Tomorrow's Pharmacist (2005)

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What is Agenda for Change?

Agenda for Change, the new scheme governing pay for hospital and primary care pharmacists, was rolled out nationally last December. Gareth Jones describes the key facts

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Agenda for Change is the new scheme governing pay, terms and conditions which was implemented nationwide for all NHS staff except doctors, dentists and senior managers on 1 December 2004.

The national profile for preregistration trainees has not yet been agreed. Once you have registered as a pharmacist, your first job will probably start at band 6 level, from which you can work your way up the payscale (see Panel 1).

Agenda for Change has rasied the ceiling of earnings for pharmacists. Duncan McRobbie, principal clinical services pharmacist at Guy’s and St Thomas’ Hospital NHS Foundation Trust, comments that the experience at Guy’s and St Thomas’ (an early implementer site) shows that Agenda for Change could offer new opportunities for hospital pharmacists. “While the extended length of the pay scale for pharmacists is an advantage of Agenda for Change, national clarity is required about what pharmacists do for their money. This will be advantageous in the long term with a structured career path,” he says.

The hospital pharmacist career path is more attractive under Agenda for Change than under the previous Whitley Council arrangement because it has brought out a new level of clinical practitioner, suggests Dave Thornton, principal pharmacist at Aintree University Hospital NHS Trust. Under Whitley Council arrangements, many hospitals did not have any purely clinical posts above grade D, with grade E and above being only available for management roles. Under Agenda for Change, pharmacists can do basic rotational training and obtain a clinical diploma, stay about three years at band 6, move to band 7 and start to do specialist training, and then move to band 8a as a highly specialist clinical pharmacist. This could equally be applied to technical posts. The difference between a band 7 specialist and a band 8a highly specialist post is the requirement for the latter job to have a higher level of knowledge, training and expertise. “More steps are more easily accessible to more people,” he says.

Mr Thornton comments that under Whitley Council arrangements, newly qualified pharmacists completing a clinical diploma could advance to a D grade post within three years. He says: “Progression under Agenda for Change could be a culture shock because it will not be possible to make such a quick progression in terms of salary.” The key difference across the bands in general is the score for knowledge and skills. The knowledge and skills requirement for bands 6 and 7 is the same, so the difference between these bands is about taking on more clinical responsibility. This could potentially devalue the clinical diploma, suggests Mr Thornton, because it will not get points in the job analysis. Junior pharmacists may question the value of a clinical diploma, although the job profiles for band 7 at Aintree ask for a diploma or equivalent experience.

According to Cath McKenzie, principal critical care pharmacist at Guy’s and St Thomas’ Hospital NHS Foundation Trust, career paths will be better mapped out under Agenda for Change. It will no longer be possible, for example, to undertake a D grade post in elderly care followed by an E grade post in critical care and then a F grade post in medicines information. The career path will be much clearer, although people will need to make decisions about their direction much earlier. In band 7 pharmacists will need to decide what they want to do (eg, clinical pharmacy, technical services, education and training, etc) and then get the experience they need for an 8a highly specialist role.

Terms and conditions

Contracted hours for pharmacists will reduce from 39 per week to 37.5 per week under Agenda for Change (see Panel 2). Ms McKenzie comments that this change is having an impact on the provision of the weekend service at Guy’s and St Thomas’.

Holiday entitlement under Agenda for Change is based on years of service. Staff will receive 27 days when starting in the NHS, rising to 29 days and 33 days after five and 10 years of service, respectively (in addition to general public holidays).

A further change to the terms and conditions is the introduction of gateways at either end of the bands. Rather than automatically receiving an increment every year, as has been the case under Whitley Council grading, staff will need to demonstrate that they have developed sufficiently to continue moving up the band at two points on the scale.

What happens next?

National roll-out of Agenda for Change started last December, following a ballot by Amicus of members of the Guild of Healthcare Pharmacists in the autumn. The agreement is backdated to October 2004. Increasingly, jobs advertised in the recruitment pages of The Pharmaceutical Journal will be under the Agenda for Change format. Roll out should be completed by September 2005.

The implications for pharmacists of Agenda for Change are now starting to become clearer with the experience of the early-implementer sites. There appears to be some optimism among those most closely involved in the process that it should offer hospital pharmacists a fair deal. While salary increases at the lower end of the spectrum may be slower, the ceiling at the top has been lifted allowing all hospital pharmacists to work towards more challenging and better paid jobs.

This article is based on one published in The Pharmaceutical Journal (21 August 2004, p249)