1.    How do I find out how this would affect me?

Use the pay calculator on this website. All you need to do is put in your current pay band and pay point and you will be able to see exactly what would happen to your basic pay over the three years.

2.    Why are unions recommending this proposed agreement?

When Agenda for Change was first agreed over 13 years ago it was far from perfect. There was unfinished business including pay bands that were too long, overlaps between bands, and points which were too close together. These issues have been made worse by eight years of pay restraint.

The autumn of 2014 saw the first industrial action in the NHS over pay for 30 years. One of the things we got out of the settlement was agreement to hold talks about refreshing the pay structure to make it work better for the NHS and staff in the future.

Since then the trade unions have been pushing their agenda for improving the rate for the job at the top of pay bands – to ensure payment of at least the real living wage, improve starting salaries, remove overlaps between bands and reduce how long it takes to reach the top of bands.

The shift in government pay policy created by union campaigning and the general election outcome meant we had a window of opportunity for another push for change. We were successful and got funding in the 2017 Budget for the reforms we have so long wanted to see. This proposed agreement gives us wins on every one of our aspirations. The only exception is that future staff in bands 8abcd and 9 would have the same length of time to the top of the new bands (five years) – for all other bands it would be quicker.

The unions believe that the overall balance of the package delivers real gains for NHS staff currently in the service and will make working in the NHS more attractive for the new recruits we so desperately need to attract.

3.    How does this agreement match up against the joint union pay claim?

 Our joint union pay claim had three elements: an increase to match RPI inflation; a flat-rate additional sum of £800; and investment in reforms to the pay structure to improve starting salaries, remove band overlaps, make it quicker to get to the top of bands and to lift pay above the real living wage.

The proposed agreement would fully deliver on the third element of the claim because there is new money committed to pay for the reforms that we wanted.

Our claim asked for RPI plus £800 in 2018/19 but did not extend to subsequent years. The most recent RPI rate (Feb figure published in March 2018) fell to 3.6%.

For staff at the top of the bands the increase in the first year of the proposed agreement is less than what we asked for in the claim.

For staff below the top of the bands the increases proposed over the three years are between 9% and 29%. For some this would be worth more to them in a single year than RPI plus £800, but for some it would be less, and these total increases wrap up pay awards, reform and accelerated progression.

In any negotiation a pay claim is what the unions bring to the table as the starting point for discussion. But the other side comes to the table with a very different set of demands.

We believe that the proposed agreement is the best that we could achieve through negotiations and comes close enough to our claim overall for us to recommend it. This is because it delivers major increases for those not yet benefiting from the full rate for the job, and meaningful increases for those who already do. It is also a big step forward in ending low pay in the NHS. Above all it would deliver the longer-term reforms to the pay structure we have been working for since 2015, and would give staff some certainty – in increasingly uncertain times – about what will happen to their pay over the next few years.


4.    Does it just apply in England – what about the other countries?

 The proposed agreement applies to England only, at least for now. If the agreement is adopted in England, the Treasury would provide the funding to pay for it. This funding increase would flow through to governments in Scotland, Wales and Northern Ireland.

The unions are talking separately to devolved governments and employers about how they could draw on the England agreement to put together a package that might work in their own countries.

The unions remain committed to preserving the Agenda for Change pay framework across the UK and to seeking levelling up where pay rates have diverged.

5.    How will this deal be paid for?

The Treasury has committed to providing £4.2 billion of new money to pay for the deal. If it’s accepted by union members the money would be distributed via the normal Department of Health spending allocation processes and NHS Improvement is working on a system for how the extra money will be allocated appropriately to individual employers.

6.    If we don’t accept this deal, what’s the alternative?

We believe that the proposed deal is the best we could achieve by negotiation so members need to be aware that if the outcome of union consultations is for the unions to reject the deal, it is unlikely that the government will agree to re-open talks.

Instead they are likely to revert to the Pay Review Body and ask it to recommend a one-year award. We would either have to accept that outcome or try to force the issue through a dispute that members would need to be prepared to participate in.

The £4.2billion the Treasury has said they will provide is conditional on the deal being accepted. If we reject the deal then there is no guarantee that any additional money will be forthcoming and the PRB would have to base any recommendation on what it deems to be affordable to the service. It might also look to recommend awards targeting particular occupations or geographical areas, as it has previously indicated that it might do.

7.    What happens if inflation rises in the latter part of the deal?

 Inflation is forecast to keep coming down over the next couple of years but we all know that these are very uncertain times for the economy, not least because the effects of EU exit are not yet known.

