Why was Agenda for Change introduced to the NHS?

The NHS Agenda for Change contract was introduced in 2004 as a response to a number of concerns regarding the terms and conditions of employment for National Health Service (NHS) staff in the United Kingdom. Prior to the introduction of Agenda for Change, NHS staff were employed under a number of different pay and grading systems, leading to a lack of consistency and transparency in the way in which staff were contracted to do their work.

The Agenda for Change contract was designed to address these issues by introducing a new, national pay and grading structure for NHS staff, covering almost all staff groups, from nurses and midwives to administrative and support staff. Doctors, dentists and some very senior managers were the only staff groups not included in Agenda for Change.

One of the main aims of Agenda for Change was to ensure that NHS staff were paid fairly for the work they do. This was achieved through the introduction of a job evaluation system, which assessed the relative value of different roles within the NHS based on a range of factors, including the skills and knowledge required, the level of responsibility involved, and the complexity of the work. This job evaluation system was used to determine the appropriate pay band for each role, ensuring that staff were paid based on the value of their work rather than on arbitrary factors such as length of service or geographical location.

Another key aim of Agenda for Change was to promote transparency and consistency in the way in which NHS staff are paid. Under the previous system, there was a lack of clarity around the different pay scales and grades used for different staff groups, which made it difficult for staff to understand how their pay was determined. The Agenda for Change contract introduced a clear and consistent set of pay bands and grades for all staff groups, making it easier for staff to understand their pay and for employers to manage their pay systems.

In addition to improving the pay and grading structure for NHS staff, Agenda for Change also introduced a number of other important changes to the terms and conditions of employment for NHS staff. For example, the contract introduced new arrangements for annual leave, sick leave, and flexible working, designed to provide greater flexibility and support for staff. It also introduced new arrangements for career development and training, designed to help staff to develop their skills and progress in their careers.

Whilst the contract has changed in the nearly 20 years it has been used (for example through the removal of some lower bands), the same principles largely remain in place today.