Agenda For Change

This is a post that has been a long time coming, if only because I can't really think of a way to make it in the slightest bit interesting.
Agenda For Change.

The short (and therefore hopefully less boring) version is this.

The government want to standardise pay for the whole of the NHS, so they are splitting different wages into 'bands', from band 1 the lowest, to band 9, the highest. Within each pay band is a range of potential wages, so, for eaxample, pay band 4 starts at £16,004 and then increases in 6 increments to £19,284.

Band 5 starts at £18,698 and then increases in 8 increments to £24,198.

Are you with me so far?

To decide what banding each profession in the health service starts at a group is convened, and they “job match”. So if for example you “Supervise fellow workers”, or “At risk of potentially serious physical abuse”, then you score some points and can be put into a higher band.

This is the problem that we in the ambulance service have – because of the things we are expected to do in our daily work, the government would have to pay us a lot of money.

So it has taken two years for them to try and work out how much to pay us.

They still haven't decided.

But today (actually I as was writing this) they published their findings.

Paramedics will be paid in band 5 (to be reviewed in 12 months).

They still haven't decided on EMTs (which is yours truly).

The bulletin that we have just recieved states that 'experienced' EMTs will be paid in Band 5, while less experienced ones will be paid less.

This is, frankly, a load of bollocks.

The reasoning behind the different increments within the band is that this is to represent increasing experience. The banding is supposed to represent what our job is.

EMTs all do the same work, so why I should I find myself working with someone who does all the same things that I do, has the same skills and has exactly the same job description, and yet gets paid a differing amount.

(But we won't know for sure for another two weeks…)

I can see a few things happening.

First, the Unions have all signed up for this, and so the general feeling from the crews on the road is that we have been sold down the river, this means that morale, which is poor at best, is going to plummet.

Secondly, I imagine that our ORCON percentage (our main benchmark of performance) is going to also take a nosedive.

Thirdly, it's going to cause friction between EMTs, paramedics and Team Leaders (who are on Band 6 despite hardly touching a patient). Especially when you consider that Paramedics are going to be paid their new, higher rate much earlier than any change in EMT wages. Add in the time that it will take for them to decide which EMTs are better than other EMTs and there will be a huge disparity in pay for quite some time.

My next post (assuming a Major Incident doesn't happen beforehand) will be about how the LAS could have lessened this problem.

Just to remind everyone (because at the moment I am incredibly angry, and this may explain any typos) is that the thoughts and views expressed here are mine alone – they do not reflect on my employer, or anyone else in the service.

48 thoughts on “Agenda For Change”

  1. as i understand it, the salary protection issue is a load of c##p. the way it is being interpreted is that although,as tecks, our basic salary is reduced – and should be protected – the unsocial hours etc will take us over the salary we now get, so there will be no protection. effect their looking at it as a pay rise despite the fact that we may loose up to 3k in a basic wage. less pay no protection, when all the exciting “extras” are added on.

    you may have to pay back the 1/hour. I'd get your union rep involved and insist on legal action.

  2. Well…. the sad fact of the matter is that it's not just ambulance staff facing this… the whole NHS. You have cleaners writing excellent job descriptions and getting “matched” to salaries higher than trained professionals with a mountain of student debt to do… you have the new banded salaries being proposed as a fraction of the average salary of the same job in private practice. In a lot of cases (occuptional therapy, optometry, physiotherapy etc..) people knew the NHS wage was always a bit lower but chose to stay in the NHS for the different type of job, the atmosphere, the security, now i know the BBC has reported that occupational therapists for one are about to do a mass resignation with regards to their bandings and I'm sure other professions are going the same way as we're going not from slightly below average across the profession…. but sizeable chunk of thousands of pounds less than the average wage for that job. The only people I see benefiting from agenda for change are the porters, cleaners and catering staff…Agenda for Change doesn't match you, the person, to the wage your worth for the abilities and skills you bring to the task. Reynolds i'm sure brings more to the job than his job description is worth… he isn't the bare minimum, barely competent level of skills that the job requires… and those are the skills you get matched on – what the job is not what you are. So Reynolds like the rest of us will be on the wrong end of what should have been a great opportunity.

