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Stuart Gentle Publisher at Onrec

Toolkit launched to help NHS organisations link pay to improved performance

An online toolkit was launched today (5 June) to help NHS organisations ensure staff pay progression is linked to performance as clearly and objectively as possible

An online toolkit was launched today (5 June) to help NHS organisations ensure staff pay progression is linked to performance as clearly and objectively as possible.

Developing that link is important for patient care and in better supporting morale and motivation.

This NHS Employers resource is a ‘one stop shop’ of free advice covering ideas, good practice and examples of where in the NHS the process is working best.

The toolkit, called ‘Linking Pay With Performance’, applies to the Agenda for Change (AfC) framework which covers over one million NHS staff, including nurses, scientist, therapist support staff, administrators and line managers.

Dean Royles, chief executive of the NHS Employers organisation, said:

“The mutually-agreed Agenda for Change framework has been constantly evolving since it was developed in 2004. Changes made last year give greater flexibility on pay progression. We now have an opportunity to use its consistency and flexibility to support improved patient care.

“I know employers throughout the NHS want to deliver the best possible care to patients. We all know high quality appraisals are essential in a safe and modern NHS and this toolkit will help show how to better link pay increments to that process – something that historically has been an issue. Staff want to be rewarded for the work they do and of course it's really important we deliver this as objectively as possible.”

There is of course no simple conjurer’s trick when it comes to pay progression. This is a sensitive issue but no one-size-fits-all approach to this that would work across all NHS organisations, therefore this toolkit encourages local tailoring using the inherent flexibility within AfC. The toolkit’s guidance on this covers many areas including:

  • Making sure that the changes are part of the overall workforce strategy improving services to patients and not implemented in isolation.
  • Engaging early and work in partnership with trade union colleagues.
  • Reassuring staff that the changes are about pushing forward effective performance management and accountability within the organisation.
  • Listening to staff, seeking their feedback and input, keeping the channels of communications open and acting on that feedback.


The toolkit follows a significant adjustment to AfC in April 2013 that saw a greater emphasis on linking pay and performance, which was agreed between unions and NHS Employers.

In the year since that agreement, employers have asked us to share progress on what organisations are achieving and there have been great examples of progress that are explored in the toolkit. Trusts that have taken steps to link performance to pay have reported many improvements:

  • Increased staff motivation, morale and retention as employees are recognised for achieving/exceeding objectives.
  • Cost savings from avoiding overpayment of underperforming employees.
  • Improved performance management processes.
  • Fewer staff on formal disciplinary measures.
  • Increase in staff engagement scores, including stakeholder engagement as seen in organisations like Wrightington Wigan and Leigh NHS Foundation Trust.
  • Using the pay system to help embed core values, as seen in organisations like University College London Hospitals and Cambridge University Hospitals NHS Foundation Trust.


The full toolkit with be available at www.nhsemployers.org/afctoolkit from 9am on 5 June and a full PDF is now available upon request.