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Agenda for Change

December 2004

On 1 December 2004, the Agenda for Change single pay system came into operation in the NHS. It applied to all directly employed NHS staff, with the exception of medical staff, dentists and very senior managers.

Former Secretary of State for Health Alan Milburn had first put forward proposals for reforming NHS pay and working conditions in 1999. A collective agreement was researched with NHS unions at the NHS staff council on 23 November 2004.

Jobs were evaluated using a set of criteria, and posts were allocated to set pay bands, with the aim of ensuring consistent working conditions and fair remuneration across a range of jobs and skill sets. Increments within pay bands provided for pay rises linked to career progression and length of service.

Southend NHS Foundation Trust leaves system

In July 2006, staff at Southend University Hospital NHS Foundation Trust voted to leave the national Agenda for Change pay system and return to locally negotiated terms and conditions, becoming the first NHS trust to do so. The trust had a history of local pay bargaining, and when balloted on a return to local conditions, 95% of the trust's 4,000 members of staff voted to return to locally negotiated deals. The trust had gained FT status on 1 June 2006, giving the organisation additional flexibilities to negotiate pay and conditions.


Department of Health.
Agenda for Change.
Department of Health; 2004.

Berry M.
Southend hospital trust staff vote to ditch Agenda for Change pay system.
Personnel Today; 2006.