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The NHS staff council working in partnership

The NHS staff council working in partnership

Framework agreement on the proposed reform of NHS pay structure for Agenda for Change staff

21 March 2018

Scope and status

i.This framework agreement is conditional on government clearance and on agreement through the NHS Staff Council.  This means it will be subject to consultation and agreement with constituent parties.

ii.It is intended that this agreement covers all NHS employers in England listed in Annex A of the NHS Terms and Conditions of Service handbook.

iii.If the framework agreement is endorsed and implemented in England, partners in Scotland, Cymru/Wales and Northern Ireland will be able to hold discussions about whether, and how, the content of this agreement is implemented, in light of the funding available in accordance with the Barnett formula. 

27 June 2018 

This framework agreement was adopted by the NHS Staff Council for NHS staff in England on 27 June 2018 following consultation and agreement with the constituent parties in England.   

2 July 2018

In accordance with iii) above, this Framework Agreement has been endorsed by the NHS employers and trade union partners for implementation in NHS Wales.  This is conditional on Welsh Government clearance and agreement by the trade union partners to this collective agreement through consultation with their respective members.   

Introduction and context  

The introduction of Agenda for Change (AfC) in 2004 was a significant achievement; bringing together several different pay arrangements into one overall structure underpinned by job evaluation.  

Whilst this structure has stood the test of time, NHS trade unions and employers have agreed on the need for changes to be made to modernise AfC in a number of areas. The agreement reached in England in 2013 was recognised by all parties as the start of a wider conversation on a refresh of AfC.  

At the November budget the Chancellor of the Exchequer reconfirmed the intention to end the 1 per cent basic pay policy, and announced that additional funding could be made available for a multi-year pay deal for AfC staff that would support productivity and recruitment and retention.

This draft framework document sets out a proposed three-year agreement covering the years from 2018 to 2021. It sets out both the pay investment that will be made and the reforms that employers, NHS trade unions and the Department of Health and Social Care in England have agreed to implement over the period of the agreement and going forward. Welsh Government, Welsh NHS employers and NHS trade union in Wales now similarly agree to implement this agreement on the same basis as that applied to NHS staff in England.

The key objectives in the discussions leading to the details set out in this framework agreement document have been to:

•support the attraction and recruitment of staff by increasing starting pay in every pay band

•support the retention of staff by increasing basic pay for the 50 per cent of staff who are at the top of pay bands and speeding up progression to the top of the pay band

•increase staff engagement by putting appraisal and personal development at the heart of pay progression, so that staff are supported to develop their skills and competences in each pay band and are rewarded for this. This will help ensure that all staff have the appropriate knowledge and skills they need to carry out their roles, so they can make the greatest possible contribution to patient care. It will be underpinned by a commitment from employers to enhance the relationship line managers have with their staff and to fully utilise an effective appraisal process

•ensure that the pay system can support the growing use of apprenticeships in the NHS.

•ensure that the pay system is supportive of new training pathways and that the health service can deliver on the aspiration to focus on ‘careers, not jobs’ as set out in the draft workforce strategy  

•map out future work that the NHS Staff Council will undertake to encourage consistency of approach to bank working (including how the service can better incentivise staff to offer their own time to the bank) and to the development of apprenticeship routes to healthcare careers.

•improve the health and wellbeing of NHS staff to improve levels of attendance in the NHS with the ambition of matching the best in the public sector.

The partners have developed this agreement in full awareness of the Public Sector Equality Duties and recognise that an equality impact assessment will need to be commissioned to support this agreement.


1.To help the NHS attract and recruit new staff 

1.1.Starting salaries across all pay bands will increase as outlined in Annex A. 

1.2.The increases to starting salaries are achieved by the following action: points which overlap with a lower pay band will be removed from the bottom of each current pay band, with one point being removed in 2018/19, and further points being removed in 2019/20. 

1.3.A new provision detailing pay for apprentices will be negotiated by the NHS Staff Council as a matter of priority, and added to the NHS Terms and Conditions of Service Handbook (the Handbook). This will help employers find affordable solutions, that make maximum use of the apprenticeship levy, to develop a new as well as existing workforce and to increase capacity. 

2.To help the NHS retain staff 

2.1 The intention of the reforms to the pay structure is that by the end of the three-year period - and on 1 April of each of the years covered by this agreement – individuals will have basic pay that is of greater value than under current expectations (which are defined as a 1 per cent pay award per annum plus contractual increments).  

2.2 The value of the top points of each pay band will be increased by 6.5% cumulatively over the three-year period for Bands 2 - 8b. The NHS Wales pay points will be aligned to the new values as agreed in England for staff in all Bands. The value of the top pay points in Bands 8d and 9 in England will be capped at the level of the increase in value at the top of band 8c and for staff in these bands in Wales their pay points will be aligned to the same pay points.  

The value of the top pay points for Bands 2 – 8b will increase each year as follows:  

•3 per cent in 2018/19 (for band 2 in Wales the top pay point will increase by 4.17 per cent in 2018/19) 

•1.7 per cent in 2019/20 

•1.67 per cent in 2020/21.  

In England, the value of the top pay points in bands 8d and 9 will be capped at the level of the increase in value at the top of band 8c and for staff in these bands in Wales their pay points will be aligned to the same pay scale.

2.3 The effective date for pay awards will remain as 1 April in the relevant year.   

2.4 In 2019/20 only, a cash lump sum will be made available to deliver an additional 1.1 per cent to the staff employed on the top points in bands 2 – 8c. For the staff employed on the top pay points in bands 2 – 8c on 31 March 2019 the total in year cash value of the award on basic pay and the additional cash sum in 2019/20 will be 2.8 per cent. The lump sum will be paid out to staff in April pay and will be non-consolidated.  

