NHS Pay Review Body's observations on Agenda for Change and seven-day services


The Government asked the NHS Pay Review Body (NHSPRB) to make observations on the barriers and enablers within the Agenda for Change pay system for delivering seven-day services.

In particular the NHSPRB was asked to consider the need for affordable out-of-hours working arrangements and any transitional arrangements.

Danny Mortimer, Chief Executive NHS Employers said:

“We welcome the observations of the NHSPRB in today’s report.  Patients and employers want to see improved and better seven-day services, and employers have consistently told us that the national pay and conditions of service for all NHS staff, need to continue to adapt in order to make them affordable and sustainable.

"In order to support the move to delivery of more services over seven days, as well as other ambitions for a better NHS, employers want to review conditions of service to give them greater scope to address their local patient care and affordability challenges.

"We will continue to speak with our trade union colleagues, to ensure we continue to work in partnership to progress pay and contract reforms. Although we recognise that the recent announcement from the Government of continued public sector pay restraint is likely to make talks more difficult, we hope trade unions will continue working with us in partnership to achieve the reforms necessary to improve patient care across the NHS."

Key message contained in the report:
  • All the parties are committed to improving patient care and providing access to seven-day services where there is an identified clinical need.
  • More work needs to be done to understand the potential productivity gains and cost implications that a move to seven-day services would deliver.
  • The Agenda for Change pay structure, including unsocial hours payments, should support shift scheduling which is linked to patient needs and not skewed by rules around shifts and payments.
  • Agenda for Change presents no contractual barriers to seven-day services, in some cases this is already being delivered by core staff groups covered.
  • A wider move to a seven-day service model will likely require more resources, in particular more staff, and further modelling will be needed to understand the cost implications.
  • There is a case for adjustments to the current unsocial hours’ arrangements but these should be undertaken in the context of a wider review of the Agenda for Change pay structure. If undertaken in isolation there is a risk of negative repercussions on staff moral and motivation. Transitional arrangements will be key to mitigate any adverse impact on staff.
  • All parties should set a deadline for reaching agreement. . It is noted that England is working to May 2016 as a deadline.
  • Good management practice and staff engagement will be crucial and consideration should be given to how to support line managers, along with lessons learnt from the use of early implementer sites.
  • Any changes to the Agenda for Change reward package will need to be seen as fair, in the context of addressing the contractual barriers present in the medical contracts. 

Next steps

We are seeking urgent discussions with the trades unions to explore with them in partnership how these issues can best be addressed. We will keep employers informed of developments using the Workforce Bulletin and our news pages.

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