  3. I think they said they'd get round to IT staff the day before the deadline and then just pay us what we're on now. And experienced EMTs could get more money. Its all about knowledge and skills. And being in a job longer means you have more – which is rewarded. So maybe an Advanced EMT is on the cards.I scored and matched my own job and I came out in the band which my current pay is in. So frankly my dear, I don't give a damn.

    Unless they cock up royally.

  4. Are these figures with or without any London weighting? You should push for added merit for all of the unpaid PR work you're unofficially doing for the LAS!Cheers


  5. Oh great. So in essence:-a bunch of bureaucrats in a meeting came up with the strapline “Agenda for Change” and then hurried along to the buffet.

    – a state of confusion settled in as the people working under those bureaucrats tried to decide what was meant.

    – frontline staff ended up feeling even MORE undervalued than they already did. Some will leave.

    Batsgirl's Predictions:

    – the remaining frontline staff have an increased workload which adds even more stress to the drop in morale.

    – waiting lists for OTs, physiotherapists etc get even longer than they already are.

    – bureaucrats read about how Joe Public is affected by this and another meeting will be called, probably to apportion blame to the frontline staff and come up with another, more dynamic strapline.

  6. The way I read it, the point was more that EMTs will be in different pay bands for doing the same job, rather than one pay band for the job with differing pay levels within that band according to experience and so on.

  7. yup.. thats it as i see it (from the outside looking in) and it makes you wonder why the unions even bothered to show up to the… the other rescue services…

    I dont think we need worry about terrorists, our own red tape muppets are going to do more to destroy morale than any nutter with a rucksack….

  8. Jesus bleeding Christ. What is so difficult about the concept that people who have to put heart and soul into a job really *need* good morale? You'd have to be a desk jockey who never did an honest day's work in your life.(I'm slipping into my usual reaction to nasty events: I'm having this beautiful daydream. Ambulance crews everywhere start working-to-morale. Collapsing bureaucrats slowly expire, listening to the crews argue about whether they get paid enough to deal with people like that.)

  9. Local authority workers got hit by exactly the same thing (at least our lot did), in February. Poor sods with twenty years service lost up to four thousand a year as I recall. One guy lost a quarter of his salary under the self same scheme.My version of our reaction was posted on 2nd February 2005. All I can do is sympathise.


    Bill Sticker

  10. Something pretty similar is happening in universities – a 'unified pay scale'. Or actually is that the opposite? Currently academics and other university staff are paid on different named scales, which will be collapsed into one. Seems to me that the only reason pay scales are messed with (whichever way) is to make savings to the overall wage bill.

  11. “now i know the BBC has reported that occupational therapists for one are about to do a mass resignation with regards to their bandings”Can you tell me more about this? I'm an Occupational Therapist, and while I'm not overly impressed with Agenda for Change, this is the first I've heard of this report. (Feel left-out!)

    Would be great to know more or have a link to report if it's online.


  12. “now i know the BBC has reported that occupational therapists for one are about to do a mass resignation with regards to their bandings”Can you tell me more about this? I'm an Occupational Therapist, and while I'm not overly impressed with Agenda for Change, this is the first I've heard of this report. (Feel left-out!)

    Would be great to know more or have a link to report if it's online.


  13. “now i know the BBC has reported that occupational therapists for one are about to do a mass resignation with regards to their bandings”Can you tell me more about this? I'm an Occupational Therapist, and while I'm not overly impressed with Agenda for Change, this is the first I've heard of this report. (Feel left-out!)

    Would be great to know more or have a link to report if it's online.


  14. That's appalling! I've known for a long time that us dispatchers are going to get a raw deal — it hasn't been decided yet, but rumour has it we will be on band 2, the same as cleaners, but I was consoling myself with the fact that once I get my driving in order I would benefit from a juicy EMT wage which would make up for these years on the breadline.I just have to keep telling myself that I didn't choose this path for the money…

  15. while I appreciate that cleaners are an essential part of the service and so on, that comment is making me wonder which employees are in band 1…

  16. Personally I'm doing well out of agenda for change. Really rather well.But I'm embarrassed to be put in band 6, when an EMT would be 5. I work hard yes, but 9 – 5 in a comfy office with no client contact.

    I'm still underpaid for my profession, but I'm in this for more than the money luckily.

