Frequently Asked Questions
What is Agenda for Change (AfC)?
Agenda for Change is the UK wide pay, terms and conditions agreement for all NHS staff, apart from doctors, dentists and very senior managers. AfC seeks to ensure equal pay for work of equal value, harmonise terms and conditions of service and provide better pay and career progression. The agreement sets out pay rates, incremental pay progression, what constitutes unsocial hours or overtime, maternity arrangements, annual leave, sickness absence, facility time, and many others. You can find all the details in the NHS Handbook.
What is happening around AfC at UK level?
As you may be aware England only revisions to Agenda for Change were consulted and agreed on last year in response to a number of NHS trusts in England attempting to ‘break away’ from the national agenda for change agreement. Members in these trusts had to organise, campaign and take industrial action to try and stop the employers reducing terms and conditions and moving to local contracts. As a result of members accepting the England only revisions to agenda for change, this halted break away trusts from pursuing local agreements and has ensured that the national agreement was maintained.
What is happening around AfC in the Wales?
Health boards in Wales need to find savings of between 4-5% each year over the next three years due to a cut in funding from the UK Westminster government to the Welsh government. In fact the Welsh government is putting an additional £570 million into NHS Wales over that period, but this is still not enough. Of the 4-5%, the health minister is looking at finding 1% of those savings from staffing costs.The NHS unions have only agreed to consult our members on these proposals on the basis that staff costs are looked at across the board, including doctors, dentists and senior managers. It is also important to note that the proposal on offer is a significant improvement on the original proposal tabled by the employers which included the Agenda for Change changes which mirror those agreed in England, plus cuts to annual leave entitlement, changes to unsocial hours payments, two years of incremental freezes and a two year pay freeze of pay uplifts. The removal from the proposals of all these additional elements are a direct result of the input the trade unions have had in the negotiations.
What is the current proposal?
The current proposal which we are consulting members on is:
- Changes to incremental progression based on performance, changes to flexibility on senior posts, changes to accelerated pay progression for new entrants to pay band 5, changes to the management of sickness absence and new guidance on workforce re-profiling.
- New mileage rates.
What do the proposals say about incremental progression?
The proposals outline changes to incremental progression so that progression through all pay points in all AfC bands will be based on performance – in effect, creating a gateway on each spinal point. If the proposals are accepted, individuals will be required to demonstrate that they meet the performance requirements before they can move onto the next pay point. Clearly this is dependent on staff having access to an appraisal process. In circumstances where staff do not have access to an appraisal process, increment cannot be withheld. Staff in bands 8c, 8d and 9 will have to earn their increments, but in addition to this, they will also be required to demonstrate their performance each year in order to maintain their incremental level. Staff who are already on the top of their pay band will not be affected.
What about preceptorship?
Newly qualified staff joining at pay band 5 currently have an accelerated pay progression through the pay points during their first year of employment. The proposal is for this provision to be removed.
What do the proposals say about sickness absence?
The proposals include changes to pay during sickness absence, which would mean that all staff above pay point 8 – which is midpoint band 3 and above – would be paid at the basic salary allowance during periods of sickness. So no enhancements or allowances would be paid whilst a person is off work sick. This would not apply if the absence was due to a workplace injury or sickness.
What will the new guidance on workforce re-profiling mean?
This process of negotiation has presented an opportunity for us to raise areas where we have previously had concerns. Since the implementation of AfC we have seen staff pooling around certain bands – for example bands 3 and 5 – but the intention of AfC pay was to provide clear and real career progression that is available to the entire workforce. New guidance around job profiles will, in the long term, provide a better and clearer career structure which will allow fair pay for work of equal value across the NHS. It will also limit the opportunity for the employer to down-band jobs.
What would the new mileage rates be?
The proposal is for the mileage rates to be brought into line with the HMRC approved rates – currently that rate stands at 45p per mile up to the first 10,000 miles and then 25p per mile thereafter. These rates are not subject to tax deductions.
Are these permanent changes?
These proposals, if implemented, will be for a three year period. With effect from 1 April 2017, the Agenda for Change terms and conditions and mileage rates would revert back to as they are nowunless a new agreement is negotiated before that date.