The trade unions insisted on a clause in the draft agreement confirming that the NHS Pay Review Body will monitor implementation of the agreement and that parties will be able to go to the PRB with concerns about how it is panning out in practice. This means that if the economic situation changes significantly we will be able to go and make a case to the PRB for additional pay awards to ensure that NHS pay doesn’t start falling behind again.

8.    How can I be sure I won’t lose out because of my particular individual circumstances?

Throughout the negotiations, the trade unions have sought to cover every eventuality and we are confident that the proposed deal would deliver real gains for every member of staff compared with the existing policy of pay awards capped at 1% and any incremental progression due. In the unlikely event that a combination of special circumstances would mean this was not the case, the trade unions secured a ‘no detriment’ clause which would protect any such individuals.

To see how much  better the pay proposals are for your pay point compared with current arrangements go to What does the pay deal mean for me? and click on your band

9.    Our pay rise was due from April 2018, will it be back-dated?

Yes the agreement would be effective from 1 April 2018 and increases would be backdated to this date.

10. What do employers get out of the deal?

Employers in the NHS have been increasingly concerned that pay restraint was adding to the difficulties they face in recruiting new staff into the NHS and retaining the staff they already have.

Pay in the NHS has fallen further behind comparator occupations, and the financial pressure on staff, and damage to morale, are making existing staffing shortages considerably worse. The pay proposals should help the employers improve recruitment of staff. This is particularly the case for the key shortage professions, and for lower paid staff where the NHS is struggling to compete because of the rising National Minimum Wage and increasing number of living wage employers in other sectors.

In addition, the employers wanted provision in the agreement for joint partnership work at national and local to improve staff health and well-being through measures to reduce sickness levels. This may include better absence management and access to more support for staff with musculo-skeletal and mental health problems. The national agreement provisions on managing sickness absence would  be reviewed as part of that work.

Finally, the proposed agreement would introduce a new system for pay progression – coming in from April 2019 – which will mainly affect new staff and those who get promoted. This would require all employers to follow what some have been doing since 2013, in linking pay progression to appraisals so that increments no longer happen automatically.

The employers were keen to make this standard practice in order to bring consistency of approach and use pay progression as a tool to drive up the importance of high quality appraisals, staff development and good line management.


 11. Will I have to give up a day’s holiday?

No. Annual leave was one of the things put forward during the negotiations by employers and a leak to the press suggested that this would be in the final package. The trade unions made it clear at the time of the leak that members should wait until they heard from us about what was in the final proposals rather than believe rumours and speculation. All annual leave entitlements will stay as they are.

12. Will any other leave entitlements change?

No other leave entitlements will change. But the proposed agreement would provide for local employers and trade unions to work together to introduce local ways of guaranteeing that staff can access the annual leave and TOIL entitlements they do have, as we know many staff struggle to take what they are owed.

We have also agreed to have further negotiations on new entitlements, to be added to the NHS terms and conditions handbook covering child bereavement leave, enhanced shared parental leave, and a national framework for buying and selling of some annual leave.


 13. I’m on band 1, what’s going to happen to my pay?

Your pay will rise to £17,460 from 1 April 2018. The proposed agreement would also mean that at some point before 31 March 2021 your local union reps and your employer will work together to alter band 1 job descriptions so that they become  band 2 jobs. This would be done in consultation with you and your colleagues, and you would get training and support to take on any additional duties. The type of changes involved could include more interaction with patients (such as serving drinks) or more responsible for ordering and maintaining stock and supplies.

This process has already been completed across Scotland with full union involvement , so we would be able to draw on the Scottish experience to provide advice and guidance to local employers and unions.

During the three-year proposed agreement the band 1 rate will increase to £17,652 in April 2019 and in April 2020 it will hit £18,005, which will also be the bottom rate of band 2.

At some point before April 2021 you should have completed your move into band 2 and after two years in that band you would be eligible –  through the new pay progression system linked to appraisals – to progress to the top of band 2.  From April 2020 this is £19,337 and will get uprated by any annual pay awards due from April 2021 onwards.

In exceptional cases individuals will be able to choose to stay on band 1 if, for example due to certain benefit entitlements, they would be better off doing so.

14. Why are staff in bands 8abcd and 9 being treated differently?

Cap for 8d and 9: If you are on the top of band in bands 8d and 9 you will receive a lower percentage increase than colleagues at the top of other bands. This is because the Government insisted on limiting the award to staff on the highest points of the top two pay bands. If you are on the top of pay band 8d you will get 5.4% over three years (rather than 6.5%) plus the same 1.1% lump sum as other staff in 2019. If you are on the top of pay band 9 you will get 4.6% over three years (rather than 6.5%). You would also receive a lump sum in April 2019, worth about £800.

