises the government on healthcare sector pay, advised that the public sector 1% pay cap be extended for another year.
96:
The NHS Whitley system had essentially been unaltered since its inception, although there had been some changes. Nevertheless, it had been heavily criticised for decades. These criticisms centred on its structure, complexity and over-centralisation, and its lack of flexibility. There was also concern
177:
In June 2018 employers and unions announced that NHS staff in
England had accepted a deal to reform the current Agenda for Change system and provide a three-year pay deal. The reforms include the removal of overlapping pay points between bands and incremental pay progression no longer occurring on a
233:
Chief
Pharmacist, Very Senior Clinicians managing large/multiple services, Head/Director of Psychology, Head of Adult Services (Social Work), Deputy Board Directors and Very Senior Managers just below Corporate/ Board level responsibility, Directors of services which are not a Board level positions
138:
On 1 December 2004 it was implemented across the UK, with pay and conditions backdated to 1 October 2004. Although most NHS employees in
England and Wales were quick to transfer to the new system with staff receiving their back-pay, Scotland had been slower to implement the system because Scotland
65:
Under AfC, all staff have annual development reviews against the NHS Knowledge and Skills
Framework (KSF). Normal pay progression is one point a year, but pay progression at specified 'gateway' points in each pay band depend on how the individual matches the KSF outline for their post. Progression
106:, decided that the pay of speech therapists, mostly women, was of equal value to higher paid clinical psychologists, mostly men. The differences in pay were because the two groups bargained separately under the Whitley system. This highlighted an important inadequacy of the NHS Whitley system.
226:
Department
Manager, Senior Sister, Advanced Nurse Practitioner, Clinical Lead Dietitian, Senior Radiographer (Diagnostic/Therapeutic Team Leader), Sonographer, Chief Dental Technician, Specialist Clinical/Counselling/Forensic Psychologist, Senior Paramedic, Chief Clinical Physiologist, Highly
222:
Management
Accountant, Junior Sister, Specialist Staff Nurse, Specialist Dietitian, Paramedic, Senior Radiographer (Diagnostic/Therapeutic) Emergency Nurse Practitioner, Health Visitor, Specialist Speech and language therapist Senior Physiotherapist, Senior Occupational Therapist, Biomedical
250:
The Agenda for Change national agreement includes a commitment to introduce a system of annual development reviews and to create lifelong learning development opportunities. Staff have their own
Personal Development Plan, developed jointly in discussion with their manager or reviewer.
113:
was published. It aimed to address the issues of the
Whitley system, and highlighted the need for a change of pay, career structures and terms and conditions of employment within the NHS. It stated that any new pay system must deliver equal pay for work of equal value.
227:
specialist Speech and language therapist, Senior
Physiotherapist, Senior Occupational Therapist, Physician Associate, Biomedical Scientist (Senior Level), Clinical Scientist (after completion of STP), Approved Mental Health Professional, Senior Social Worker
267:. There are three separate bands: Inner London, Outer London and London Fringe. The Inner London rate in 2017 was 20% of salary, with a minimum payment of ÂŁ4,200 and a maximum payment of ÂŁ6,469). Outer London rate was 15% of salary and London Fringe 5%.
214:
Office Supervisor/ Team Leader, Medical Secretary, Personal Assistant, Finance Officer, Assistant Nurse Practitioner, Occupational Therapy Assistant/ Technician/ Support Worker, Nursery Nurse, Pharmacy Technician, Social Work Assistant/ Social Case
57:
The AfC system allocates posts to set pay bands by giving consideration to aspects of the job, such as the skills involved, under an NHS Job Evaluation Scheme. There are nine numbered pay bands subdivided into points, similar to the old alphabetic
134:
Negotiations on the new pay system were concluded in November 2002, allowing full-scale testing of the new Agenda for Change pay system to begin at twelve "early implementer" sites in England in June 2003, with pilot sites in Scotland following.
247:(KSF) is a competence framework to support personal development and career progression within the NHS in the United Kingdom. It applies to all staff except board members, doctors and dentists, as they did not come under Agenda for Change.
274:
called for a flat rate “weighting system” across Greater London in September 2018, saying that living in Richmond was no cheaper than living in Islington and that cost of living was a leading contributor to their staff turnover.
254:
Employers and staff have called for a simplified KSF that is easier to use. In response, the NHS Staff Council has developed a simplified KSF that gives employers more flexibility and can be tailored to meet local needs.
454:
46:. It covers more than 1 million people and harmonises their pay scales and career progression arrangements across traditionally separate pay groups, in the most radical change since the NHS was founded.
