Practice Nurses Networking and Learning Event Thursday 21st of April 2005

1. Practice NursesNetworking and Learning EventThursday 21st of April 2005 David Renshaw JE Lead, Pay Modernisation Team SEHD

2. Agenda for Change Based on a partnership approach - 17 trades unions and representatives of NHS employers across 4 countries Covering all NHS staff groups except doctors and dentists Negotiations were continued over four years to reach a workable agreement Signed off following the second ballot of some staff side partners on 23 November 2004 A main feature of Agenda for Change is partnership - this has run throughout the negotiations and will continue during implementation. Agenda for Change applies to all staff in the NHS except doctors, dentists and directors (board level managers) as they were included in other pay modernisation negotiations. It has taken over four years for the many different aspects to be negotiated and there are several staff partners who will ballot their members late 2004. A main feature of Agenda for Change is partnership - this has run throughout the negotiations and will continue during implementation. Agenda for Change applies to all staff in the NHS except doctors, dentists and directors (board level managers) as they were included in other pay modernisation negotiations. It has taken over four years for the many different aspects to be negotiated and there are several staff partners who will ballot their members late 2004.

3. Agenda for Change - Implementation NHS Scotland Pay Modernisation Team SPRIG NHSBoard Project Teams SEHD

4. Pay Modernisation Team -Support for NHS Scotland Networking Events Project Managers Job Evaluation Leads KSF Leads Terms and Conditions Leads

5. Agenda for Change - 3 Work Strands: Job Evaluation Knowledge and Skills Framework & Career and Pay Progression Terms and Conditions of Service

6. AGENDA FOR CHANGE � THE 3 STRANDS JOB EVALUATION

7. Job Evaluation Factor Plan Job Matching, JDs & National Profiles Job Evaluation and JAQs Monitoring of Outcomes Allocation to Pay Band

8. Job Evaluation � Why? Basic Pay Determined by new NHS Job Evaluation Scheme Equity and Fairness Equal Pay for work of Equal Value

9. FACTOR PLAN 16 Factors Knowledge and Skills Responsibilities Physical, Mental or Emotional Effort Factor levels & definitions Scoring Weighting

10. MATCHING PROCESS Trained Panellists working in Partnership Job Descriptions & Additional & Verbal evidence Use of National Profiles Do they Match (not evaluate)?

11. Job Descriptions(For Matching) Need to reflect the Factor Plan Identification, Purpose, Scope Organisational Chart Main Tasks Systems, Equipment & Machinery

12. Job Descriptions(continued) Knowledge, Training, & Experience Communications and Relationships Physical, Mental, Emotional Demands Decisions and Judgements Signature

13. JE : Knowledge Factor QUALIFICATION OR EQUIVALENT Nurse - Degree level Nurse Specialist - Post-registration/graduate diploma Team Manager - Diploma + managerial training Nurse Advanced - Diploma + specialist training to Masters equivalent Nurse Consultant - Diploma + specialist training Masters equivalent

14. Agenda for Change Nursing Profiles: Nurse (GP Practice) & (Hospital) Band 5 Nurse Specialist (GP practice) Band 6 Nurse Team Manager (7) Nurse Advanced (7) Nurse Consultant (8)

15. GP Practice Profiles Nurse (GP Practice) 1 Delivers nursing care, including running clinics 2 Provides health promotion advice 3 Carries out immunisations and smear tests Communications 4 Knowledge 5 Freedom to Act 3

16. GP Practice Profiles NURSE SPECIALIST (GP PRACTICE) Delivers nursing care, including running specialist clinics Provides Health Education Carries out immunisations and smear tests Communications 4 Knowledge 6 Freedom to Act 3 - 4

17. EVALUATION PROCESS Trained Panellists working in Partnership Job Analysis Questionnaires Job Analysis Evaluation

18. AGENDA FOR CHANGE � THE 3 STRANDS KNOWLEDGE AND SKILLS FRAMEWORK Career and Pay Progression

19. NHS KSF - Main Purpose Provide an NHS-wide framework that can be used consistently across the service to support: personal development in post career development service development The NHS KSF grew out of the Career and Pay Progression strand of Agenda for Change. Its purpose is to support the development of individuals in their work and in the post they currently hold, to support individuals� career progression throughout their working lives, and to facilitate the development of services so that they better meet the needs of patients and the public. The NHS KSF will be an ongoing focus of the implementation of Agenda for Change. Everyone in the NHS will need to understand the KSF and its use in their own development. The NHS KSF grew out of the Career and Pay Progression strand of Agenda for Change. Its purpose is to support the development of individuals in their work and in the post they currently hold, to support individuals� career progression throughout their working lives, and to facilitate the development of services so that they better meet the needs of patients and the public. The NHS KSF will be an ongoing focus of the implementation of Agenda for Change. Everyone in the NHS will need to understand the KSF and its use in their own development.