Length of stay unchanged: For new starters to pay bands 8 and 9 it will take five years to get from the bottom of the band to the top. This is the same as now. The length of stay for other bands has been reduced because it has been much longer, for example, seven or eight years for pay bands 5, 6 and 7.

Re-earnable pay for pay bands 8c, d and 9: There will continue to be an element of re-earnable pay for staff in pay bands 8c, d and 9. However, annually earned pay will only be used in the year after you have reached the top of the band. Subject to performance, you will keep your basic salary or your employer will reduce your salary by 5 or 10 per cent. If your salary is reduced, you will be able to restore it the following year by achieving agreed levels of performance.  Detailed guidance will be produced to help employers use annually earned pay effectively and consistently. These arrangements build on the current system whereby the top two increments (worth about 5% each) are re-earnable. The main difference is you will become subject to re-earnable pay after you have reached the top of the band and not before, as now.

You may have a reserved right to one of the top two points when re-earnable pay was introduced for pay bands 8c, d and 9 in 2013. If so you will keep that reserved right on a marked time basis.

15. Why is my colleague getting a much bigger increase than me when we’re on the same band?

Individual pay awards vary because they are made up of differing mixtures of annual pay awards, incremental pay progression and improvements to the pay structure. Staff at the top of their pay bands are already benefiting from the full rate for the job they do. Unions have long heard from our members how unfair it is that some of the current pay bands contain so many pay points meaning that it can take six, seven or eight years to reach the full rate for the job.

We are also concerned that the overlaps between pay bands are both unfair, and risky from an equal pay point of view. This is because they mean that staff doing a job that evaluates higher can, for a period, get paid the same or less than someone in a job that evaluates lower.

In the pay negotiations we were determined to make the reforms needed to put this right. That means that the proposals give greater increases over the three years to those staff at or near the bottom of the pay bands. This arises from deleting pay points from the bands and merging points upwards, at the same time as individuals may be moving up an increment. This is complicated and means that the proposed pay deal would mean different things for different people, but we believe it is worth it in order to create a fairer system for the future. 

16. What would happen to my High Cost Area Supplement?

The current arrangements for calculating HCAS remain unchanged. The minimum and maximum thresholds for each tier of HCAS will be uplifted by the headline top-of-band consolidated awards for each year. That means they will rise by 3% from 1 April 2018, 1.7% from 1 April 2019 and 1.7% from 1 April 2020.

17. The government cut unsocial hours payments for doctors, aren’t they cutting ours too?

There are no fundamental changes to unsocial hours in these proposals. There are three areas where adjustments would be made to ensure greater consistency and deal with the knock-on effects of major changes to the pay scales.

The first is that staff in bands 1,2 and 3 who are on pay points 1-8 currently get paid unsocial hours payments if they are off sick. In the new structure these pay points will not exist anymore. So, the proposal is that eligibility for unsocial hours in sick pay will be pegged to the current value of pay point 8 – £18,160. In future those earning up to this cash amount will still get the unsocial hours in sick pay. Those above will not. As salary bands rise this provision will be phased out altogether as minimum salary levels overtake £18,160.

The second area is that for staff in bands 1-3, the current cash value of your unsocial hours payments would be held for the duration of the deal. So, for example, an employee at the top of band 2 currently gets an unsocial hours payment for work on a Saturday of time plus 44%, which is £4.09 an hour extra. This same cash rate would be applied until 31 March 2021. Then from 1 April 2021 unsocial hours entitlement would revert back to being calculated as a percentage and this percentage would be time plus 41%. These changes have the effect of preserving the cash value of unsocial hours while the pay restructuring takes place, but stop any leapfrogging effects where staff in lower bands end up earning more than those in the next band up for the same unsocial hours shift. Once the changes to pay bands have been complete the system resets with the new adjusted percentages for the future.

Finally, for current ambulance staff there will be an individual choice as to whether to continue with the unsocial hours entitlements in annex 5 of the NHS terms and Conditions handbook or to switch to the system that applies to all other staff in section 2 of the handbook. New recruits would be recruited onto the section 2 arrangements and this would also apply for existing staff who change roles where a new contract is required.

