Agenda For Change (AfC): Bandings, Profiles, Pay, etc

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Agenda For Change (AfC): Bandings, Profiles, Pay, etc

Post by maven » Sun Jan 06, 2008 4:25 pm

What is AfC?

Agenda for Change is the government's pay system for the health service, and includes everyone except medics, dentists and senior managers (sceptics might say that these groups were powerful enough to opt out and demand more money). It began to be implemented in a phased manner in December 2004 and was rolled out nationally from this date. Prior to this there were many different scales pertaining to different professional groups.

In November 2017, the Chancellor announced that the government will be looking to modernise the Agenda for Change pay scales, so there is likely change in the offing ... structure/

The scheme intended for everyone to be paid on the same system, with pre-determined pay ranges for different professional groups and roles. The theory is that it makes pay more equitable and transparent (so, in theory an AP doing a similar role would be paid the same in any NHS trust in the country, for example; and a member of another profession doing a job requiring the same level of skill would also be paid the same). The pay is determined by the job requirements, and not by the skills of the person in the post, or what they actually do (that is, if the role requires a Band 5 set of skills, then even if you have much more training or take on much more responsibility the job is paid at Band 5) so you normally need to change jobs in order to progress through bands. One exception to this is "preceptorship" where a newly qualified CP can be appointed to a post with ringfenced 8a funding, but be paid at Band 7 for the first two years whilst they acquire more experience and autonomy, though this is not always possible to secure. In practice, this preceptorship arrangement is not very widely used.

The job role determines the pay band on which the person is placed (eg all trainees are on Band 6) and the number of years of experience the person has accumulated in the NHS on that band determine the point within the band, with everyone starting at the bottom point when they are appointed/promoted/transferred onto AfC from previous pay system. There is also clear guidance about what happens when a person transfers from one job to another in terms of where on the band they can start.

The system still has a weighting for higher cost of living, which is highest in London (20% extra pay in inner London up to an annually set max and 15% in outer London up to an annually set max), but also gives a smaller bonus (5% up to an annually set max) to surrounding areas of the South East.

In the past, each year, an increase in pay has been negotiated between the government and the unions, to reflect the increase in cost of living. This has historically been around 2.0-3.5% of pay, and is applied in April. More recently, there have been pay freezes and where there has been an uplift, it has been in the region of 1%.

Different health economies in the devolved regions mean that England, Scotland, Northern Ireland and Wales have implemented austerity measures in different ways and this has resulted in some disparity in the scales meaning the same point may represent a different salary in different nations. These differences permeate all the pay bands, and are most noticeable at the lower pay bands, where the nations have implemented minimum/living wages in different ways and along different timescales. For example in 2017-2018 in England the entry spine point for Band 1 and Band 2 is 15,404; in Scotland it is 16,532, in Northern Ireland it is 14,437, and in Wales it is 14,727. In 2017-2018, a trainee clinical psychologist starting in England at the bottom of band 6 would start on 26,565 and leave on 28,746; in Scotland they would start on 26,830 and leave on 29,034; in Northern Ireland they would start on 26,041 and leave on 28,180; in Wales they would start on 26,566 and leave on 28,747. Other changes are significantly noticeable further up the bands, where the devolved nations have implemented pay freezes and austerity measures in different ways.

AfC also equalises other terms and conditions. So, all NHS staff have a minimum of 27 days of paid leave per year and a 37.5 hour working week.

Costs and Benefits

Initially, AfC was a little controversial because of the fact that it was not applied equitably across all Trusts (for example, some CPs who have been qualified 4 or more years are on Band 7, and in Scotland some Consultant CPs have been put on Band 8B, and heads of departments vary from band 8C to 9, without this reflecting the size of department or complexity of role). It has also been used to justify both pay increases, job cuts, and pay freezes, which appear to reflect more local NHS trust financial situations, rather than a national concensus. This was due to the job profiles being matched to bandings by local matching panels. Over time, this has equalised somewhat, although many Trusts and Health boards have undergone significant periods of "downbanding" where pay has been adjusted after the initial matching process.

The cost of any grade of psychologist is now very expensive compared to other professions. For example, an experienced staff nurse, OT, speech and language therapist or physiotherapist might be paid the same as a trainee CP. A qualified nurse, OT, or Physio might be paid the same as an AP. This has led to a reduction in posts, as they are used for other professions or vacancies are frozen to pay the inflated costs of existing staff. This has also led to an expectation that CPs will earn their higher salaries by taking on more leadership/management/supervision/consultancy and also by dealing with much more complex cases than other professional groups. It should be noted that Assistant Psychologist pay benefitted enormously from the implementation of A4C, doubling over three years.

Further information

Links to latest Pay Scales Relevant to ENGLAND ONLY

The RCN publishes the pay grades of all four nations here ... es-2017-18

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Content checked by qualified Clinical Psychologist on 28/01/2018
Last modified on 28/01/2018 to bring up to date in terms of changes since 2004 and to highlight the differences in the devolved nations
Last edited by BlueCat on Sun Jan 28, 2018 11:02 pm, edited 5 times in total.
Reason: Bring up to date and highlight the differences that have developed in the devolved nations

Wise men talk because they have something to say, fools because they have to say something - Plato
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Re: Agenda For Change (AfC): Bandings, Profiles, Pay, etc

Post by BlueCat » Sun Jan 28, 2018 10:45 pm

It is worth highlighting that this post has been substantially edited to bring it up to date with the current landscape, including the differences in the ways the devolved nations have implemented minimum/living wage and pay freezes/uplifts, resulting in some differences in the pay scales across the nations.

Also that the chancellor announced in November 2017 that the government will be looking to modernise the A4C pay structure.
There's no such thing as bad weather, just the wrong clothes. Billy Connolly.

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