NHS: Career Development and Pay
The question
To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure (a) pay progression and (b) career development opportunities for the lowest-paid NHS staff.
Answered by Karin Smyth
Section 1 of the NHS Terms and Conditions of Service, also referred to as Agenda for Change (AfC), sets out the principles for pay progression in the National Health Service in England. It states that pay progression for all AfC pay points, within each pay band, is conditional upon employees demonstrating that they have the requisite knowledge and skills and competencies for their role and that they have demonstrated the required level of performance and delivery during the review period.
The Government accepted the NHS Pay Review Body recommendations for 2024/25 and 2025/26 in full, which included a recommendation to provide the NHS Staff Council with a funded mandate to make improvements to the AfC pay structure.
Improvements to the AfC pay structure, including any band progression for the lowest paid NHS staff, will be for the NHS Staff Council to agree. The NHS Staff Council is a partnership body made up of trade unions and employers and has overall responsibility for maintaining the AfC pay system and associated terms and conditions of service.
The Department intends to issue this mandate as soon as possible. Once the mandate is confirmed, the Department will work closely with the NHS Staff Council to agree reforms to the pay structure which will be backdated to 1 April 2026.
It is the responsibility of individual employers to ensure career development opportunities for their lowest paid staff through investing in the future of their workforce and ensuring appropriate ongoing training and continuing professional development.
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