18. I work in the ambulance service, what is happening to our terms and conditions?

For current ambulance staff there will be an individual choice as to whether to continue with the unsocial hours entitlements in annex 5 of the NHS terms and Conditions handbook or to switch to the system that applies to all other staff in section 2 of the handbook. New recruits would be recruited onto the section 2 arrangements and this would also apply for existing staff who change roles where a new contract is required.

19. Some of the pay in increases look big – what do they include?

We have won the argument that the top of each pay band is the proper rate for the job. The offer includes a major reform of the pay system with agreement to get most staff to the top of their bands faster than under current arrangements.

Getting to this new system means variation in changes in earnings for staff, depending on which pay point they are on. If the offer is accepted it is guaranteed that everyone will be better off compared to existing arrangements

For some staff the gain over three years is quite small. However, most staff who do not gain much compared to existing arrangements over three years get a bigger gain in 2021/22 as they reach the top of their band earlier than they would do under existing arrangements.

For staff not yet at the top of their pay back the exact timing of increases will depend on their anniversary/incremental date.

For example:

Band 2 Point 3 - Current pay                                                        £15,671 (second point in band)
Increase over three years (current arrangements)           £1,811 / 12%
Increase over three years (pay offer)                                     £3,666 / 23%

Band 7 Point 34 - Current pay                                                     £41,787 (top of band)
Increase over three years (current arrangements)           £1,266 / 3%
Increase over three years (pay offer)                                     £2,716 / 6.5% (plus a £437 lump sum)

Band 6 Point 24 - Current pay                                                     £29,626 (3 years in job, or paramedic transferred from top of Band 5)
Increase over three years (current arrangements)           £4,097 / 13.8%
Increase over three years (pay offer)                                     £4,153 / 14%
Increase over four years                                                               £8,264+ / 28%+

20. How does the pay offer compare to inflation?

For nearly a decade the government has restricted NHS pay to below inflation. This pay offer is better than what was previously on offer, but does not make up for earnings lost over those years.

There are lots of different ways of measuring inflation. None of them are certain. For example, the Office of Budgetary Responsibility predicts total CPI inflation to be 6.9% over the course of the three years, compared to a 6.5% headline pay award plus a one-off 1.1% lump sum. Other measurements of inflation, such as RPI, are higher, which would mean the pay offer would be below inflation.

Paul Johnson from the Institute of Fiscal Studies, a respected economist, noted that for those on the top of the band “over three years [6.5%] is likely to do little more than maintain the real value of earnings once inflation has been taken into account.”

However, no-one can predict inflation for certain. What is certain is that the pay offer is more for everyone than existing arrangements.

21. How does pay progression work during the three years of the deal?

Pay progression is not automatic under existing Agenda for Change arrangements. Since 2013 employers have been able to introduce arrangements that allow progression to be withheld if staff do not meet required standards. Because there is significant structural reform proposed to the pay structures over the three years, numerous pay points are being removed. These pay points will be removed in April 2018, April 2019, and April 2020. Staff who are already on a pay point at the time it is to be removed will be immediately moved to the next available point, even where this does not coincide with their existing incremental date. These staff will not receive an increase on their incremental date, because they will have received their pay increase early. 

In 2018/19, this will only be the case for those who were previously on the bottom pay point. In the subsequent two years it will affect more pay points.

Staff will retain their existing incremental date throughout transition. On their incremental date, (if they have not already benefited from deletion of a pay point) it is expected that all staff will move to the next pay point reflecting their additional complete year of experience. Where employers have arrangements in place as a result of the 2013 changes, progression can be withheld where staff are not meeting the required standards.

22. How would the new progression system affect me during the three years of the pay deal?

If you are already employed in the NHS, the pay point you are on will move as set out in the journeys’ document. These movements happen as part of the pay restructuring process. It is expected that during transition employees will progress to the next pay point, subject to any required standards that are in place within their employer. The expectation is that all staff will meet the required standards and therefore be able to progress.

For example, if you are on pay point 14 in Band 4, your journey would be as follows:

Now: £21,263
On/after 1 April 2018: £22,238
On/after 1 April 2019/20: £22,707
On/after 1 April 2020: £24,157 – you would be at the top of the band. 

Roughly 14 per cent of the staff currently employed in the NHS would not reach the top of their band by the end of the three-year deal. If you are on an intermediate point by the end of the deal, your onward pay progression will be determined by the new pay progression system which is described in outline in the Framework document, with operational details agreed in partnership within your organisation. If you end the three-year deal on one of the following paypoints:

£27,416 (Band 5)
£33,779 (Band 6)
£41,723 (Band 7)

You will move to the next point up on 1 April 2021.