211:
Secretary, Health Care Support Worker (Emergency Medicine/ Theatres), Occupational Therapy Assistant/ Technician/ Support Worker, Physiotherapy Assistant, Speech Therapy Assistant, Social Care Assistant
263:
Agenda for Change, like its predecessors since at least 1974, includes additional payments, called the high cost area supplement, intended to relate to the additional costs, particularly housing, of
979:
832:
781:
431:
149:
for the top three bands, 8c, 8d and 9, increments will have to be earned annually, and might not be retained where the appropriate local level of performance is not reached
223:
Scientists, Chaplains, Trainee Clinical Scientist (STP), Social Worker, Psychologist/ Trained Nurse/Social Work Therapist, Trainee Approved Mental Health Professional
953:
755:
927:
942:
730:
937:
850:
291:
609:
932:
806:
836:
139:
took a more robust approach to the implementation. All the signatory organisations agreed to implement it through a partnership approach.
557:
219:& Language Therapist (Newly Qualified), Biomedical Scientist (Entry Level), Social Worker (Newly Qualified), Assistant Psychologist
526:
422:
336:
49:
Agenda for Change came into operation on 1 December 2004, following agreement between the unions, employers and governments involved.
897:
313:
190:
947:
271:
968:
653:
583:
193:, that NHS staff will not be fully subject to the public sector pay freeze when the three-year pay deal end in April 2021.
167:, resulting in about 2,400 employees receiving an increase in salary of up to ÂŁ470 above UK wide Agenda for Change rates.
102:
73:
with tiered employee contribution rates starting at a 5% rate increasing in 7 steps to 14.5% on income above ÂŁ111,337.
921:
375:
171:
164:
994:
146:
incremental pay rises for staff will now be conditional on individuals meeting locally set performance requirements
86:
872:
682:
999:
635:
97:
that the existing pay scales were not easily adaptable to developing equal pay for work of equal value.
974:
505:
501:
82:
810:
27:
975:
e-KSF: The official NHS Knowledge & Skills Framework & Development Review Process System
704:
185:
reducing the number of pay points thus shortening the time to reach the top of the pay scale.
534:
421:
8:
530:
479:
117:
A number of organisations were involved in the discussions and negotiations including:
70:
833:"The NHS Knowledge and Skills Framework (NHS KSF) and the Development Review Process"
371:
178:
yearly basis. The final year of implementation is 2020/21. The objectives included:
264:
152:
for the top three bands employers may introduce alternative local pay arrangements
365:
59:
39:
367:
The Modernisation of the Public Services and Employee Relations: Targeted Change
398:
988:
782:"Chancellor confirms NHS nurses will be spared from public sector pay freeze"
124:
90:
121:
The four health departments of England, Northern Ireland, Scotland and Wales
610:"Why the government's pay rise for NHS workers is barely a pay rise at all"
109:
Negotiations on a new system began in February 1999, when the White Paper
100:
In 1997 an eleven-year-long landmark legal case for equal pay in the NHS,
963:
455:
Realising the Benefits? Assessing the Implementation of Agenda for Change
584:"Lowest-paid NHS staff in Wales to receive living wage increase in pay"
43:
799:
160:
31:
423:"Landmark victory for women in in[sic] fight for equal pay"
731:"NHS Terms and Conditions of Service 2018 - at a glance factsheet"
30:(NHS) grading and pay system for NHS staff, with the exception of
35:
93:
in 1916 and provided a framework for pay, terms and conditions.
654:"Nurses have voted 'overwhelmingly' to accept the NHS pay deal"
208:
Administrative Assistant, Health Care Support Worker, Portering
234:(e.g. Estates, Digital Services, Mental Health Services etc.)
89:
and local government. The system stemmed from work done by
558:"Agenda for Change deal will preserve national pay system"
142:
In 2013 some amendments to Agenda for Change were agreed:
980:
NHS Pension Scheme: 2013/14 Tiered Employee Contributions
452:
363:
954:"Framework agreement on the reform of Agenda for Change"
748:
502:"Support for you: Pay and conditions: Agenda for change"
337:"Fair pay to the NHS? - Agenda for Change five years on"
835:. Department of Health. 11 October 2004. Archived from
677:
675:
636:"NHS Pay Review Body Recommends 1% Pay Cap is Extended"
155:
better protection for staff moved to lower grade posts.
756:
Framework agreement on the reform of Agenda for Change
16:
English National Health Service grading and pay system
773:
601:
81:
When the NHS was established in 1948, it adopted the
898:"Hospital CEO calls for changes to London pay rates"
672:
419:
328:
948:
Agenda for Change national pay scales for 2018-2019
943:
Agenda for Change national pay scales for 2017-2018
938:
Agenda for Change national pay scales for 2016-2017
933:
Agenda for Change national pay scales for 2015-2016
928:
Agenda for Change national pay scales for 2014-2015
413:
851:"Simplified Knowledge and Skills Framework (KSF)"
843:
723:
555:
238:
986:
399:"NHS Pension Scheme - Member contribution rates"
201:Example job profiles within the nine bands are:
809:. NursingNotesUK. 29 March 2017. Archived from
334:
130:Twenty trade unions and representative bodies.
