In the second of his articles on developments with Agenda for Change Colin Adkins, Amicus/MSF’s research and policy officer, looks at the Knowledge and Skills and Framework.


The Agenda for Change negotiations on a new NHS pay system have been underway for nearly three years. As the talks are being conducted on the basis that "nothing is agreed until everything is agreed", it has been difficult to report on the new system that was emerging in the talks as this was still evolving.

It has however been agreed that some factual information about the proposed system can be made available to NHS stakeholders, provided its status is made clear and it does not prejudice the position of either side in the talks. The following information on part of the new system known as the "Knowledge and Skills Framework" (KSF) has been prepared on this basis.

What is the KSF?

The White Paper Agenda for Change said that the Government would work in social partnership with unions and employers to develop guidance on, amongst other things, how staff can move up new pay spines dependent upon the demonstration of applying increasing levels of knowledge and satisfactory performance.

Presently in nursing staff move through the spine by ‘natural progression’ until they reach the top of the scale. There they can progress further by Discretionary Points or meeting the criteria for the Modern Matron or the NVQ linked increment for grades A and B.

A "Knowledge and Skills Framework" or KSF is being developed to support the consistent application of standards for all jobs in the NHS. It has strong links with a number of other skills based initiatives such as the lifelong learning framework in England and it will be important in developing a workforce focused on delivering patient centred care and service improvements. The KSF does not seek to replicate existing work – for example on National Occupational Standards – but rather to provide a common framework which unites existing initiatives with local standards in a way which supports consistent development and appraisal of staff, as they move around the service.

What progress has been made?

This is a highly ambitious task. A group of NHS managers, representatives of staff organisations and civil servants was formed last year to design the framework, with help from external experts in the field. Maximum use has been made of existing work (for example, on National Occupational Standards, QAA benchmarks and regulatory frameworks). A draft is expected to be available shortly, after which there will be a period of testing with front-line managers and staff (similar to earlier testing of the Job Evaluation Scheme).

Amicus MSF is represented in this work by Anne Owen, CPHVA Professional Officer in Wales.

How will the KSF be used?

The expectation is that although in practise the KSF is a large document, locally management and staff will only access the element relevant to their use. It is envisaged that a computerised tool will be developed to support management and staff in agreeing and applying common descriptions of knowledge and skills to both their current jobs and also when planning future job roles, through an informed development and appraisal process.

To do this the KSF describes a number of "dimensions" of knowledge and skills. Some, which are expected to be relevant to all NHS jobs, are described as "core", for example "oral communication". All staff need communication skills although the level of skill required will vary between different types of job. Other dimensions, such as "research and evaluation", will apply to some jobs but not others. These are known as "specific" dimensions.

Each dimension has "level descriptors" with further detail relating to them - these describe the generally recognised steps in extending and applying knowledge and skills in a NHS environment. Across the KSF there is an aim to have a common language between the dimensions and levels and this should link easily to existing national and most local frameworks.

What will happen next?

Over the next few months the Knowledge and Skills Framework group will continue to test the KSF against real jobs in the NHS. After agreement on Agenda for Change is reached, further refinement of the KSF will take place in a number of early implementer sites.

What is the staff side view and will this effect my pay?

The KSF development work is being developed jointly, with Staff Side involvement. The development of the KSF is still at an early stage. Much more work and testing is required before a final document can be produced and agreed. The Staff Side fully supports moves to improve staff development and learning opportunities for staff. We have argued of strong link between any competency framework and access to funding and time-off for Continuing Professional Development. The Staff Side do not support a link between pay and the KSF.

However, as we have seen in teaching we have seen that the Government is committed to improving the public sector by linking pay movements through the pay system to performance or competence. Amicus MSF believes that Government over estimates the effect of pay as a driver for change or at least there are other factors, particularly for health professionals, that determines the level of performance. But the Chancellor is linking additional resources to modernisation and improved performance. This will be particularly true as far as additional monies for pay modernisation is concerned.

Any new system has to overcome scepticism because Staff Side has been badly bitten in the past with such systems. For example Discretionary Points are a crude competency based system and we have proven them to be discriminatory in their implementation. Often employers left to their own volition distort agreed criterion in order to control the salary bill.

In their defence many professions have competency frameworks but with professional practice in mind.

Therefore it is a major task to develop a fair, objective and non-discriminatory system that acts as a facilitator of change and improved clinical practice. The alternative is that it is used by local management to hold staff back and prevent them fulfilling their potential or as a means to not reward staff who make an extra contribution to improving the service.

The ‘vision’ for the KSF will be very important to ensuring its success. Otherwise it will quickly fall into disrepair and disrepute. We are hopeful that the Department of Health has learnt the lessons of the past through our discussions around Agenda for Change and initiatives around Improving Working Lives. Certainly draft HR supporting documentation underlines our optimistic approach to a successful outcome of this aspect of the talks. Although we still have some to travel till they reach their conclusion.

Amicus MSF is aware that a number of trusts have or are considering developing their own staff development schemes (some potentially linked to pay). Local Accredited Representatives in such trusts can use this statement to help argue that local employers should not at this stage undertake such work as a national framework is being developed in partnership. If this fails a reference to the Audit Commission for wasting public money should be made.

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