According to a National Audit Office (NAO) report, the NHS has successfully transferred 1.1 million NHS employees to a new simplified pay system. Given the scale of the NHS, this was a substantial task that the NHS, in partnership with trades unions, achieved in a short timescale.
There are some examples of NHS trusts using Agenda for Change (AfC) to help introduce new roles, but the Department of Health (DH) did not put enough emphasis on getting trusts to develop these new ways of working to secure the full benefits from the new pay system, so the programme has yet to achieve the intended value for money.
The DH predicted that AfC would save at least £1.3 billion by 2008–09 and productivity would increase. It did not, however, put in place any central monitoring arrangements to show what impact the new contract has had on productivity. The only productivity measure available for the NHS as a whole shows that productivity continued to fall when AfC was introduced, although the rate has since slowed.
A key element of AfC, the Knowledge and Skills Framework (KSF), which defines the skills needed for a certain role and provides a tool for reviewing their use in the workplace, has yet to be fully implemented by many trusts. Effective use KSF is fundamental to achieving the full benefits of AfC, but initial take-up was limited and KSF had to be relaunched in 2007.
Tim Burr, NAO head, said: "It was no mean feat transferring virtually all NHS staff on to a new pay system within a very constrained timeframe, and this element of Agenda for Change has been a success. On the other hand, the benefits that should have come with this new simpler system, such as more effective working, have not been wholly achieved. So, the programme as a whole has further to go before it achieves the intended value for money for the taxpayer."