Performance-related pay has become a central part go the employers’ armoury to lower pay and undermine union organisation. We are publishing the article below from the Anarchist Federation outlining the intentions of the government’s Agenda for Change in the NHS


Representatives of the approximately 20 trade unions who collectively bargain for workers within the NHS have been negotiating at length with the pay cartel. As it stands the deal on the table to “protect” Agenda for Change in England (Scotland and Wales are not affected) is:

1) Performance Related Pay to be introduced with exact implementation to be decided locally (protected for the lowest paid worker, those in bands 1+2 and first 3 points of band 3). This is the major, major change here. Speaking to UCU members who have seen similar performance related pay in some universities, they inform me that this a form of gatekeeping that unsurprisingly amounts to a major attack on their ability to earn this money. Unreasonable expectations or unsuitable criteria are set in place, where it can actually be logistically impossible to ever proceed up pay points.

Performance related pay is also currently being fought by teaching unions, so would possibly seem to represent the beginnings of a pay model for public sector workers.

2) The removal of preceptorship. This is a pay device that allows newly qualified registered nurses, midwives and allied health professionals to initially proceed at an accelerated rate through their pay points.

3) An agreement to accept strict sickness absence policies and the removal of any payments associated anti-social hour’s rate. This will inordinately affect all care giving staff, who are of course expected to provide a round the clock, 365 days a year service.

4) Staff on bands 8c, 8d and 9 to be placed on a ‘spot salary’. This translates as “pay as low as they think the market can bear”. Whilst these are management roles with the power to hire and fire and instigate structural change, they are also the pay bands responsible for deciding on pay and conditions. From a pragmatic point of view and being clear about the role of the market in this, opting them out of a national agreement is unlikely to engender a desire to fight for agenda for change if they themselves are already opted out of it.

Out of these 20 trade unions (number of healthcare workers they represent in brackets), GMB (30,000) and Unite (100,000) have the rejected the deal out of hand. Unite have explicitly said they are preparing for industrial action in the event of any opting out of Agenda for Change. Other unions have said they intend to accept them, but most including Unison (400,000) and Royal College of Nursing (380,000) are consulting their members with guidance to accept the measures.

These moves show that a majority of health trade bureaucracies to be utterly complicit in what amounts to a managed decline of a workers’ Terms and Conditions. The industrial relations equivalent of, “we had to destroy the village in order to save it”. Even on their own terms Unison states that by agreeing with these proposals may still result in trusts continuing to seek to leave the national agreement.

“While there is no guarantee that agreeing to these proposals will hold 100% of trusts in England to Agenda for Change, the Health SGE believes these would hold the majority and will be consulting branches to get better information on this.”

However with guarantees for unions to have a consultative role in any job re-gradings, and to being involved with local performance related pay structures, the union will retain its primary representative function. When push comes to shove, this is the fundamental bottom line for unions. That is the right to represent workers, including the right to a “consultative role” even if that consultation leads to poor outcomes for their members. In fact we can see how important this role is, how it sees actions by its members as secondary to its own from in this passage, taken from the accompanying Unison consultation briefing (italics by author):

“Over the last year, a number of NHS trusts in England have tried to “break away‟ from Agenda for Change. Members in these trusts have had to organise, campaign and take industrial action to try and stop the employers reducing terms and conditions and moving to local contracts. If members reject these proposals it is likely that the number of these attacks would increase significantly, requiring more members to take action to defend their conditions.”

Of course Unison sells the removal of hard, fought Terms and Conditions as a victory. If it can pass these changes it will accept them as the least worst option rather than risk the unpredictable nature of a demobilised rank and file organising initiative, that will be either sclerotic through underuse or even worse from their view point, has the potential to not be under the full control of the union. Unison made its playbook clear during the recent pensions’ dispute. Even with a mandate it did not risk anything more than tokenistic one day strike action.

So these moves are a clear attempt to gauge exactly how much the membership will take. Any union member in a branch organised enough to arrange this consultation would be advised to reject this slow erosion of Terms and Conditions and stress the need to lay officers and fellow workers of the need for sustained industrial action to defeat them. If your trade union branch recommends these measures then it makes clear the need for all workers, clinical or administrative, on all kinds of contracts to organise and meet and organise outside the union where necessary.

The fight continues.