Agenda for Change pay deal 2023 - latest non-pay commitments update

Overview

This workstream was led by NHSE with its objective to identify ways that NHS organisations can support registered professionals (such as allied health professionals, nurses and midwives) to successfully move from education into NHS employment. Recognising the relevance of the issue, the group agreed to broaden the scope to include all professions. Two working groups were established:

Group one - Focused on legacy mentoring and personal development. This group explored ways to strengthen current tools and resources to enable universal implementation across all professions. 

Group two - Focused on quality assurance, and explored options on developing and providing systems with tools and resources to allow them to demonstrate commitment and improvement for all newly qualified registrants in their transition.

Conclusion

The final recommendations to be considered by ministers include:

• Development and implementation of newly qualified registrants’ policies at organisation/region or system level.
• Appointment of nominated executives to be accountable for delivery of the ‘newly qualified health registrants (NQHRs) commitment’.
• Implementation of structured transition programmes for NQHRs within all organisations with each integrated care board (ICB) establishing a system-wide practice and professional development team to support this.

NHSE has now integrated this workstream into their retention programme. They are currently rolling out the first-phase interventions with other work such as developing a multi-professional preceptorship quality mark, which is being developed in consultation with established social partnership structures.

Overview

This workstream was led by the NHS Staff Council. The key objective was to agree amendments to the NHS Terms and Conditions of Service (TCS) Handbook to ensure that existing NHS staff do not suffer a detriment to their basic pay when they undertake apprenticeships as part of agreed career development with their employer.

Conclusion

Changes were made to the NHS TCS Handbook to support the preservation of pay for existing NHS staff that develop their careers through apprenticeships. These amendments came into effect on 1 July 2024.

Overview

This workstream was led by DHSC. The objective was to identify specific challenges in relation to recruitment, retention and professional development. DHSC worked with NHSE, NHS Employers, employer representatives from the NHS Staff Council and trade unions to identify ways to improve opportunities for nursing career progression. DHSC undertook evidence gathering through literature reviews, data analysis and qualitative interviews with nurses to understand the barriers and enablers to career progression.

Conclusion

The evidence highlighted five core themes which impact progression:

1. Development culture and line management support.
2. Access to career information.
3. Training and education funding.
4. The pay system. 
5. Equity of opportunities.

Recommendations were made in the following areas for ministers to consider:

• Interventions to improve development culture and consistent support for career development such as promoting the use of career coaches, creation of organisational learning and development committees and greater transparency on how continuing professional development (CPD) funding is spent.
• Actions to increase support and improve career development for BAME nurses such as bespoke career reviews, further guidance for employers on applying the NHS terms and conditions to recognise prior overseas experience, and national support for the work of international nursing and midwifery associations in this area.
• Action to determine the required deployment model of nursing taking account of the NHS Long-Term Workforce Plan, potentially working with pilot sites to gather evidence and test any recommended changes.
• Review by the NHS Staff Council of Annex 20 of the NHS TCS Handbook to clarify that the provisions can apply to nursing roles.

Overview

This workstream was led by DHSC. The objective of this commitment was for the pay setting process and the NHS Pay Review Body (NHS PRB) to operate effectively with the confidence of key stakeholders and NHS staff. DHSC has worked with key stakeholders including the NHS Staff Council and HM Treasury to identify possible areas of improvement under four key themes:

1. Timing of the pay round.
2. The appointments process.
3. The provision of data and the interaction between the NHS Staff Council.
4. The NHS PRB.

DHSC has proposed draft recommendations under these four key themes. Due to further discussion being required and as to not hold up the remainder of the non-pay workstreams, it has been agreed that time-limited conversations will take place between the government and the NHS Staff Council executive to refine these proposals, and to ensure that all parties’ views are considered and reflected in the final report.

Improvements to data sharing between the organisations have been discussed and are being taken forward for the 2025/26 pay round. This includes DHSC sharing the data pack used for written NHS PRB evidence with all organisations, so that they may use the contents in their own written evidence.

A summary of the final recommendations from this workstream will be provided following further exploration with the NHS Staff Council executive.

Overview

This workstream was led by the NHS Staff Council and was asked to consider how the work to maintain and update national job profiles (currently undertaken by the Job Evaluation Group) can be applied fairly and appropriately to aid career development of the NHS workforce. Alongside key stakeholders, the group explored options of how to ensure consistent local job evaluation (JE) processes for all professions.

