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Agenda for Change: how will the new structure affect you?

Mike Smith

The Whitley Industrial Relations system and more recently, the Clinical Grading system, have been heavily criticised for their structure, complexity, lack of flexibility and failure to offer equal value to workers within the NHS. Agenda for Change aims to reform the current pay, career structure and terms and conditions for NHS staff (excluding doctors and dentists). Agenda for Change will offer a significant pay increase for nurses over the next 3 years with other benefits including increased holiday entitlement and improved career structure. This article outlines how the new structure will affect diabetes nurses and how to get a head start.

The fundamental principle underlying Agenda for Change is equal pay for work of equal value (Department of Health, 2003). Agenda for Change is currently being demonstrated within the 12 early implementer sites, placed throughout the UK. The project will be implemented throughout the NHS by October 2004.

Agenda for Change will replace current Whitley terms and conditions of service later this year and will include three separate pay spines:

  • Nurses and other healthcare professionals covered by the pay review body.
  • Non-pay review body staff. 
  • Doctors and dentists.

Agenda for Change will radically overhaul the NHS pay system. It introduces a new job-evaluated pay structure and creates a common set of conditions. It will merge literally hundreds of separate pay scales and grades into three spines and will create a new single pay negotiating forum for all NHS workers.

Job evaluation
Basic pay will be decided through job evaluation. Many posts have already been evaluated and placed into the appropriate pay band. Jobs not yet evaluated will be placed into the correct pay band following detailed assessment at a later stage.

There are eight new pay bands, each containing several pay points. Within each pay band progress is made annually, one pay point at a time, until the top point of the pay band is reached.

The job evaluation is a system which enables users to compare different jobs. In simplistic terms it measures the size of one job in comparison to another. For example, the Director of Nursing can be judged to have a ‘bigger’ job in comparison to a Staff Nurse. Job evaluation establishes the relativities between jobs and forms the basis for grading jobs in the new pay structure. Job evaluation measures the job (i.e. how big it is) and not the person who holds the post. Job evaluation cannot be considered precise. However, it is clear and systematic in its approach.

To formulate job evaluation all NHS jobs were measured using identical factors (16 in total) which can be seen in Figure 1. These included knowledge and skills, responsibilities, effort and environment. Each factor has been divided into a range of different levels which depict the impact that a factor has within a job. The different levels are then each allocated points and the total score of all the levels under each factor shows where each job stands in relation to every other job in the NHS (i.e. how big it is in comparison to another job).

The total score for the job will then place the job within a band. It is anticipated that most specialist nurses will be assimilated into bands 6 and 7. However, if enough points are scored, people will be placed into a higher band regardless of their job titles.

If you wish to evaluate your own job the process is simple. Firstly, download the Job Evaluation Booklet from the Department of Health website ( Then follow the booklet systematically as per the detailed guidance offered. If you ultimately disagree with your job banding, you have the capacity to appeal. Appeal is through a standard form which is scanned and evaluated. You can then be reviewed by the job evaluation panel who comprise two trained NHS managers and two trained staff side employees. Their decision is final; you cannot appeal beyond this point.

Knowledge for Skills
Everyone is expected to develop skills and knowledge to improve their performance and the service. Knowledge for Skills will indicate the knowledge and skills that are needed for each post. Every nurse will undergo a yearly development review with their line manager, and agree a personal development plan. Successful development will allow progress through the pay points to the top of the band.

Knowledge for Skills is a common description of the knowledge and skills applied in all NHS jobs. These are applicable and transferable across the entire NHS. Knowledge for Skills will be designed to be simple and easy to explain and understand and will be easily implemented. In addition Knowledge for Skills will be available electronically to all personnel. They will be somewhat similar to core competencies.

In order for each nurse to progress through the pay points to the top of their pay band they will need to pass through a minimum of two ‘gateways’ positioned at strategic points within the pay band. Passage through a gateway (and thus progression to higher pay) will only be possible if Knowledge for Skills is achieved and agreed as part of the personal development plan. However, it is important to note here that Knowledge for Skills has not yet been implemented and is unlikely to be before the launch of Agenda for Change later this year. Authorities have made it clear that in the absence of Knowledge for Skills no-one will be disadvantaged and all staff will automatically pass through gateways until Knowledge for Skills is fully implemented.

The benefits of Agenda for Change
The proposals mean a pay increase of 15.5% on basic pay over 3 years for nurses. For the first year nurses will receive a pay increase of 3.225%. When Agenda for Change is implemented in October 2004, nurses will receive another 3.225% plus 2.7% for assimilation. In the third year nurses will again receive an increase of 3.225% plus 3.1% as part of their incremental pay increase as can be seen in Figure 2. These figures are based on General E Grade nurses.

Specialist nurses can expect to receive a pay rise of approximately 11% over 3 years from implementation. Specialist nurses will mainly be assimilated into the higher bands. These start at band 6 rising to band 8 (Figure 3). Within band 8 there are four distinct levels (A–D). It is clear from the banding that the pay rates are wider than in the current grading system. This demonstrates the benefits to nurses giving them more scope

within their career to develop and progress without the overly tight restrictions of clinical grading. It is important to state here that nurses need to consign clinical grading to the dustbin. Referring back to it will be of little benefit; nurses must now focus on their particular job and its size and not rely on an arbitrary label afforded it as a consequence of clinical grading.

Annual leave entitlement
There are significant improvements to annual leave entitlement for nurses as can be seen in Figure 4. However, nurses who leave the NHS for a period of 12 months or more will automatically revert to the start position and be treated as a new employee.

Update your job description!
The job description describes the role. It is therefore critical that your job description is up-to-date and accurately reflects your job. If your job is not automatically assimilated, then your job description will be used for the job evaluation. It will be impossible for the job evaluation panel to evaluate your job properly without an accurate and up-to-date job description. Many NHS trusts have now issued clear guidance on how to update job descriptions. This usually entails having full agreement of your line manager prior to, during and on completion of the updating process. Please ensure that you comply with the policies of your trust before embarking on any changes to your job description. Each NHS trust has a human resources lead for Agenda for Change and a union representative who is an expert in this area. Both can be identified through the human resources department.

Detailed guidance on how to write a job description in preparation for Agenda for Change is given on the Royal College of Nursing website ( agendaforchange/overview/resourcecentre. php).

The Guardian newspaper offers a neat summary of the Agenda for Change:

‘Any new pay system, particularly one based on job evaluation, throws up relative winners and losers. Sources close to the talks say certain key groups – such as nurses – are likely to benefit most.’ (The Guardian, 28 November, 2002)

This was written prior to early implementer site commencement and it is now clear that nurses are the winners. Agenda for Change heralds a bright new dawn for nurses.

Nurses can at the very least expect improvements to pay, conditions and careers. Agenda for Change will apply UK- wide and include foundation trusts. It will hopefully have a positive impact on recruitment and staff retention. The government has given reassurance that the Agenda for Change will be ‘fully funded’, have a ‘robust implementation infrastructure’ and has been fully ‘negotiated in partnership’ with the Staff Side (union representatives and other non-management staff; Department of Health, 2003).


Department of Health (2003) Job Evaluation Hand Book. Department of Health, London

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