2.5 For band 8d and 9 the cash lump sum will be capped at the value given to band 8c. 

2.6 Existing pay bands will be restructured and the number of pay points will be reduced to 2 points for Bands 2, 3, 4, 8a, 8b, 8c, 8d and 9 and 3 points for Band 5, 6 and 7.  Restructuring will be completed by 1 April 2021.   

2.7 Pay Bands 8c, 8d and 9 will continue to include an element of re-earnable pay.  In the year after the employee has reached the top of the band, up to 10 per cent of basic salary will become re-earnable subject to performance. This process is described in full in Annex A. Those staff on bands 8c, 8d and 9 with reserved rights from the 2013 AfC agreement (2015 in Wales) will receive protection of reserved rights on a marked time basis. 

2.8 The new pay structure will enable staff in Bands 2-7 to access the top of the pay band more quickly than in the current system. 

Current systemNew system

Band 11 yearN/A

Band 27 years2 years

Band 36 years2 years

Band 46 years3 years

Band 57 years4 years

Band 68 years5 years

Band 78 years5 years

Band 8a5 years5 years

Band 8b5 years5 years

Band 8c5 years5 years

Band 8d5 years5 years

Band 95 years5 years


2.9 For each pay point on each pay band, the detail of the ‘individual journey’ for staff is detailed in Annex A. 

2.10 The new pay structure and values for each point in each of the years 2018/19, 2019/20 and 2020/21 is set out at Annex A.  

2.11 Paragraph 2.1 sets out the policy intention for the reforms to the pay structure.  In the unlikely event that transition to the reformed pay structure results in this policy intention not being met, the principle of ‘no detriment’ will apply to the individual(s) concerned. 

3 To ensure the NHS is better able to recruit and retain staff in the lower pay bands

3.1A new rate of £17,460 will be introduced from 1 April 2018 as the minimum basic pay rate in the NHS, in order to future proof the pay structure, stay ahead of statutory requirements, and ensure the NHS retains a competitive market advantage in the jobs market for staff employed at this level. 

3.2 Band 1 will be uprated to this minimum pay rate with effect from 1 April 2018. Band 1 will be closed to new entrants from 1 December 2018.

3.3 The NHS Staff Council will agree a framework to support and encourage provider organisations to upskill roles currently in Band 1 to Band 2 roles. This exercise should be completed by 31 March 2021, in line with a process that will be agreed by the NHS Staff Council. For NHS Wales, this process will be managed on an all Wales basis in partnership through the Welsh Partnership Forum.    

3.4 Welsh Minsters will continue to consider the Foundation Living Wage recommendations on an            annual basis as agreed in 2017 alongside the pay scales set out in this agreement.

4 Pay progression

4.1 A new NHS Staff Council progression framework will be put in place by 1 April 2019, so that within each pay band staff will be supported to make the best use of their skills. The new progression framework is set out in Annex B. A partnership approach will be developed to implement the framework consistently in Wales building on the existing Pay Progression Policy. 

4.2 The new pay progression system will help ensure that all staff have the appropriate knowledge and skills they need to carry out their roles, and so make the greatest possible contribution to patient care. It will be underpinned by a commitment from employers to strengthen and improve the appraisal process.

4.3 The new pay progression system will:

a. enable staff in Bands 2-7 to reach the top of their pay band more quickly 

b. describe minimum periods of time before progression to the next pay-step point

c. not be automatic

d. give staff the opportunity to demonstrate they have met the required standards, including appraisals

e. require line managers and staff to follow the pay-step submission process (described in the pay progression framework document) in order to access the next pay-step point

f. require employers to provide information to enable the NHS Staff Council to undertake monitoring of pay progression and re-earnable pay in relation to employees with protected characteristics.

4.4 The Staff Council will oversee the implementation of the pay progression system.  This will include the amendment of payroll systems from 2018/19.

5.To help support the service and members of NHS staff 

5.1 The partners will work together through NHS Staff Council and Social Partnership structures to improve levels of attendance through a focus on staff health and wellbeing at a national and local level. The ambition is that through positive management of sickness absence the NHS will match the best in the public sector. To identify changes that will support this ambition, a work programme will be set up to include an assessment of the principal factors affecting levels of attendance and a review of the current agreement on absence management. This will include reviewing Annex 26. This will not alter the sick pay provisions set out in Section 14 of the terms and conditions of service handbook in England. A separate and specific agreement has been reached in Wales to address attendance with a renewed emphasis on health and wellbeing in the workplace. The details of this approach is set out in Annex C. The key actions and principles which will guide this are; 

A new approach to attendance management with a new policy to be agreed and implemented by 30 September 2018.

The policy will provide:

-A greater emphasis on the prevention of illness by improving staff health and wellbeing; and 

-Improved arrangements for returning staff to work after illness including the consideration of rapid access and early referral of staff to certain key services.

-The development and implementation of a joint training programme in support of the new policy approach so as to equip managers with the necessary tools and skills to support staff and maintain attendance.

-The monitoring of sickness absence data in partnership. 

-Aligning approaches to flexible working, re-deployment and other workplace policies to ensure that they support the aims of supporting staff in work.

-The development of a NHS Wales Menopause Policy

5.2 The NHS Staff Council will explore what scope there is for a collective framework agreement on bank and agency working, including the opportunity to provide cost-effective incentives to encourage staff to offer their own time to internal staff banks to increase capacity. NHS Wales representatives and trade unions will work in partnership on the development of this framework through the NHS Staff Council and will work jointly on effective ways to develop and deploy temporary staff capacity across the NHS in Wales.  