    (Oh, and remember that even though the others may get their rise before you, it will all be back dated to 01/10/04)

  17. It seems like Agenda for Change is causing the same kind of controversy that clinical regrading caused for nurses back in the 80s – and I believe that some of those appeals are still outstanding!

  18. This is effecting technicians all around the country and no one is happy and the unions don't care. A lot of techicians are taking a cut in their basic pay which is wrong and the unions have agreed to it!! and now on top of it all they are merging some ambulance services as well

  19. I'm also a technician with the London Ambulance Service and i agree with renolds. It has been a complete and utter co*k up from start to finish. The people who are going to suffer the most are the people of london, Why should i break my balls doing a job i love when i'm not getting paid a decent working wage. Morale is at an all time low in the few years i've been in the firm and i can only see morale getting even worse. Then add on crews being taken off the road for an unpaid meal breaks. London wants a world class ambulance service (from the firms mission statement), Well i'm sorry but someone has to pay for it.

  20. Back in my days (a whole year ago) working as a clerk for the Scottish Ambulance Service, I was on 5.50/hr – so, 10k/year? – and that was in Edinburgh. Granted we were temps, and permanent staff probably got a bit more (they certainly paid the agency a good bit more), and I have no idea what cleaners get – but it couldn't be much less without getting into interesting minimum-wage problems.-AG

  21. I've always been stunned that the unions seem to accepting so much of Agenda for Cheaper Staff without a fight.Out initial job descriptions did not bear any resemblance to nursing, the revised descriptions to bear some relationship to nursing, but horrible nursing. Difficult to explain how bad they are.

    Who are the people doing better out of Agenda for Change ?

    Thank you for your compliment about my site, love yours.

  22. I am a Technician with a different service to LAS. However we are still undergoing the same problems with A4C. We as Techs have had to take a cut in our basic wage. That wage cut is backdated to 1/10/04. This means that where as at the end of september 04 I was getting paid 9 per hour for the work I do it means that I am now only getting paid 8 per hour.Because it is all backdated though it means that all the overtime I have done since 1/10/04 and they have paid me 9 per hour for they will be asking for about 1 per hour back. So we are being sold up the river and right royally screwed over.

  23. You have to pay back money you've earned because it's taken them this long to get their paperwork sorted?Jeez. That's worse than the Tax Credits fiasco.

  24. For my sins, I'm responsible for implementing AfC in an area to the east of the big city. I'm too tired of the whole thing to defend it, and hey, it affects me as an employee too so I have my own gripes…. But just to spice the debate up:Agenda for Change is costing a lot more than the old system, That extra pay is going somewhere.

    The Unions supported it because they can see how much people gain over time.

    It's costing more to implement in Ambulance Trusts across the country than any other employers (up to 20% on the paybill but not all in the first two years). This is because Ambulance staff get among the highest increases of anyone in the NHS….

    …..That may be because Ambulance staff were traditionally underpaid

    The old system was patently unfair to lots of people. Agenda for Change is less unfair.

    Last year hospital Consultants got an average 9.5% pay rise for doing nothing extra. Their morale was reported to have collapsed after the award….

    Don't be angry for too long, Reynolds

  25. The only people across the board who'll benefit from A4C are newly qualified staff with a degree… going onto the NHS Graduate wage of c.15-16K. Regardless of degree, regardless of profession, regardless of anything else! Oh…. that and the managers….

  26. As was said at start, if you are a tech, you move from current pay point 20 to 18 on the scale, top of scale 4 no way to gain pay for skills increase etc. if you do not work shifts thats a 1500 – 2000 pay cut for life, and yes, they would want back any overpayment for time it has taken them to sort it, paramedics will at least be assimilated (BORG ?) on to scale 5 at no worse pay point than they have now, so no loss of pay at all. What dose it mean in reality? well it seems that technicians are not worth having to the nhs persons that wrote the initial outlines. The roumer is it was typed up by a clark that put paramedic down on a description of a tech job and it never got changed, hey presto, shaft the techs by not even being recognised.If many of you had ever met e tech, have been told they were a tech , first question ” so do ambulances need a lot of fixing then?” – most seem to think my job is to fix them. Lord knows they fail enough, but no, i fix people, and so many people call me a paramedic i have to try to stop them, but it is just getting too much trouble.