Conclusion

This workstream submitted its recommendations under these themes for ministers to consider. The group stressed that the recommendations need to be considered as a combined package:

a) Restoring confidence - by reaffirming contractual entitlements:

• explicit ministerial commitment
• activity to ensure oversight, governance and assurance
• enabling agreement from the NHS Staff Council.

b) Building capacity – through improving performance and accountability:

• mandatory coordinated programme to bring employer level practice up to a consistent standard
• delivery plan for how support for remedial action will be provided including guidance to prioritise JE activity relating to band 5 and 6 nursing roles.

c) Investing to modernise – through a digital JE platform:

• national commission for the procurement of a digital solution for England to save time and improve efficiency across all JE activity and provide strategic business intelligence.

Overview

This workstream was led by NHSE. The objective was to provide safe, high quality and effective NHS clinical services and ensure the NHS has appropriate staffing levels. This work involved reviewing existing arrangements, taking into consideration the NHS Long-Term Workforce Plan to ensure there are sufficient staffing levels.

NHSE had already begun extensive evidence-based work to review and update safe staffing guidance as part of a separate commission from the National Quality Board (NQB). As part of the AfC deal, work has taken place to ensure that trade union and employer representatives from the NHS Staff Council can feed into this existing work, alongside independent academics and other national organisations.

Conclusion

Safe staffing guidance is either being reviewed and updated (where this already exists) or being created (where no guidance currently exists) across a range of health service areas. The completion of this work will take longer than the other workstreams, and the publication of the guidance will begin in late 2024/early 2025.

The national Social Partnership Forum will maintain oversight of this work.

Overview

This workstream was led by the national Social Partnership Forum (SPF), who have brought together expertise from across the service. There has already been extensive work in this area from NHSE, therefore the group focused on evaluating existing measures for their level of impact via surveys/call for evidence and focus groups and identifying gaps.

Conclusion

This workstream submitted recommendations for ministers to consider on:

• clear strategy for setting out roles and responsibilities across government, non-departmental public bodies (NDPBs) integrated care systems (ICSs) and regulatory bodies
• national, regional and system working to maximise resources and funding
• mandating the violence prevention and reduction standard which could be through NHS standard contract and assurance through Care Quality Commission (CQC) regulatory processes
• data and reporting including implementation of a common data standard to inform pro-active risk management, and development of a user-friendly digital reporting system
• communication and further support and guidance to organisations on matters such as dealing with clinically challenged patients, withholding of treatment, use of criminal prosecutions and links to the People Promise
• risk assessment, training and support – core training and guidance to be developed by NHS England; standard approach to post incident support as part of the violence prevention and reduction (VPR) standard
• embedding of partnership working in delivery including through SPF structures and joint work with local unions recognising the status and expertise of health and safety reps.

Overview

This workstream was led by DHSC. The objective was to extend the suspension of NHS pension abatement rules for special class status members that were in place during the pandemic, to allow staff to contribute additional capacity to deliver NHS services.

Conclusion

Changes have been made to the NHS Pension Scheme regulations to ensure these staff can retire and return to work in the NHS without the previous limits on how much work they can do when they return. These changes came into effect from 1 April 2024 and the government’s consultation document contains further information about the changes.

Overview

This workstream was led by the NHS Staff Council and the commitment was to identify measures available through the NHS terms and conditions of service, that could help reduce agency spend. Evidence was also gathered via NHSE to understand what drives staff to work for agencies (for example, total reward or flexible working). The group explored how to better showcase the benefits of substantive contracts.

Conclusion

This workstream made recommendations for ministers to consider using the NHS terms and conditions of service, and included sections of the handbook relating to:

• Flexible working – further work through national partners on barriers including how to enable effective technological solution to allow accurate recording and monitoring for national assessment of progress.
• Pay on promotion – reinforcement of the contractual provisions and dissemination of NHS Staff Council guidance.
• Time off in lieu (TOIL) – resumption of NHS Staff Council work on guidance and consistent application of TOIL to support work-life balance.
• Review of Annex 7 (Good practice guidance on managing working patterns) of the NHS TCS Handbook, recognising that it no longer reflects current ways of working and that new employment rights legislation are likely to create additional rights such as shift notice and guaranteed hours.

Overview

This workstream was led by the NHS Staff Council and considered the implementation of a cap of just under £100k via changes to NHS contractual redundancy terms under Section 16 of the NHS TCS Handbook. This would have reduced the maximum redundancy payment agreed in 2015 from £160k to £99,999.

Conclusion

The group explored options which included impact assessments considering financial, legal, operational and equality factors. However, the group did not reach a consensus on any proposal to change the current redundancy cap arrangements.