5.3 The NHS Wales local agreement on the reimbursement of travel costs to replace Section 17 of the National Terms and Conditions of Service Handbook will continue to apply from 1st January 2018. This agreement sets the rates of reimbursement in line with the HMRC as approved mileage allowance payments (AMAP rates).   

5.4 The arrangements covered by the Section 6(a) (England and Wales): Career Progression will continue to apply from 1st January 2018 up to the date of the implementation of this agreement. 

6.To encourage greater consistency of terms 

6.1 Employing organisations will work in partnership with trade unions to introduce local mechanisms (and a national approach for NHS Wales) to guarantee access to those annual leave and time off in lieu (TOIL) provisions set out in the NHS Terms and Conditions of Service Handbook.  

6.2 New provisions will be added to the NHS Terms and Conditions of Service Handbook to give staff access to consistent child bereavement Leave, enhanced shared parental leave (extension of statutory), and a national framework for buying and selling annual leave. 

6.3 The variation in approach to payment schemes for unsocial hours will be reduced by taking the following steps: 

a. A new provision will be added to the handbook to open Section 2 (maintaining round the clock services) unsocial hours payment arrangements to all ambulance staff. This will apply to all new entrants to the Ambulance Service in England from 1 September 2018 and all changes of roles (including promotion). Existing ambulance staff in England will be offered a voluntary move to the Section 2 rates with details of how this will be offered and managed to be agreed via the NHS Staff Council. Section 2 currently applies to all staff working in NHS Wales including ambulance staff working for the Welsh Ambulance Services NHS Trust. 

b. In England Section 14 (sickness absence) paragraph 4 of the NHS Terms and Conditions of Service Handbook will be adjusted to convert the eligibility for payment of unsocial hours during occupational sick leave (currently available to staff on spine points 2-8) to a cash value (basic salary) of £18,160. New entrants to the NHS, appointed with effect from 1st July 2018 onwards, will not have access to payment of unsocial hours during occupational sick leave. This will ensure that over time, the calculation for sickness absence pay is the same for all staff on the NHS terms and conditions of service. A specific agreement on the approach being taken in NHS Wales is set out in Annex C. 

c. Section 2 of the handbook will be adjusted to introduce new percentage rates for Bands 1, 2 and 3. The new percentages will reflect the increase to basic salary levels while preserving the value of the current payment tiers. The percentage rates are set out at Annex A. The percentages will stay at the 2020/21 rates going forward. 

6.4 In conjunction with the ongoing review of senior pay in England, the NHS Staff Council will explore the scope for further alignment between Agenda for Change and other senior NHS pay arrangements in England, with a view to achieving greater coherence. For NHS Wales this will be taken forward by Welsh Government considering the work by the UK Staff Council. 

7. The role of the NHS Staff Council 

7.1 The NHS Staff Council will retain its existing role as described in the NHS Terms and Conditions of Service Handbook.  

7.2 In addition, the Staff Council will agree a work programme in partnership to monitor the implementation of the proposed deal over the three-year period, and ensure all aspects of the agreement are implemented as intended. The Welsh Partnership Forum will similarly agree a process to monitor implementation. 


Annex A 

The new NHS Wales pay structure for 2018/19, 2019/20, & 2020/21

In each band and year, the number of times a pay value is repeated indicates the length of stay on the pay point.

BandSpine Point2017/18 (current)2018/19 (Year 1)2019/20 (Year 2)2020/21 (Year 3)