Why can’t the Welsh government ask Westminster for more money to fund the NHS in Wales?
The Barnett Formula is a mechanism used by the Treasury to calculate the amount of money given to the devolved nations by the UK Westminster government and was established in the late 1970s. It is based on the population of each devolved nation as opposed to the ‘health and economic needs’ of each country. In reality it was a formula introduced when all nations of the UK were directly governed from Westminster, which is now not the case. This funding formula means that the Welsh government receives less funding from Westminster than the other devolved nations and this shortfall in funding has led to a significant financial deficit in NHS Wales’s finances.
Can these challenges be met by current cost improvement or savings plans, or by working more efficiently?
A review of the published accounts of NHS Wales reveals a huge financial deficit and despite the Welsh government putting additional money into the NHS, there is still a significant shortfall in funding. Health boards in Wales have been asked by the Welsh government to draw up cost improvement plans and currently this has happened without resorting to cutting the pay, terms and conditions of their staff. The sheer scale of the cost savings needed by NHS Wales means that 1% of these savings will need to be found from staffing costs including NHS staff on Agenda for Change and doctors and dentists who are paid under a different agreement.
I have heard up to 9,000 NHS jobs could be safeguarded if we accept these proposals?
UNISON along with the staff side trade unions has been meeting throughout 2013 to establish a way forward. The aim was to explore those areas of Agenda for Change which might be amended to support an overall reduction in costs associated with pay while continuing to protect jobs. The current proposal from NHS employers is a three year deal, after which (depending on the financial situation in 2017) the Agenda for Change terms and conditions would revert back to the current status quo. It is clear from the costings given to the unions by the Welsh government that by accepting these proposals jobs will be safeguarded, although there is no absolute guarantee of no compulsory redundancies.
What will happen if I reject the current proposals?
England only revisions to Agenda for Change were consulted and agreed on last year in response to a number of NHS trusts in England attempting to ‘break away’ from the national Agenda for Change agreement. As a result of members accepting the England only revisions to Agenda for Change, this has halted break away trusts from pursuing local agreements. If these proposals are rejected in Wales, the Welsh government has indicated that it will instruct the individual NHS Health Boards in Wales to find the financial savings needed on a board by board basis.
The likely situation is that a number of these Health Boards would have to reduce the terms and conditions of staff and move staff to local contracts (dismiss and re-engage staff) and that these new contracts would include cuts to terms and conditions that go further than those in the current proposal. UNISON believes that members would need to be prepared to take industrial action on a board by board basis in order to halt moves by Health Boards to impose local arrangements. We also believe this could lead to the dismantling of Agenda for Changes in Wales.
What will the impact be on the local economy?
Moving staff onto local contracts and pushing down the wages of NHS staff covered by Health Boards will have a massive knock-on effect to the local economy, reaching far beyond staff employed by NHS Wales to workers in the public sector, private sector and even those who are not employed, as spending drains from the local economy. Studies have found that a regional pay system across the UK would take a £10 billion slice out of the value of the economy.
What will be the impact of regional pay?
Regional pay in Wales will:
- Drive down wages – employees would suffer most under a regional pay system because private sector pay rates allow employers more scope for pay cuts.
- Push already high workloads and stress facing staff to breaking point – although high unemployment levels may hide the effect in the short term, in the long run it will damage the ability of health boards to recruit good staff and hold on to them.
- Deliver a blow to gender equality – as in all regions of the NHS, women make up the majority of the NHS Wales workforce who would be hit by regional pay.
- Fragmentation of the Agenda for Change agreement – Wales would be the only devolved nation not covered by the agreement. In the longer term, it would mean that NHS staff in Wales could have worse pay and conditions then staff in England, Northern Ireland and Scotland.
- Create a costly, bureaucratic system of local negotiations that has been tried before in the NHS and failed – even by the admission of employers themselves!
What happens if these financial challenges cannot be met?