20. NHS KSF - Development Developed in Partnership Used existing competences to inform development Tested with different staff groups Working draft 6 : developed and tested during early implementation with EI, Project sites, and specific groups Roll out October 2004 version on SHOW website for reference & training I would now like to move on to look in more detail at the NHS KSF. The NHS KSF was developed by a partnership group of management and staff side. They started their work in 2001and used existing competences to inform the development of the KSF. A number of different drafts were produced and tested with different staff groups. The KSF Development Group produced Working Draft 6 - the first publicly available version of the NHS KSF - for use and further development during early implementation of Agenda for Change. In addition the KSFDG has been undertaking other testing of the KSF to ensure that the version that is produced for rollout, sufficiently captures all of the different roles of staff who work in the NHS. Feedback has been gained and the roll-out version (The NHS KSF) can be used for training purposed until the outcome of the second ballots is known.I would now like to move on to look in more detail at the NHS KSF. The NHS KSF was developed by a partnership group of management and staff side. They started their work in 2001and used existing competences to inform the development of the KSF. A number of different drafts were produced and tested with different staff groups. The KSF Development Group produced Working Draft 6 - the first publicly available version of the NHS KSF - for use and further development during early implementation of Agenda for Change. In addition the KSFDG has been undertaking other testing of the KSF to ensure that the version that is produced for rollout, sufficiently captures all of the different roles of staff who work in the NHS. Feedback has been gained and the roll-out version (The NHS KSF) can be used for training purposed until the outcome of the second ballots is known.

21. What the NHS KSF is not It does not seek to describe what people are like or their attitudes It does not describe the exact knowledge and skills that people need to develop It does not determine job weight or pay band It is important to be aware of what the KSF does not do as well as what it does. As the KSF is designed to inform career and pay progression, it does not seek to describe what people are like or the particular attributes they have (eg courage in the face of danger). Rather it focuses on how people need to apply their knowledge and skills to meet the demands of work in the NHS. It consequently relates to behaviour but in the sense of what people actually do - not any underlying characteristics. This is because it would not be fair to make such generalisations to affect people�s pay and career progression. The KSF is a broad generic framework that focuses on the application of knowledge and skills - it therefore does not describe the exact knowledge and skills that people need to develop. More specific standards/competences would help to do this as would the learning outcomes of learning programmes. The KSF does not determine job weight or affect the payband that jobs are placed on - that is the purpose of the job evaluation system. It is important to be aware of what the KSF does not do as well as what it does. As the KSF is designed to inform career and pay progression, it does not seek to describe what people are like or the particular attributes they have (eg courage in the face of danger). Rather it focuses on how people need to apply their knowledge and skills to meet the demands of work in the NHS. It consequently relates to behaviour but in the sense of what people actually do - not any underlying characteristics. This is because it would not be fair to make such generalisations to affect people�s pay and career progression. The KSF is a broad generic framework that focuses on the application of knowledge and skills - it therefore does not describe the exact knowledge and skills that people need to develop. More specific standards/competences would help to do this as would the learning outcomes of learning programmes. The KSF does not determine job weight or affect the payband that jobs are placed on - that is the purpose of the job evaluation system.