11 £16,523 £17,460 £17,652 £18,005

Additional Wales point£16,523 £17,460 £17,652 £18,005

3 £16,523 £17,460 £17,652 £18,005

21 £16,523 £17,460 £17,652 £18,005

2 £16,523 £17,460 £17,652 £18,005

3 £16,523 £17,460 £17,652 £19,337

4 £16,523 £17,460 £17,652 £19,337

Additional Wales point £16,523 £17,460 £17,652 £19,337

5 £16,764 £17,460 £17,652 £19,337

6 £17,321 £17,787 £17,983 £19,337

7 £17,954 £18,702 £19,020 £19,337

36 £16,764 £17,787 £18,813 £19,737

7 £17,321 £17,787 £18,813 £19,737

8 £17,954 £18,429 £18,813 £21,142

9 £18,334 £18,608 £18,813 £21,142

10 £18,840 £19,122 £19,332 £21,142

11 £19,410 £19,700 £19,917 £21,142

12 £19,852 £20,448 £20,795 £21,142

411 £19,410 £20,150 £21,089 £21,892

12 £19,852 £20,150 £21,089 £21,892

13 £20,552 £20,859 £21,089 £21,892

14 £21,263 £21,582 £21,819 £24,157

15 £21,909 £22,238 £22,482 £24,157

16 £22,129 £22,460 £22,707 £24,157

17 £22,683 £23,363 £23,761 £24,157

516 £22,129 £23,023 £24,214 £24,907

17 £22,683 £23,023 £24,214 £24,907

18 £23,597 £23,951 £24,214 £26,970

19 £24,548 £24,915 £26,220 £26,970

20 £25,551 £25,934 £26,220 £27,416

21 £26,566 £26,963 £27,260 £27,416

22 £27,635 £28,050 £28,358 £30,615

23 £28,747 £29,60 8£30,112 £30,615

621 £26,566 £28,050 £30,401 £31,365

22 £27,635 £28,050 £30,401 £31,365

2 3£28,747 £29,177 £30,401 £33,176

24 £29,627 £30,070 £32,525 £33,176

25 £30,661 £31,121 £32,525 £33,176

26 £31,697 £32,171 £32,525 £33,779

27 £32,732 £33,222 £33,587 £33,779

28 £33,896 £34,403 £34,782 £37,890

29 £35,578 £36,644 £37,267 £37,890

726 £31,697 £33,222 £37,570 £38,890

27 £32,732 £33,222 £37,570 £38,890

28 £33,896 £34,403 £37,570 £40,894

29 £35,578 £36,111 £37,570 £40,894

30 £36,613 £37,161 £38,765 £40,894

31 £37,778 £38,344 £38,765 £41,723

32 £39,070 £39,656 £40,092 £41,723

33 £40,429 £41,034 £41,486 £44,503

34 £41,787 £43,041 £43,772 £44,503

8a33 £40,429 £42,414 £44,606 £45,753

34 £41,787 £42,414 £44,606 £45,753

35 £43,469 £44,121 £44,606 £45,753

36 £45,151 £45,827 £46,331 £45,753

37 £47,092 £47,798 £48,324 £45,753

38 £48,515 £49,969 £50,819 £51,668

8b37 £47,092 £49,242 £52,306 £53,168

38 £48,515 £49,242 £52,306 £53,168

39 £50,972 £51,737 £52,306 £53,168

40 £53,818 £54,625 £55,226 £53,168

41 £56,666 £57,515 £58,148 £53,168

42 £58,217 £59,964 £60,983 £62,001

8c41 £56,666 £59,090 £61,777 £63,751



44 £63,652 £63,966 £64,670 £63,751

45 £67,920 £68,256 £69,007 £63,751

46 £69,860 £71,243 £72,597 £73,664

8d45 £67,920 £70,206 £73,936 £75,914

46 £69,860 £70,206 £73,936 £75,914

47 £72,772 £73,132 £73,936 £75,914

48 £76,329 £76,707£77,550 £75,914

49 £80,210 £80,606 £71,49 3£75,914

50 £84,091 £85,333 £86,687 £87,754

949 £80,210 £84,507 £89,537 £91,004

50 £84,09 1£84,507 £89,537 £91,004

51 £88,127£88,563 £89,537 £91,004

52 £92,357 £92,814 £93,835 £91,004

53 £96,791 £97,269 £98,339 £91,004

54 £101,436 £102,506 £103,860 £104,927


Increases in starting salaries

Cumulative change from current (2017/18) NHS Wales starting salaries:

Cumulative change from 17/18 (£)Cumulative change from 17/18 (%)


Band 116,5239371,1291,4825.70%6.80%8.90%

Band 216,5239371,1291,4825.70%6.80%8.90%

Band 316,7641,0232,0492,9736.10%12.20%17.70%

Band 419,4107401,6792,4823.80%8.70%12.80%

Band 522,1298942,0852,7784.00%9.40%12.60%

Band 626,5661,4843,8354,7995.60%14.40%18.10%

Band 731,6971,5255,8737,1934.80%18.50%22.70%

Band 8A40,4291,9854,1775,3244.90%10.30%13.20%

Band 8B47,0922,1505,2146,0764.60%11.10%12.90%

Band 8C56,6662,4245,1117,0854.30%9.00%12.50%

Band 8D67,9202,2866,0167,9943.40%8.90%11.80%

Band 980,2104,2979,32710,7945.40%11.60%13.50%

Individual pay journeys – 2018 to 2021 

Please note a pay calculator is available online at www.nhspay.org. 

Spine Point 2017/18 (current) 2018/19 (Year 1) 2019/20 (Year 2) 2020/21 (Year 3) Earnings gain (£) Earnings gain (%)