Threats to pay, terms and conditions are all a result of a shortfall in funding of NHS Wales from the Westminster government. Alternatives can be explored by re-examining procurement processes and contracts, looking if there are opportunities for cost sharing, looking at where green savings can be made in the organisation and in turn this would help meet the health boards’ environmental impact targets. The sheer scale of the financial pressure in NHS Wales means that savings will need to be made from staff pay costs. Currently the Welsh government has said there are no plans for compulsory redundancies; however UNISON believes that if efficiency savings are passed to individual health boards to find, then jobs may be cut.
Why are NHS Employers looking at staff pay, terms and conditions?
NHS employers are looking at changing staff terms and conditions as part of the proposal as staffing costs make up 60-70% of a health board’s out-goings. UNISON acknowledges that NHS Wales has financial challenges and that it has to make savings, however many of the health boards have already made service cuts which in turn have put pressure on their existing workforce. We will, however, continue to work with them to find further non-pay savings where this is possible.
UNISON is committed to working in partnership with the other staff side unions, NHS Employers and the Welsh Government at a national level to discuss workforce planning and address the productivity challenges thrown up by the financial constraints facing NHS Wales. Government wants the health boards to meet other non-staff/pay related savings in partnership with trade unions.
Can NHS employers dismiss and re-engage staff on new pay, terms and conditions, as I've read and heard about?
Yes. There are very clear legal requirements on employers to explore options that don’t involve dismissal and conduct meaningful consultation over any proposal they come forward with. These issues are set out in the UNISON ‘Tackling dismissal and reengagement strategies’ factsheet available in the negotiating and bargaining section of the following webpage: unison.org.uk/for-activists/help-and-advice/supporting-members
However, ultimately defeating such aggressive tactics by the employer will often come down to organising a powerful campaign of opposition, including industrial action.
Do these proposals affect me?
In theory the proposals could affect everyone working for NHS Wales as these proposals are a three year deal to change the current agenda for change agreement. However, if you are already at the top of your pay band and do not take sick leave, then you will not be affected unless you use your car for NHS business. There is also protection for the lowest paid. Our belief is that there will be wider implications if this proposal is rejected and Health Boards start moving staff onto local contracts, as these changes will drive down pay, drive down terms and conditions, drive skilled health workers out of the region and drive down the economy in Wales.
What does UNISON want?
UNISON believes the employers’ proposals are the best achievable through negotiations and has agreed to take this proposal back to our members for consultation. UNISON will be holding workplace meetings with members to discuss the implications of accepting and rejecting this proposal. Following the month long consultation UNISON will be balloting our members because we want members to make up their own minds. Please use your vote. We will also be asking if you are prepared to take industrial action if you don’t accept the changes to your terms and conditions.
Is UNISON recommending which way we should vote?
UNISON has taken the decision not to make a recommendation on how you should use your vote. We understand that our members are going to be affected differently by these proposals. Our view is that it is important for you to look at the information that has been provided and consider how you would be affected by these changes, and whether you are prepared to accept that or not. It may not be an easy decision for you to take, but it is important to consider the consequences of voting yes or no as the outcome of each is likely to be very different.
What is the decision of the other NHS staff side trade unions?
The proposals were agreed for consultation unanimously by the trade union side of the Workforce Partnership Forum (WPF). The WPF consists of all the trade unions including: RCN; RCM; CSP; BAOT; SoR; SCP; Unite; GMB. Unite and GMB have made clear that they will be recommending that their members reject the proposals. Other unions are recommending acceptance, but most – UNISON included – have said that they want to consult members without making a recommendation.
Where can I get more information about this issue – defending agenda for change in Wales?
As well as holding workplace meetings throughout February, up-to-date information, briefings on the proposed changes and frequently asked questions will be available on the UNISON website. You can follow us on UNISON Health twitter account, join our Facebook page to be part of the campaign or contact us at and we will put you in touch with your local branch and activists.
What can I do to help?
- Join UNISON If you are not in a union join UNISON now unison.org.uk
- Ask colleagues to join UNISON
- Join the Facebook group to see latest news reports facebook.com/unisoncymruwales
- Follow us on Twitter - @UNISONWales
- Contact your local branch
- Interested in becoming a UNISON rep or a workplace contact? – email
- Speak to colleagues, friends and family about what is happening and the impact it will have on your working life
- I have a question that hasn’t been answered – who should I ask? – email and we will put you in touch with your local branch