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Agenda for Change at a glance  

Agenda for Change is the most significant reform of NHS pay
since the creation of the health service in 1948. 

Supported by the NHS Job Evaluation scheme (JES) and the Knowledge and Skills Framework, the pay system was designed to: 

  • deliver fair pay for non-medical staff based on the principle of equal pay for work of equal value
  • provide better links between pay and career progression using the new NHS Knowledge and Skills framework
  • harmonise terms and conditions of service such as annual  leave, hours and sick pay, and more recently for work performed in unsocial hours.

How it works

Staff are placed in one of nine pay bands on the basis of their knowledge, responsibility skills and effort needed for the job rather than on the basis of their job title. The assessment of each post using the Job Evaluation Scheme (JES) determines the correct pay band for each post, and so the correct basic pay. Within each pay band, there are a number of pay points.  As staff successfully develop their skills and knowledge they will progress in annual increments up to the maximum of their pay band,  At two defined "gateway points"  on each pay band pay progression will be based on demonstration of the  applied knowledge and skills needed for that job.

Benefits of Agenda for Change

The new pay system provides benefits for both individual staff and for NHS employers. For employers the system provides greater flexibility to enable them to:

  • devise new ways of working that best deliver the range and quality of services required, to best meet the needs of patients
  • design jobs around the needs of patients rather than around grading definitions
  • define the core skills and knowledge they want staff to develop in each job
  • pay extra to address local recruitment and retention difficulties.

For staff the key benefits include:

  • a system that is fair and transparent
  • recognition and reward for the skills and competencies staff acquire throughout their career
  • harmonised conditions of service.

Role of NHS Employers

At national level, NHS Employers Pay and Contracts team supports employers and the devolved administrations on the NHS Staff Council and its Executive.  The NHS Staff Council is a partnership body and has overall responsibility for operation of the pay system in respect of NHS-wide non-medical terms and conditions.  

At a local level, NHS Employers supports employers, offering  advice and guidance on a range of pay and terms and conditions issues and on articulating the aspirations and concerns of employers.  

If you are an NHS employer and need advice you can contact the Agenda for Change team (using the contact details on the right hand side).  If you are an employee and have a query on Agenda for Change, you should,  in the first instance, contact your human resources or personnel  department.

The key Agenda for Change documents can be accessed using the links on the right hand side of this page.

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