11 £16,523 £17,460 £17,652 £18,005 £1,4828.97%

Additional Wales point £16,523 £17,460 £17,652 £18,005 £1,4828.97%

2 £16,523 £17,460 £17,652 £18,005 £1,4828.97%

22 £16,523 £17,460 £17,652 £19,337 £2,81417.03%

3 £16,523 £17,460 £17,652 £19,337 £2,81417.03%

4 £16,523 £17,460 £17,652 £19,337 £2,81417.03%

Additional Wales point £16,523 £17,460 £17,652 £19,337 £2,81417.03%

5 £16,523 £17,460 £17,983 £19,337 £2,81417.03%

6 £16,764 £17,787 £19,020 £19,337 £2,57315.35%

7 £17,321 £18,702 £19,020 £19,337 £2,01611.64%

8 £17,954 £18,702 £19,020 £19,337 £1,3837.70%

36 £16,764 £17,787 £18,813 £21,142 £4,37826.12%

7 £17,321 £18,429 £18,813 £21,142 £3,82122.06%

8 £17,954 £18,608 £19,332 £21,142 £3,18817.76%

9 £18,334 £19,122 £19,917 £21,142 £2,80815.32%

10 £18,840 £19,700 £20,795 £21,142 £2,30212.22%

11 £19,410 £20,448 £20,795 £21,142 £1,7328.92%

12 £19,852 £20,448 £20,79 5£21,142 £1,2906.50%

411 £19,410£20,150 £21,08 9£24,157 £4,74724.46%

12 £19,852 £20,859 £21,819 £24,157 £4,30521.69%

13 £20,552 £21,582 £22,482 £24,157 £3,60517.54%

14 £21,263 £22,238 £22,707 £24,157 £2,89413.61%

15 £21,909 £22,460 £23,761 £24,157 £2,24810.26%

16 £22,129 £23,363 £23,761 £24,157£2,0289.16%

17 £22,683 £23,363 £23,761 £24,157 £1,4746.50%

516 £22,129 £23,023 £24,214 £26,970 £4,84121.88%

17 £22,683 £23,951 £26,220 £27,416 £4,73320.87%

18 £23,597 £24,915 £26,220 £27,416 £3,81916.18%

19 £24,548 £25,934 £27,260 £30,615 £6,06724.71%

20 £25,551 £26,963 £28,358 £30,615 £5,06419.82%

21 £26,566 £28,050 £30,112 £30,615 £4,04915.24%

22 £27,635 £29,608 £30,112 £30,615 £2,98010.78%

23 £28,747 £29,608 £30,112 £30,615 £1,8686.50%

621 £26,566 £28,050 £30,401 £33,176 £6,61024.88%

22 £27,635 £29,177 £32,525 £33,176 £5,54120.05%

23 £28,747 £30,070 £32,525 £33,779 £5,03217.50%

24 £29,627 £31,121 £32,525 £33,779 £4,15214.01%

25 £30,661 £32,171 £33,587 £37,890 £7,22923.58%


27 £32,732 £34,40 3£37,267 £37,890 £5,15815.76%

28 £33,896 £36,644 £37,267 £37,890 £3,99411.78%

29 £35,578 £36,644 £37,267 £37,89 0£2,3126.50%

72 6£31,697 £33,22 2£37,57 0£40,894 £9,19729.02%

27 £32,732 £34,403 £37,570 £40,894 £8,16224.94%

28 £33,896 £36,111 £38,765 £41,723 £7,82723.09%

29 £35,578 £37,161 £38,765 £41,723 £6,14517.27%

30 £36,613 £38,344 £40,092 £44,503 £7,89021.55%

31 £37,778 £39,656 £41,486 £44,503 £6,72517.80%

32 £39,070 £41,034 £43,772 £44,503 £5,43313.91%

33 £40,429 £43,041 £43,772 £44,503 £4,07410.08%

34 £41,787 £43,041 £43,772 £44,503 £2,7166.50%

8a33 £40,429 £42,414 £44,606 £46,518 £6,08915.06%

34 £41,787 £44,121 £46,331 £48,519 £6,73216.11%

35 £43,469 £45,827 £48,324 £51,668£8,19918.86%

36 £45,151 £47,798 £50,819 £51,668 £6,51714.43%

37 £47,092 £49,969 £50,819 £51,668 £4,5769.72%

38 £48,515 £49,969 £50,81 9£51,66 8£3,1536.50%

8b37 £47,092 £49,242 £52,306 £55,450 £8,35817.75%

38 £48,515 £51,737 £55,226 £58,383 £9,86820.34%

39 £50,972 £54,625 £58,148 £62,001 £11,02921.64%

40 £53,818 £57,515 £60,983 £62,001 £8,18315.20%

41 £56,666 £59,964 £60,983 £62,001 £5,3359.41%

42 £58,217 £59,964 £60,983 £62,001 £3,7846.50%

8c41 £56,666 £59,090 £61,777 £64,931 £8,26514.59%

42 £58,217 £61,105 £64,670 £69,285 £11,06819.01%

43 £60,80 5£63,966 £69,007 £73,664 £12,85921.15%

44 £63,652 £68,256 £72,597 £73,664 £10,01215.73%

45 £67,920 £71,243 £72,597 £73,664 £5,7448.46%

46 £69,860£71,243 £72,597 £73,664 £3,8045.45%

8d45 £67,920 £70,206 £73,936 £77,863 £9,94314.64%

46 £69,860 £73,132 £77,550 £81,821 £11,96117.12%

47 £72,772 £76,707 £81,493 £87,754 £14,98220.59%

48 £76,329 £80,606 £86,687 £87,754 £11,42514.97%

49 £80,210 £85,333 £86,687 £87,754 £7,5449.41%

50 £84,091 £85,333 £86,687 £87,754 £3,6634.36%

949 £80,210 £84,507 £89,537 £94,213 £14,00317.46%

50 £84,091 £88,563 £93,835 £98,736 £14,64517.42%

51 £88,127 £92,814 £98,339 £104,927 £16,80019.06%

52 £92,357 £97,269 £103,860 £104,927 £12,57013.61%

53 £96,791 £102,506 £103,860 £104,927 £8,1368.41%

54 £101,436 £102,506 £103,860 £104,927 £3,4913.44%

Unsocial hours enhancement rates – 2018/19 to 2020/21 


Band 1

All time on Saturday (midnight to midnight) and any week day after 8 pm and before 6 am

Time plus 49%

Time plus 48%

Time plus 47%

Band 1

All time on Sundays and Public Holidays (midnight to midnight

Time plus 97%

Time plus 95%

Time plus 94%

Band 2  

All time on Saturday (midnight to midnight) and any week day after 8 pm and before 6 am

Time plus 43%

Time plus 42%

Time plus 41%

Band 2

All time on Sundays and Public Holidays (midnight to midnight

Time plus 85%

Time plus 84%

Time plus 83%

Band 3

All time on Saturday (midnight to midnight) and any week day after 8 pm and before 6 am

Time plus 36%

Time plus 35%

Time plus 35%

Band 3

All time on Sundays and Public Holidays (midnight to midnight)

Time plus 72%

Time plus 70%

Time plus 69% 

Re-earnable process for Bands 8c, 8d and 9 

Annually earned pay is already a feature of the NHS terms and conditions of service for Bands 8c, 8d and 9, this was introduced in 2013 in England and 2015 in Wales. Creating an effective link between personal accountability for performance and pay is a key objective of these arrangements, building on the 2013 changes.