446:
964:NHS terms and conditions of service handbook
900:. Health Service Journal. 17 September 2018
472:
359:
357:
306:
971:, Fourth edition, July 2013, NHS Employers
705:"NHS Agenda for Change 2018/19 Pay Scales"
581:
189:In 2020 the government agreed, due to the
761:(Report). NHS Staff Council. 27 June 2018
779:
633:
354:
807:"Agenda for Change Payscales 2017-2017"
987:
607:
556:Richard Johnstone (27 February 2013).
370:. Palgrave Macmillan. pp. 67–69.
272:Kingston Hospital NHS Foundation Trust
172:financial crisis which started in 2007
163:intends to pay NHS staff at least the
127:– which represents NHS employers
480:"NHS pay modernisation gets go-ahead"
434:from the original on 23 February 2018
420:Patricia Wynn Davies (4 April 1997).
780:Mitchell, Gemma (25 November 2020).
527:"NHS unions endorse new pay package"
482:. Scottish Government. 11 June 2003
258:
103:Enderby v Frenchay Health Authority
83:Whitley industrial relations system
13:
959:. NHS Staff Council. 27 June 2018.
533:. 23 November 2004. Archived from
453:James Buchan, David Evans (2007).
364:Stephen Bach, Ian Kessler (2011).
14:
1011:
915:
316:. NHS Employers. 20 February 2014
294:. NHS Employers. 20 February 2014
52:
335:Richard Staines (21 July 2009).
890:
865:
825:
697:
646:
627:
575:
549:
519:
270:In 2018 the Chief Executive of
494:
391:
284:
245:Knowledge and Skills Framework
239:Knowledge and Skills Framework
1:
608:Dromey, Joe (22 March 2018).
292:"How Agenda for Change works"
278:
182:increasing starting salaries
7:
969:NHS Job Evaluation Handbook
205:Catering Assistant, Cleaner
10:
1016:
634:Ian Snug (28 March 2017).
582:Mark Smith (9 July 2014).
76:
506:Royal College of Nursing
196:
85:, which was used in the
995:National Health Service
683:"2018 contract refresh"
314:"National job profiles"
28:National Health Service
878:. Unison. 1 April 2017
71:a contributory pension
922:Agenda for Change pay
736:. NHS Employers. 2018
460:(Report). King's Fund
159:From September 2014
873:"London Allowances"
531:Scottish Government
1000:Wages and salaries
839:on 7 January 2013.
537:on 6 October 2008
111:Agenda for Change
26:) is the current
20:Agenda for Change
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265:living in London
259:London weighting
42:and some senior
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853:. NHS Employers
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813:on 9 March 2018
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711:. 21 March 2018
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685:. NHS Employers
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191:COVID-19 crisis
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60:Whitley Council
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916:External links
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786:Nursing Times
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660:. 8 June 2018
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902:. Retrieved
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880:. Retrieved
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855:. Retrieved
845:
837:the original
827:
815:. Retrieved
811:the original
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789:. Retrieved
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763:. Retrieved
750:
738:. Retrieved
725:
713:. Retrieved
709:NursingNotes
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699:
687:. Retrieved
662:. Retrieved
658:NursingNotes
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640:NursingNotes
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629:
617:. Retrieved
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591:. Retrieved
588:Wales Online
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565:. Retrieved
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539:. Retrieved
535:the original
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509:. Retrieved
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436:. Retrieved
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765:21 February
740:21 February
689:21 February
165:living wage
69:Staff have
40:apprentices
989:Categories
904:20 October
882:20 October
791:19 January
619:19 January
464:27 January
438:25 October
383:6 February
346:27 January
279:References
161:NHS Wales
857:11 April
593:6 August
567:15 March
541:3 August
511:3 August
486:3 August
432:Archived
320:3 August
298:3 August
215:Officer,
44:managers
36:dentists
77:History
32:doctors
817:1 June
715:9 June
664:9 June
405:19 May
374:
957:(PDF)
876:(PDF)
759:(PDF)
734:(PDF)
458:(PDF)
197:Bands
906:2018
884:2018
859:2017
819:2017
793:2021
767:2020
742:2020
717:2018
691:2020
666:2018
621:2021
595:2014
569:2013
543:2014
513:2014
488:2014
466:2017
440:2020
407:2016
385:2017
372:ISBN
348:2017
322:2014
300:2014
243:The
24:AfC
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