22. Structure of the NHS KSF 30 dimensions 6 core dimensions for all posts 24 specific dimensions Each dimension has level descriptors Further supported by indicators Clear examples of application that can be applied to different posts References to national/UK quality assured standards, competences etc The NHS KSF is made up of 30 dimensions: 6 of the dimensions are core - these core dimensions will apply to every post in the NHS 24 of the dimensions are specific - the specific dimensions will apply to some but not all jobs in the NHS, the ones that apply are selected for the post being looked at. Each dimension has level descriptors - these show successively more advanced levels of knowledge and skills and/or the increasing complexity of application of knowledge and skills to the demands of work. There are 4 level descriptors for each dimension. Each level descriptor has indicators attached to it - these describe the level at which knowledge and skills needs to be applied and are designed to enable more consistent and reliable application across the NHS. Each of the dimensions and levels has examples of application attached to it - these are designed to illustrate how the dimensions and levels can be applied to different posts. UK/ national standards/competences are referenced in the computerised tool to the relevant dimensions and levels in the KSF so that users can move between the broad generic KSF and the more detailed standards /competences if they wish to do so. The NHS KSF is made up of 30 dimensions: 6 of the dimensions are core - these core dimensions will apply to every post in the NHS 24 of the dimensions are specific - the specific dimensions will apply to some but not all jobs in the NHS, the ones that apply are selected for the post being looked at. Each dimension has level descriptors - these show successively more advanced levels of knowledge and skills and/or the increasing complexity of application of knowledge and skills to the demands of work. There are 4 level descriptors for each dimension. Each level descriptor has indicators attached to it - these describe the level at which knowledge and skills needs to be applied and are designed to enable more consistent and reliable application across the NHS. Each of the dimensions and levels has examples of application attached to it - these are designed to illustrate how the dimensions and levels can be applied to different posts. UK/ national standards/competences are referenced in the computerised tool to the relevant dimensions and levels in the KSF so that users can move between the broad generic KSF and the more detailed standards /competences if they wish to do so.

23. Core dimensions The 6 core dimensions that apply to every post in the NHS have been identified to date as: 1 Communication 2 Personal and people development 3 Health, safety and security 4 Service Improvement 5 Quality 6 Equality and diversity These core dimensions will be in every post outline developed, they cannot be left out.The 6 core dimensions that apply to every post in the NHS have been identified to date as: 1 Communication 2 Personal and people development 3 Health, safety and security 4 Service Improvement 5 Quality 6 Equality and diversity These core dimensions will be in every post outline developed, they cannot be left out.

24. The 24 specifhc dimensions are shown in this diagram, split into the four sections. These will relate to some jobs and not others. For example, dimension HWB6 � Assessment and treatment planning and dimension HWB7 Interventions and treatment are likely to apply to some, if not all, healthcare practitioners. On the other hand, dimension IK1 Information processing, IK2 Information Collection and analysis and EF1 Systems Vehicles and Equipment are likely to be relevant to health informatics staff.The 24 specifhc dimensions are shown in this diagram, split into the four sections. These will relate to some jobs and not others. For example, dimension HWB6 � Assessment and treatment planning and dimension HWB7 Interventions and treatment are likely to apply to some, if not all, healthcare practitioners. On the other hand, dimension IK1 Information processing, IK2 Information Collection and analysis and EF1 Systems Vehicles and Equipment are likely to be relevant to health informatics staff.

25. This is another example of a post � this post has one specific dimension alongside the 6 Core. The next three slides will show how this would apply to a post.This is another example of a post � this post has one specific dimension alongside the 6 Core. The next three slides will show how this would apply to a post.

26. Once the specific dimension/s are identified the level for the second gateway is set. This describes the level the postholder will reach once fully developed. Once the specific dimension/s are identified the level for the second gateway is set. This describes the level the postholder will reach once fully developed.

27. Once the levels for the post are agreed in partnership, it is the annual development review which will give individual postholders feedback on how they are meeting the KSF outline for their post. The blue squares are showing us where this person is meeting or above the required level for the post. You can see that in Core 3 Health Safety and Security this person is above the level required for the post, this is because they are a health and safety rep. The pink squares show us where the postholder and their reviewer agree that there is a development need as they progress towards the second gateway. This becomes the focus of the personal development plan for the coming year.Once the levels for the post are agreed in partnership, it is the annual development review which will give individual postholders feedback on how they are meeting the KSF outline for their post. The blue squares are showing us where this person is meeting or above the required level for the post. You can see that in Core 3 Health Safety and Security this person is above the level required for the post, this is because they are a health and safety rep. The pink squares show us where the postholder and their reviewer agree that there is a development need as they progress towards the second gateway. This becomes the focus of the personal development plan for the coming year.