The new pay progression framework will apply to bands 8c, 8d and 9, and more detailed guidance will be produced to help employers achieve an effective and consistent use of annually earned pay.

In the year after the employee has reached the top of bands 8c, 8d and 9, up to 10 per cent of basic salary will become re-earnable. Subject to performance, the employee will retain their basic salary or their salary will be reduced by 5 per cent or 10 per cent. The employee will be able to restore their salary at the end of the following year by achieving agreed levels of performance.

Employers will put in place robust monitoring arrangements for the use of annually earned pay. The NHS Staff Council will also evaluate monitoring data to ensure the arrangements are compliant with equalities legislation.

Employees on the top two points of these bands on 31 March 2013 and 31 March 2015 in Wales have reserved rights to the relevant point. This reserved right will be retained on a marked time basis. At the end of 2020/21, 5 per cent of pay will become annually earned and then, when annual increases to the top of the band add a further 5 per cent, annually earned pay will apply to 10 per cent of basic pay.

Annex B 

Progression within the new pay system 


1. Patients are at the heart of everything the NHS does. The introduction of a new pay system is an opportunity to ensure that, in a patient centred health care system, staff are supported to develop and utilise the skills and behaviours a modern NHS needs. This is crucial whether staff are just starting their NHS career or are long-serving and already at the top of their pay band. 


2. The new pay system will help ensure that all staff have the appropriate knowledge and skills they need to carry out their roles. This will be underpinned by a commitment from employers to strengthen and improve the appraisal process. 


3. The NHS Management and Health Service Quality report, from Michael West et al. found that good management of NHS staff leads to higher quality of care. It states that:


“The more engaged staff members are, the better the outcomes for patients and the organisation generally. Engagement can be fostered through good staff management. Having wellstructured appraisals (where clear objectives are set, the appraisal is helpful in improving how to do the job, and the employee is left feeling valued by their employer) is particularly important”. 


The report’s summary concludes that: 

“The proportion of staff receiving wellstructured appraisals is related to patient satisfaction, patient mortality, staff absenteeism and turnover, and better performance on the Annual Health Check… By giving staff clear direction, good support and treating them fairly and supportively, leaders create cultures of engagement, where dedicated NHS staff in turn can give of their best in caring for patients.” 

4. By strengthening the existing national mandatory appraisal system within a new pay structure, and insisting on good quality appraisals between staff and line managers, organisations will be better placed to identify, right across their workforce, ways to improve patient care through staff learning and development. Effective use of appraisal will enable trusts to identify those staff that would benefit from further development opportunities, and to help develop a culture of continuous learning which in turn will help improve the patient experience. This approach is supported in the CQC’s well led guidance, which states that in well led organisations, “the leadership, management and governance of the organisation assures the delivery of high-quality and person-centred care, supports learning and innovation, and promotes an open and fair culture”. 

5. Getting the appraisal process right is an integral part of patient care. The responsibility for patient care does not rest on individuals alone but on how the entire health care team works together. Capability of line managers is critical in ensuring the new pay system operates in a fair and transparent way. All staff should be supported to demonstrate that they have the knowledge, skills, values and behaviours their organisation expects. 

6. The aim is to create a partnership approach between staff and line managers where line managers are supported to make the appraisal experience as positive as possible and where staff are supported to take shared responsibility for showing how they meet the required standards.  

7. The new pay system is just one part of creating an NHS where staff want to work, where continuous learning and development is encouraged, where work life balance and health and wellbeing is taken seriously, and where bullying, harassment, and violence are not tolerated. 

8. The new pay system seeks to: 

i. create a simple process for assessing the standards for progression through the pay band, where a manager/employee submission process needs to be followed for pay-step points to be achieved

ii. help drive consistency across the NHS whilst allowing local flexibility to develop assessments against individual and/or organisational objectives, including values and behaviours

iii. allow faster progression to the top of each pay band through fewer pay-step points

iv. provide meaningful pay increases at each pay-step point

v. encourage staff to take responsibility for showing that they meet the defined standards

vi.ensure line managers make available to their staff the appropriate training, support and development opportunities

vii. encourage organisations to assess staff against local values and behaviours, agreed in partnership with staff side and informed by the NHS Constitution

viii. ensure pay-step points are achieved only where managers are satisfied that their staff have met the required standards.

Employer and employee support

9. Further details on how the annual appraisal process, required standards and progression through pay-step points should operate will be agreed in partnership and set out in further NHS Staff Council guidance. The partners will also work closely with colleagues responsible for the Electronic Staff Record to consider how existing functionality (or any new functionality) can best support line managers and staff in the effective delivery of annual appraisals and the new pay system.


Equality analysis

10. Local NHS organisations are required to demonstrate that they have paid ‘due regard’ to their Public Sector Equality Duties under the Equality Act 2010. A national equality analysis is being developed in partnership and which will cover any wider changes to Agenda for Change terms and conditions of service. Local organisations will be able to use the national analysis as a basis for carrying out their own local equality analysis. 


Pay structure and pay-step points

11. The new pay system includes fewer pay points but significant pay increases on average at each pay-step point.  To deliver good patient care whether staff work directly with patients or not, there is an expectation that standards must be met. The mandatory annual appraisal process should involve regular conversations between staff and their line manager to ensure the required standards are understood and additional support identified in good time. The expectation is that all staff will meet the required standards and therefore be able to progress. 

