Agenda for Change: is reform on the way?

The Agenda for Change (AfC) framework is the nationally agreed UK-wide package of pay, terms and conditions for all NHS staff other than very senior managers and medical staff (practice nurses and nurses working for non-NHS employers are not covered). AfC was introduced in December 2004 with the aim of creating a consistent and fair pay structure across different NHS occupations. The framework covers various aspects including pay scales (9 pay bands), career progression and working conditions (Buchanan et al, 2021). The NHS Terms and Conditions of Service Handbook sets out the conditions of employment and legal agreements that apply (NHS Employers, 2023). In Scotland the Management Steering Group (2024) addresses AfC in the NHS pay system for staff directly employed by NHS Health Boards.

Nurses in the NHS have been operating within the AfC framework for two decades and there have been significant changes within the profession over this period, yet AfC has remained largely unchanged. Initially, a set of national job profiles were agreed to assist in the process of matching posts to pay bands; staff were matched to a national job profile or their job was evaluated locally. The Job Evaluation Group, a subgroup of the NHS Staff Council, measures the skills, responsibilities and effort required for a job, allocating it to an AfC pay band.