NHS should scrap AfC and get back to basics on pay

As any cost/benefit analysis would show, Agenda for Change (and pay reforms for doctors) has been an unmitigated disaster for the NHS, costing hundreds of millions of pounds to implement, and even more to assimilate staff onto the new grading system.

However, I take issue with the suggestion that local pay determination was divisive, ineffective and conducted by ‘maverick’ trusts. Rather, it was the creative thinking of unorthodox HR leaders that utilised local pay freedoms to redesign jobs – models which are now being extolled 10 years later as ‘benefits realisation’, allegedly emanating from Agenda for Change.

In the 1990s, attempts were made to pay employees according to their levels of competence and performance, linked to appropriate labour market conditions. The innovative work of the local pay pioneers was ahead of its time, but largely disregarded by national representatives of employers and trade unions, who instead have created a bureaucratic nightmare for HR departments, which will inhibit change and modernisation in the NHS.

If foundation hospitals follow the courageous lead taken by Southend University Hospital – which ditched the Agenda for Change in favour of locally negotiated terms (Personnel Today, 4 July) – then the whole edifice will come tumbling down within the next two years. HR staff would be able to get back to delivering policy and strategy through reward management appropriate to the needs of staff and patients at local level, while the architects of Agenda for Change would be left scurrying for cover.

Ken Hutchinson

Managing director,

HR Strategic Solutions




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