12. Pay Structure 

Standards for pay progression 

13. Staff will progress to their next pay-step point in their pay band where the following can be demonstrated set within the context of a revised NHS Wales Pay Progression Policy: 

i. The appraisal process has been completed with outcomes in line with the organisation’s standards and no formal capability process is in place  

ii. There is no formal disciplinary action live on the staff member’s record.

iii. Statutory and/or mandatory training has been completed.

iv. For line managers only - must have completed appraisals for all their staff.

v. Any local standards, as agreed through local partnership working.

Progressing through pay-step points 

14. The estimated time taken to reach the top of each pay band reflects the minimum period of time staff must remain at each pay-step point before progressing to the next. 

Achieving pay-step points 

15. It is expected that employees who meet the required standards at their pay-step date will progress to the next pay-step point. 

16. Line managers will initiate a meeting to review standards. Once the line manager is satisfied that the required standards as assessed through their local appraisal processes have been met, the pay-step point will be awarded. 

17. Although staff must have successfully completed the appraisal process to move to their next pay-step point, the date of appraisal is not linked to the pay-step point. The pay-step date is set in relation to the member of staff’s start date in their pay band.  Further guidance will be developed to ensure clarity and consistency across the service. 

The pay-step submission process 

18. The following bullet points describe the pay-step submission process:

i. Line managers will receive notification prior to an individual’s next pay-step date.

ii.The staff member and line manager will meet to review whether the standards have been met.

iii. A locally determined simple form, template or checklist should be used to support this process, which should be signed by the line manager and the member of staff.

iv. This will then be used as the basis for confirmation of movement to the next pay-step point.

If staff do not achieve a pay-step point 

19. It is expected that staff will achieve the required standards at the point of their next pay-step date. It is also expected that staff and their line manager should be aware of any problems in reaching the required standards before the pay-step date. This will allow time for issues to be raised and possible solutions found. Guidance on the circumstances when pay-step points are not achieved will be produced in partnership, including appeal processes. 

Roles and responsibilities 

20.Successful implementation of the new pay system depends on good working relationships between NHS organisations and the NHS Staff Council, and between line managers and their staff. 

Roles and responsibilities for each of these stakeholders are outline below:

NHS Staff Council responsibilities 

i. In England work with NHS Improvement (NHSI) to identify the required mechanisms that they will use to track progress from transition through to full implementation (NHSI to provide progress reports to the Staff Council).

ii. In England, post implementation, work with NHSI to establish ongoing monitoring and reporting mechanisms. 

iii. In Wales work with Welsh Government who will develop systems for implementing, monitoring and operating the new arrangements in social partnership with the Welsh Partnership Forum (WPF). WPF will report jointly on progress to the NHS Staff Council.

iv. For England and Wales, will identify, and produce guidance and advice as required.

Organisation responsibilities 

i. Operate the agreed pay structure fairly.

ii. Commit to staff development.

iii. Enable staff to work safely and effectively.

iv. Value the appraisal process and understand the importance of the line manager/staff relationship to staff development and their positive impacts on recruitment and retention, staff morale and performance, and patient satisfaction and safety.

v. Operate an agreed appraisal policy with equality monitored processes and consistent outcomes across the organisation.

vi. Ensure that the pay-step submission process does not have the effect of discriminating directly or indirectly against any member of staff. 

vii. Work with NHSI (in England) and Welsh Government (in Wales) to report on the initial and ongoing implementation of the pay structure.  

viii. Support line managers in delivering appraisals through training and resources, including, but not limited to, equalities training.

ix. Enable line managers and staff to participate in the appraisal process, including, but not limited to, facilitating adequate time to prepare and have meaningful discussions.

x. Ensure staff records are kept accurately so that pay-step dates are shared in advance and line managers alerted to the need for discussion.

xi. Ensure sufficient statutory/mandatory training is available and accessible to all staff.

xii. Financially plan and budget on the basis that all staff are expected to achieve their pay-step points.

xiii. Develop and maintain relevant policies and procedures in partnership with local staff side, including a right of appeal and effective equalities monitoring.

xiv. Have a comprehensive training and development policy covering all staff.


Line manager responsibilities

i. Carry out their role as outlined in the local annual appraisal process.

ii. Undertake annual appraisals for all members of their team and ensure they are fully completed.

iii. Ensure that all employees have access to, and undertake statutory/mandatory and any essential skills training.

iv. Hold regular appraisal discussions with staff on the basis of ‘no surprises’, so that if an individual may not be on track to reach their pay-step point any areas for development or improvement are identified and remedial action taken at the earliest opportunity.

v. Conduct an objective review of the individual’s work against the required standards as part of the annual appraisal process. This should include an assessment of the employee’s achievement of any personal and or organisational objectives, including values and behaviours.

vi. Demonstrate they have encouraged and supported the employee to achieve the standards required during each local appraisal process.

vii.Ensure that staff understand what evidence they will need and its relevance to achieving the required standards.

viii.Review submitted evidence to demonstrate that they have met the required standards. 

ix.Undertake a meeting with the employee to review standards and follow the pay-step submission process.

Employee responsibilities 

i.Actively participate in the annual appraisal process, and agree with their line manager their personal and/or corporate objectives. 

ii. Complete the local appraisal process each year, regardless of whether or not their next pay-step date is that year. 

iii. Make their line manager aware of any issues that may be preventing them from achieving their objectives.

iv. Tell their line manager about anything that is preventing them from undertaking relevant training.

v. Show through relevant evidence, where it is available, that they have met the required standards and achievement of objectives in line with the local appraisal process.

vi. Work with their line manager to ensure that all relevant statutory, mandatory and essential skills training is up to date.

vii. Undertake a review of their standards together with their line manager, completing local documentation as part of the pay-step submission process. 

