Implementation of the new pay and career development structure for the National Health Service (NHS) was rushed and has cost more than estimated, according to a report by the think-tank King’s Fund.
For some NHS trust managers, transferring staff to the new system became an end in itself rather than a way to achieve the longer-term benefits of treating patients more quickly and providing a higher quality of care, according to the Realising the benefits? Assessing the implementation of agenda for change report by the King’s Fund. The report advised that unless the Agenda for Change is properly embedded and the associated Knowledge and Skills Framework becomes fully operational, the full benefits for patients and staff will not be realised.
Agenda for Change accounted for all NHS staff, with the exception of doctors, dentists and some managers, and produced a set of pay scales and a training programme. The aim was to ensure fair pay and a clear system for career progression by paying staff not according to their job title, but for the work that they do, and their skills and knowledge.
The deal has taken nearly four years to negotiate and more than three years to put in place, but some issues remain outstanding, such as an agreement on payments for unsocial hours.
Niall Dickson, King’s Fund chief executive, said: “This limited but important study shows that, as yet, there are few signs [Agenda for Change] has delivered increased productivity or transformed practice and there is evidence that many staff are far from satisfied by the process.”
He added that a significant concern raised by the report is the absence of an “independent, robust evaluation of the impact of Agenda for Change, despite the fact that templates for such evaluation have been developed”.