    Where did the info of 4 5 and 5 come from? i would like to see any official notices of that and read the details, it might actualy make more sence, both techs and paras coming in at current pay points on existing scales. that would seem to be techs on scale 5 with paras scale 5 but about 2 or 3 steps increase.

    Status quo in other words, but just on the new scales, no body gets shafted, no one looses money if not doing shifts. Perhaps its just too simple an idea for them to handle, or was it they were going to uplift paramedics pay (lord knows they deserve it) at expence of the technicians?

    There are several things that need to be pointed out. One is that technicians always work supervised – not true, two, they never work alone – not true, three, they never supervise – not true, four they have less clinical responsibility – not true. even as what is known localy as an 80% staff member, i have had to do solo work on my way from one station to another, working un supervised, and technicaly unqualified and what did the control officer say? ” go and do it, its just a taxi job” so is that all we are? even though i can dive drugs, defibrilate people, and even deliver the odd baby here and there, i am just a taxi driver?

    Just goes to show you what is realy thought of techs by some staf members, let alone the rest of the world.


  27. AfC is viewed as essentially flawed by OTs because OTs and PTs that were paid the same under Whitley are now being banded a band apart in a lot of cases – e.g. community physios at band 6/7 and OTs at band 5/6. Also, in some areas community OTs are being banded lower than acute OTs…just hope it all sorts out before I qualify.

  28. That is disgusting! I can't believe how little they pay you for such a vital job. How come thre's money for doctors and surgeons, but not for those doing high pressure emergency work and facing life and death situations every day?Grrr! Start a petition for ambulance workers to be paid more, and we'll all sign up.

    Ladycat via livejournal.

  29. Thank you for the link.From my understanding, SALTs are in a slightly different position re Agenda for Change than other allied health professionals.

    As far as I'm aware, SALTs negotiated a substantial pay rise (and a deserved one) sometime ago and consequently are seen to be 'benefitting less' from Agenda for Change than other therapists etc.

    Someone please correct me if I'm wrong.

  30. I knew about the OT/PT discrepancies, but didn't realise community/acute OTs were being potentially being banded differently.Did you ever see the 'debate' in Therapy Weekly as to whether OTs and PTs should be on same banding? Interesting (albeit infuriating at times) reading.

  31. I feel for you, I really do. I work for a city council in the north and we been through exactly the same thing … Job Evaluation! It took the council around 7 years to get it to the stage of presenting us with the paylines and new evaluated job monetary values. Talk about a slap in the face when they were published. They say it's not a cost cutting exercise, but it smacks of such.A year later we're still trying to get recognition in our pay packets of a salary that fits the job and recognises our skills, experience, and worth.

  32. I work for a local authority and am a union steward. My understanding of the whole process (called single status in local government world) is that it's based on the idea of equal pay. You might have heard of the Equal Pay act, folks – it's the one that went onto the statute books in 1976 but have never really been enforced. This means that people like yours truly, a Support Worker with adults with learning disabilities, earn on average 18% less than their male counterparts (and that's just in the public sector – the picture in private industry is much worse).Now, I'm not saying for a minute that all union branches have negotiated a good deal for their members. Some have arrogantly just refused to sit down with councils and deal with this, meaning that really shitty deals are imposed on their members. However, the whole deal means that some will win and some will lose out. Fact of life. I find it insulting that people think that, for example, home carers (who also work bloody hard and with some pretty stressful customers) should earn 6.10 an hour just because some (mostly) male workers paid ridiculous bonuses should continue as they are.

    If this is geniunely cocked up then there is a justifiable right for people to be pissed off, but we cannot avoid equal pay and allow low paid women to live in poverty any longer.

    Rant over. Takes deep breath…aaand relax!

  33. I'm not in the NHS but work alongside a lot of people who do and are involved in this Agenda for Change mallarkey. We're up in the Highlands of Scotland and some of the NHS staff do odd jobs, or combinations of jobs that don't really have equivalents elsewhere, and there has been a lot of worry in the past about who the hell they're going to 'match' them with. Not sure where it's got to up here – I have a feeling that there has been the quiet resignation of 'we're buggered we are'.

  34. Hello Tom,This is Dee (a friend of John Young's, you might remember me from the Pit and Pendulum in St. Paul's). I've stumbled across your blog purely by chance.

