Agenda for Change could be a missed opportunity
Agenda for Change will be a missed opportunity if NHS trusts see it as just a new pay system, rather than a chance to redesign jobs and services, according to Andrew Foster, who recently resigned as director of workforce at the Department of Health.
In an interview with the British Journal of Healthcare Management Mr
Foster said: “AfC can be used to maximise improvement, to redesign
jobs, introduce flexibility, and to use the knowledge and skills framework
as a driving force to get the right types of knowledge, skills and behaviour
into organisations. Unless trusts maximise AfC, I worry that there will
have been a billion-pound investment into higher pay, not more flexibility.”
While discussing AfC, Mr Foster dismissed charges that pay reform in
the NHS had been badly managed, leading to large cost over-runs.
“We’re cautiously saying that its overspend is just over £100m
which, with a non-medical total pay bill of over £30bn, is like
landing a supertanker on a sixpence,” he said. Mr Foster pointed
out that the public’s top priority for the NHS identified by consultation
and set out in the DoH’s NHS plan in 2000 had been “more
staff, better paid”.
He also claimed that most of the 8,000 job cuts announced by NHS trusts
over the past few weeks were not real job losses involving people losing
their jobs. Rather, they were “post losses” to be brought
about by natural wastage or reduced use of agency staff. They also amounted
to little more than “the slightest foot on the brakes” in
an organisation that had created 198,000 new jobs since 2002.
However, Mr Foster was critical of disjointed management in the NHS up
to the highest level of the DoH. Activity planners tried to meet DoH
waiting list targets, financial planners tried to hit DoH financial targets
and workforce managers tried to meet their [own] targets.
“Far too often, those three have not spoken to each other,” he
said. At the same time, former NHS chief executive and DoH permanent
secretary
Sir Nigel Crisp maintained that any problems were a result of poor management
in the NHS. “So the two groups [NHS and DoH] who should have been
working more closely together than anyone were polarised.”
Mr Foster welcomed a recent statement from acting NHS chief executive
Sir Ian Carruthers that corrosive and blaming behaviour in the NHS and
the DoH had to stop.
He added that whoever was appointed chief executive would need to understand
the NHS’s staff and its values culture. |
The
Pharmaceutical Journal
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