Monitoring transition and implementation 

21. To help ensure consistency in how the new national pay system is implemented, the NHS Staff Council, NHSI and Welsh Government will consider how, over the period of transition to full implementation, NHS organisations implement the collective agreement as the partners intend. For example, in England, feedback/evidence as part of the existing performance meetings between NHSI and trusts.  

22. The NHS Staff Council will work with NHSI and Welsh Government to identify the mechanisms which will best measure and track progress and ensure that any barriers to implementing the new pay system are identified and addressed as early as practicable. For example, NHSI in England will: 

i. Track progress in implementing the collective agreement from transition to full implementation. 

ii. Monitor organisations’ appraisal processes. 

iii. Check that appropriate learning and development needs are being addressed.

iv. Ensure the new pay progression system is operating as outlined in the agreement. 

v. Monitor use of the Electronic Staff Record (the payroll system used by most NHS organisations) to unlock pay-step points.

vi. Ensure that NHS organisations comply with the agreement or explain why it has not been possible.

vii. Work in partnership with the NHS Staff Council and provide progress reports to the NHS Staff Council. 

It is anticipated that a similar approach will be adopted by Welsh Government for monitoring the implementation and operation of the new pay system which will be developed jointly with the Welsh Partnership Forum.  

It is hoped that this approach to pay progression will help improve industrial relations, prevent local disputes, and should support improvements in recruitment, retention, and engagement. 

Annex C

Management of attendance in Wales 

1. The Welsh Partnership Forum are committed to the health and wellbeing of the whole workforce and to joint working at national and local level to support individuals to remain well, to act proactively to avoid absence and enable those who are absent to return to work as quickly as possible.  We are committed to joint working to deliver best practice in managing attendance at work because we recognise this is best for individual members of the workforce and for the services they deliver for the people of Wales.    

2. The Welsh Partnership Forum (WPF) commitment is in line with the Core Principles of NHS Wales, the Healthier Wales quadruple aim of having a motivated and sustainable health and social care workforce and the ambition of the NHS Staff Council to match attendance levels with the best in the public sector through the positive management of sickness absence.  

3. Delivery of these aspirations will build on the work already underway across Wales through a strong practical commitment to partnership working through Welsh Partnership Forum structures and local partnership to prioritise a range of actions to support staff to stay in work and to return speedily from any absence. The WPF have agreed that these actions will include: 

a. A new Attendance Management Policy and associated procedures and training packages 

b. Consideration of Rapid Access and early referral for treatment for staff

c. A renewed emphasis on wellbeing in the workplace building on the existing NHS Wales Health and Wellbeing toolkits 

d. Aligning approaches to flexible working, re-deployment and other workplace policies to ensure that they support the aims of supporting staff in work.

e. The development of a NHS Wales Menopause Policy 

f. A commitment from all partners to prioritise active attendance management at local level and to remove any barriers to the process through partnership working at local and national level as required. 

4. The Welsh Partnership Forum will draw on the work being undertaken by the NHS Staff Council on their review of the current agreement on absence management and Annex 26 as appropriate.  

5. We have agreed to demonstrate our joint commitment to delivering effective policies and making a practical change for staff through this work by setting a series of targets and progress check points for the reduction on sickness absence levels.  The key objective is to deliver the equivalent of a 1% reduction in the rolling national average sickness rate by April 2019.  The baseline level against which improvements will be measured is the December 2017 rolling average which was 5.1%.  The monthly expected improvement trajectory will be set at 0.1% so that sickness levels are reduced to a maximum 4.5% by December 2018 and 4.2% by the end of March 2019 is set out in the table (overleaf).  Monitoring will be against the in-month and rolling average figures to ensure a consistent and sustained pattern of improvement.  From April 2019, we are committed to delivering a further 0.25% sickness absence rate reduction each year until the rates in Wales at least equal the sickness absence rates of comparable staff groups in England.  

A table is included below showing the month on month target reductions required:-

Month on Month Reduction (based on rolling 12-month data)Month on Month Reduction (based on in -Month data)

Baseline 5.10% 5.66%

Jul 185.00% 5.45%

Aug 184.90% 5.24%

Sep 184.80% 5.03%

Oct 184.70% 4.82%

Nov 184.60% 4.61%

Dec 184.50% 4.51%

Jan 194.40% 4.41%

Feb 194.30% 4.31%

Mar 194.20% 4.21%

6. Following the ending of the three-year agreement, the sick pay provisions for staff working in NHS Wales changed on 1st January 2018 to those which are referenced in the handbook (Section 14) as applying to Scotland and Northern Ireland. Should the annual rolling sickness absence level be above the agreed target by December 2018 then the arrangements as set out in Section 14 for England, will automatically apply in NHS Wales on a permanent basis from 1st April 2019. However, Section 14 will be amended for staff working in NHS Wales to ensure that enhancements continue to be paid after three months continuous sickness absence; and 

where an individual receives a diagnosis that they have a time specified terminal illness, any allowances or payments linked to working patterns or additional work commitments will be paid/backdated to the first day of sickness absence. 

7. The WPF members will meet regularly to monitor joint delivery of the programme of work and progress both locally and nationally against the agreed targets.  This will include tracking progress across the NHS in Wales and undertaking close examination of issues which appear to be undermining progress on the agreed programme of work and or local absence management processes. Partners will develop further actions to focus on and jointly address areas where sickness absence is consistently high. 


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