The Pharmaceutical Journal
Vol 273 No 7308 p93
17 July 2004

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Getting ready for "Agenda for change"

More pharmacy staff will be needed

More staff will be needed after “Agenda for change” has been implemented, according to David Miller, chief pharmacist, City Hospitals Sunderland NHS Trust. This is because many will be entitled to extra holiday. Pharmacist weekly hours will also be reduced from 39 to 37.5. Managers are allowed to ask staff to continue to work 39 hours for the first two years, but a problem with this is that grade 8 staff will not be entitled to overtime.

Agenda for change will lead generally to an increase in salaries, particularly at the bottom end, said Mr Miller. As a pharmacy manager, an increased budget will be required to deal with this.

“You need to find time to read about ‘Agenda for change’ [terms and conditions, job evaluation handbook, knowledge and skills framework], as the documents are going to shape your service for probably the next 15 years,” said Mr Miller.

The process of implementing “Agenda for change” started with updating job descriptions, and then identifying “families” of similar roles. Mr Miller said that the approach taken in his department was that if a member of staff thought their role was different from others the role would be considered individually — for 100 staff there were 34 job families. Representatives from each family attended matching panels, made up of equal numbers of staff and management representatives. Managers were not informed of staff bands until the post holder had been informed.

Outstanding pharmacy issues include payments for emergency duty, overtime at weekends and recruitment to cover increased holidays and reduction in working hours.

The practice of giving staff additional incremental points will not be available under “Agenda for change”. It will also not be possible to bring staff in half way up a band, as can currently occur — apart from at assimilation, everyone must start at the bottom of the band. Pharmacy-specific deals will no longer be allowed.

Points win prizes — or salaries

Under “Agenda for change”, jobs will be evaluated against 16 factors (see panel), made up of three families (knowledge and skills, responsibilities, and effort and environment). The role will be scored against each of the 16 factors, with a weighted score generated for each factor. The total score will determine what band a job is graded in, therefore “points mean prizes” or, in this case, “salaries”, said Ron Pate, pharmaceutical adviser (secondary care), West Midlands Strategic Health Authorities, and former chairman of the Guild of Healthcare Pharmacists terms and conditions committee. Many jobs will be matched to an agreed national profile (of which there are six for pharmacists), and will not therefore require a full job evaluation. Jobs that do not match will undergo the full job analysis process.

“Agenda for change” is really about modernising service delivery, and not about pay as many people think, according to Mr Pate. Patients want to be able to access health services 24 hours a day, seven days a week, and “Agenda for change” should mean that this service can be offered. It also replaces a large number of pay schemes for individual groups within the health service, and is intended to provide a fair reward and equal pay for work of equal value.

The initial negotiations for “Agenda for change” were concluded in November 2002, but union members are unlikely to be balloted on the final deal until September or October. The full roll-out would be likely in December, with the agreement backdated to October 2004. On-call pay and unsocial hours pay are both areas which are still of concern, said Mr Pate. With the implementation period approaching, he advised all pharmacy staff to update job descriptions and person specifications.

Under “Agenda for change”, everyone employed by the health service, excluding doctors and some senior managers, will move on to one salary spine. The new grades will lead to a different career structure, and the employer will have a formal requirement to provide training for staff to help them progress along their career pathway.

New pay scales mean new career pathways

Career paths for pharmacists in the NHS under “Agenda for change” will look different from the way they are under the Whitley Council system, according to Tony West, president of the Guild of Healthcare Pharmacists and chief pharmacist, Guy’s and St Thomas’ NHS Trust, one of the early-implementer sites. The new structure may mean that pharmacists start at junior level after qualification, and progression is to senior, specialist and then consultant level.

Whitley grades do not map directly across on to “Agenda for change” bands, according to Mr West. It is the job that is done that is important, not the current grade. It is, therefore, not possible to predict what band a job will be in until the job evaluation has been completed. In particular, there is no equivalent of the current D grade under “Agenda for change” — experience to date indicates that some D-grade posts are put into one band and others are put into another. This is a problem because it is the most widely used grade across the UK. “Recruitment and retention premiums” may be needed to enhance salaries for new starters in these posts.

It is recognised that there is a bias in the system against non-clinical jobs, such as a secretary, according to Mr West, but this is being addressed with new guidance on how experience is recognised.

Following the initial agreement of “Agenda for change” in 2002, a 10 per cent pay increase was promised over three years. Mr West reminded participants when looking at the new pay scales that two-thirds of this increase has already been made.