    A possibly unexpected side effect of the 'accessible' podcasts is that for people like myself, who haven't seen you in ages, it's actually just quite nice to hear your dulcet tones.

    Not shouting at people. 🙂

  35. My understanding is that if you are assesed below your current pay you are protected for 4 years, so no one will have to pay any money back. However that is not to say that I am happy with the amount of time that this whole fiasco has taken out of NHS working time (ie everyone rewritting their job descriptions as just one example).

    My own job does not match any of the proformas so today I have recieved an email asking me to fill out a job analysis form by the 31st August. The form is 31 pages long and the advice about how to fill it in is 35 pages long. Suzanne

  36. Nobody in post should be expected to take a pay cut. Pay levels should be protected for those already in jobs – after all, people take on mortgages, etc. on the basis of their income. I'm amazed that you will be on lower rates of pay, plus possibly have to pay money back. This is disgraceful.Snoop

  37. No matter what band “they” put you in, I doubt it'll be what you and the rest of the Ambulance service are truley worth.They should just give you a damn good pay rise, and stop wasting money on themselves, or these stupid fact finds

    Tube Dude

  38. They're all barstewards that dreamed up this idea then have realised that-oh! Its not so easy to implement after all! My bloke was PTS and has been promised back pay since the start of the year for A4C, now he's moving onto the EMT course I bet it'll be another year before he gets the contact for that job. Not that he's seen the PTS A4C contract as yet, there was a rumour it had *actually* been sighted at the station…. Bang goes our new kitchen til he gets that money through. And all the time its been sitting in their coffers earning them interest, while some bureacrat fannies about on a 9-5, never touching a patient, earning twice as much as the guys on the street.And breathe… 🙂

  39. I've also got the form for Agenda for Change and they only allocate 8 hours to fill it in. It doesn't have an area to complete about stupid forms tho., Although I work on Trust pilot projects in the specialist area of sexual health I also wash cups, vacuum and clean the toilet at our drop in that is too small an area for them to get a cleaner to do. Will this score me more points or not? Oh take me back to the days of whitley and my A&C 6

  40. Emergency Medical Dispatchers in London have been given the Option to opt out of agenda for change , as management have admitted as agenda 4 change stands at present EMD's would be worse off.

  41. Reynolds,I know there's a lot of bad feeling over the AFC issues, the uncertantity is a killer and I do appreciate how you all feel, however I think a bit of honesty should be interjected. EMTs will be about 2K better off, they will have a shorter working week and more anual leave. EMTs don't all do the same job, you know it and so do I, some a great, some terrible, some have taken on new skills, some are stuck in the 60s this should be reflected in the pay they receive. And finally, the vast majority of jobs have pay upgrades to reflect experience and loyalty why should ours be any different?


  42. i've been in the ambulance service for 10years, but only been an EMT for two and a half years post miller. Does my time i worked for the patient transport service not count as experience?? because i know i have more experience than the kids that are coming out of uni after completing the paramedic course. so why is the case most probably going to be EMT'S 3 PAY BAND 4 EMT'S 4 PAYBAND 4/5AND THE KIDS WHO HAVE JUST LEFT SCHOOL PAY BAND 5/6



  43. I think you should pop up to Carlisle and see how many theatre staff (old 'd'grades) have been paid, i think your opinion will change rather rapidly

  44. Does anyone know if i'm protected? Just received my Sep pay statement and i'm 's worse off! Not good. My salary s now 15069 (i'm an admin secretary) whereas before it was 14600 plus 550 in proficiency allowances which seem to have now been 'included'. Problem is that my last increment was in feb this year (onto max) and this review has 'assimilated' me as at 1st October LAST year!! Should they have then rolled me on an increment to represent February's payrise cos if they should then by my reckoning i should now be on 15509 (smiley!!). Lokks like i'll be a good few pound worse off at this rate until next years increemnt. Something wrong here surely ….. any bright people out there who'be been stitched up like me …

  45. had a bit to drink so here goes. a4c is pants. the service here in scotland cant afford to pay us, so they wont. the evaluations will be re written so paramedics dont work in a supervisory role and techs must be supervised. we have been assesed as in bands 5 and 6(acording to my union rep), but watch this space. it will never happen. lots of rumours but its all pants. if they can screw us over they will. they do in everything ealse!!


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