Effects of Agenda for Change on Psychologists

What is Agenda for Change?

What are the likely implications of Agenda for Change for clinical psychologists and other healthcare staff working in the UK?

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Agenda for Change, implemented in December 2004, is a comprehensive pay reform package for 1.2 million NHS staff. It has brought about improved correlation between career and pay, proving to be the biggest overhaul in this area for 50 years.

As part of Agenda for Change, the NHS Job Evaluation Scheme has helped coordinate rates of pay with a hierarchy of job profiles. The Job Evaluation Group, a subgroup of the NHS staff council, has so far produced over 200 national job profiles.

On a more personal level the NHS Knowledge and Skills Framework was introduced to advance the interrelation between education, development and career progression. This Framework will develop a culture of lifelong learning in the NHS, promoting annual development reviews and encouraging staff learning.

Agenda for Change aims to boost morale and staff retention, as well as improving diversity and family-friendly flexibility. Furthermore, as a result of pay improvements, it is hoped that the system will precipitate long term improvements in every aspect of patient care and service delivery. These changes aim to include a reduction in waiting times, improvement in the quality of treatment/care, and upgraded working practises.

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NHS Job Evaluation Scheme

Job Evaluation attempts to provide a systematic approach to determining the relative worth of jobs within a workplace. The Scheme makes provision for most NHS jobs to be matched to nationally evaluated profiles on the basis of information from job descriptions, person specifications and additional information. National job profiles additionally provide a framework against which to check the consistency of local evaluations.

Job Evaluation itself does not determine the rate of pay it simply produces a hierarchy of jobs. It examines the demands made by the job and the value of the job in the organisation.

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In March 2005 Clinical psychologists profiles were reviewed profiles are intended to apply to all psychologist jobs in the Health Service, (Amicus the Union: 2004).

At the end of March 2006, 99% of all NHS staff had been moved to the Agenda for Change terms and conditions, and since June 2006 the NHS has invested £ 1.1 billion in staff.

The new pay system

The impetus behind Agenda for Change was the need to address pay inequality, Thus the new system aims to create equal pay for equal work, with a series of three pay spines:

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• Doctors and Dentists
• Nursing and Other Health Professionals
• NHS staff, (excluding the most senior managers). (Agenda for Change: NHS terms and conditions of service handbook, January 2005)

Both the second and third pay spine will be divided into nine pay bands, and within each band there will be a number of pay points. The Job Evaluation Scheme determines the correct pay band for each post and thus the correct pay.

The NHS Knowledge and Skills Framework (KSF) and the development review process.

KSF and the development review process is the core of the career and pay progression outlined in Agenda for Change. By October 2005 all staff had – in addition to updated job descriptions – a description of the knowledge and skills needed to do a job. KSF concentrates on how acquired knowledge and skills might be applied in certain areas. (Department of Health: 2004)

Everyone has their own personal development plan, created jointly in discussion with their line manager. Each year there will be a joint review of the work where new targets for development are set. At the first one, the psychologist (or other NHS staff) agrees on a personal development plan with their line manager. The aim is to meet these targets and then move up one pay point. There are two points – called “gateways” in each pay band. The first gateway takes place no later than 12 months after appointment to ensure that the appointee can meet the basic demands of the post. The second gateway is set at a fixed point towards the top of the pay band.

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Implications

Positive

In June 2004 the final draft for psychology job profiles, job evaluation, job descriptions and person specifications was ready. It was a thorough and detailed document, agreed to be beneficial for clinical psychologists. For example, it included a Job description and Personal specification suitable for newly qualified clinical psychologists called Band 7 – 8a, making it possible to move from band 7 to 8 within a couple of years. (Amicus: 2004).

KSF encourages positive learning development and career progression, giving the individual more freedom and control over their career. The objectivity of the frameworks for reviewing and evaluating clinical work can be advantageous. However, evaluations will always be dependant upon the relationship between the persons involved, giving room for differences of opinions and idiosyncrasies.

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Negative

The announcement in autumn 2005 of around 13000 job cuts for nurses in NHS was in part the result of hospital trusts’ efforts to balance the books in the aftermath of the hugely increased wages bill brought about by the implementation of Agenda for Change (The Guardian, 2006).

Although no job cuts for clinical psychologists have been announced, there is a tendency to withdraw funding when vacancies arise. (Amicus: 2006)

The reduced staffing level increases the workload for existing staff, perhaps to a degree that the increased pay doesn’t compensate for.

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Increased demand for back pay^[1]

Conclusion

Although the implementation of Agenda for Change has been fraught with difficulties and economic unrest there are indications that the new system is bringing about positive changes in some areas. In the Agenda for Change Briefing (June 2006) NHS employers stated that ”the reform has been a success story.“ However, many organisations are only now coming to the end of the implementation period and it will take at least a year or two for success criteria to emerge. In conclusion, it is perhaps too early to fairly evaluate the implications for clinical psychologists and other health care staff.

References

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Agenda for Change: NHS terms and conditions of service handbook, January 2005: Available from: ‘http://www.dh.gov.uk/PolicyAndGuidance/HumanResourcesAndTraining/ModernisingPay/AgendaForChange/fs/en’ [Accessed 7/11/06]

Amicus, the Union,: Clinical psychologist and psychology assistant profiles, 2004: Available from: ‘http://www.amicustheunion.org’ [Accessed 8/11/06]

Amicus, the Union: Grading guidance for clinical psychologists,2004 http://www.amicustheunion.org/

Amicus, the Union, Press Release, September 2006: Available From: ‘http://www.amicustheunion.org/’

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Department of Health :Agenda for Change – What will it mean for you? A guide for staff, 11/10/2004: Available from: ‘http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4090842&chk=djtkBc’ [Accessed 8/11/06]

Department of Health: The NHS Knowledge and Skills Framework (NHS KSF) and the Development Review Process (October 2004): Available from: ‘http://www.dh.gov.uk’ [Accessed 8/11/06]

The Guardian, April 24, 2006 ‘Cumbrian nurses finally get equal pay cash’: Personnel Today, Jan 2006

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Footnotes

^[1] See article in Personnel Today concerning the case of hundreds of nurses lodging equal pay complaints as a result of the new NHS Agenda for Change pay system (Personnel Today, January 2006).

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