More work needed if AfC is to improve patient care
NHS staff do not all have personal development plans yet |
Agenda for Change, the pay system for NHS staff rolled out nationally in 2004, is unlikely to fulfil its potential in terms of improving patient care, or be worth its cost, unless more systematic efforts are made to use it in the way it was intended, a King's
Fund report concludes.
In the first independent report on the impact of the new pay system,
the King’s Fund says that AfC was designed to facilitate and reinforce
improvements in skills, roles and motivation.
However, based on case studies of 10 trusts and interviews with officials,
union representatives and managers at national and strategic health authority
level, the King’s Fund says that implementation of AfC was rushed
and has exceeded all cost estimates. “For some NHS trust managers
transferring staff to the new system became an end in itself rather than
a way to achieve the longer term benefits of treating patients more quickly
and providing higher quality of care.”
The report also concludes that the accompanying Knowledge and Skills
Framework has not been fully implemented and not all staff have personal
development plans in place.
Commenting on the report, David Miller, chairman of terms and conditions
at the Guild of Healthcare Pharmacists, said that AfC was simpler and
more transparent than previous pay systems and provided some protection
from equal pay claims. “The reality is that the previous Whitley
system was becoming a mess. It was a hindrance to modernisation and the
development of new roles,” he said.
However, he added that, although AfC has facilities to provide local
and national flexibilities to address the distortion in the pharmacy
pay market, there is an understandable reluctance by employers to upset
the system so soon after its implementation and fully embrace the need
for recruitment and retention premiums. But, he said, in his area, collaborative
work has begun with NHS Employers, Unite, the Department of Health and
the secretariat of the pay review body to investigate evidence of the
need for supplementary payments on a national level.
The King’s Fund report makes several recommendations, including
that a systematic, independent audit of the cost and impact of AfC should
be carried out so that lessons can be learnt and any necessary changes
made. It also advises that progress with implementation of the KSF should
be reviewed. “It must be kept simple, robust and properly resourced
in order to build staff confidence that the system is designed to deliver
career improvements,” it says.
Senior managers’ pay A framework
for “very senior managers” payin strategic and special health authorities, primary care trusts and ambulance
trusts has been published by the Department of Health. It covers chief executives,
executive directors (except medical directors and directors of public health)
and others with board level responsibility who report direct to the chief executive.
It is designed to help recruit, retain and motivate high calibre staff and is
consistent with the principles of other pay reforms, such as AfC. |
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