28. Designed to ensure consistency & fairness Normal expectation of progression within pay bands based on applying necessary knowledge & skills to the job Foundation gateway review against subset of full KSF outline for the post 2nd gateway review against full KSF post outline In relation to career and pay progression, there is a normal expectation of progression through the paybands based on individuals applying the necessary knowledge and skills to the demands of the post. There are two gateway points: 1 the Foundation Gateway at which individuals will be reviewed again a subset of the full KSF outline for that post when they are first appointed to a payband. 2 the Second Gateway - the second gateway occurs towards the top of paybands at set points detailed in the A4C agreement. The review of an individual at the Second Gateway point is against the full KSF outline for the post. The whole system is based on the principle of NO SURPRISES - if there are problems with individuals developing towards the full KSF outline for the post, or there are disciplinary issues, these must have been addressed by managers before the gateway reviews. This mirrors good management practice and should be no different from good appraisal practice as it currently exists. In relation to career and pay progression, there is a normal expectation of progression through the paybands based on individuals applying the necessary knowledge and skills to the demands of the post. There are two gateway points: 1 the Foundation Gateway at which individuals will be reviewed again a subset of the full KSF outline for that post when they are first appointed to a payband. 2 the Second Gateway - the second gateway occurs towards the top of paybands at set points detailed in the A4C agreement. The review of an individual at the Second Gateway point is against the full KSF outline for the post. The whole system is based on the principle of NO SURPRISES - if there are problems with individuals developing towards the full KSF outline for the post, or there are disciplinary issues, these must have been addressed by managers before the gateway reviews. This mirrors good management practice and should be no different from good appraisal practice as it currently exists.

29. Pay Structure The new simplified pay structure has nine paybands. The JE system determines where jobs are placed on the paybands. Each of the paybands has a number of pay points. The KSF informs individuals� development across the paybands - career progression. The KSF also informs peoples� development within the paybands - pay progression. This occurs at two key points - the foundation gateway within one year of being appointed to a payband. The purpose is to check that individuals can meet the basic demands of their post. And at a second gateway which is placed towards the top of a payband - when there is confirmation that individuals are meeting the full demands of their post, the focus at this point may move to career development. The new simplified pay structure has nine paybands. The JE system determines where jobs are placed on the paybands. Each of the paybands has a number of pay points. The KSF informs individuals� development across the paybands - career progression. The KSF also informs peoples� development within the paybands - pay progression. This occurs at two key points - the foundation gateway within one year of being appointed to a payband. The purpose is to check that individuals can meet the basic demands of their post. And at a second gateway which is placed towards the top of a payband - when there is confirmation that individuals are meeting the full demands of their post, the focus at this point may move to career development.

30. LINKING THE FRAMEWORKS STAFF GOVERNANCE Both Promote: Learning & Development � Defined competencies Personal Development Plans Partnership, Networking, Professional Leadership Effectiveness at Work, Clarity of Roles Career Structures, Opportunities to Develop for Team & Individual

31. CONCLUSION � NEXT STEPS CLEAR JOB DESCRIPTIONS CLARITY OF ROLE DEVELOPMENT OF COMPETENCIES IDENTIFICATION OF LEARNING NEEDS COLLABORATION, PARTNERSHIPS

32. Agenda for Change � Further Information www.show.scot.nhs.uk/sehd/paymodernisation.afc/htm Tel: 01324 404207 Janis.Miller@scotland.gsi.gov.uk David.Renshaw@scotland.gsi.gov.uk Morag.Thompson@scotland.gsi.gov.uk

33. AGENDA FOR CHANGE � THE 3 STRANDS SUPPLEMENTARY SLIDES TERMS AND CONDITIONS

34. Agenda for Change Terms and Conditions of Service New Pay Structure Harmonised Hours of Work Harmonised Overtime Payments Harmonised Leave Arrangements Ongoing review of Unsocial Hours working

35. Agenda for Change Nine Pay Bands Minimum Point - �11,135 Maximum point - �83,546

36. Agenda for Change Hours of Work 37.5 for all full time staff Overtime Rate Single rate of time and a half Double time only on public holidays

37. Agenda for Change Annual Leave and Public Holidays Annual Leave 27 days on appointment 29 days after 5 years service 33 days after 10 years service Plus 8 public holidays

38. Agenda for Change Payment for Work during Unsocial Hours On going Review � April 2006 Interim Regime Retain current arrangements Adopt new on-call arrangements