Foundation trusts are showing an unprecedented willingness to publicly consider moving away from nationally negotiated staff terms and conditions.

Until now, few organisations have been willing to publicly countenance locally negotiated changes to Agenda for Change.

In April, the Royal College of Nursing passed a motion allowing it to ballot for industrial action if an employer attempted to impose any proposal “which challenges the nationally agreed pay agreement”.

But an HSJ analysis of the latest published three year plans of England’s 138 foundation trusts has found that organisations in at least three of the 10 strategic health authority regions admit they are considering moving away from Agenda for Change.

In the North West, Mid Cheshire Hospitals Foundation Trust’s plan said it was “working alongside other providers at a regional level to consider options to negotiate alternative terms and conditions” on areas including incremental progression and sick pay.

Earlier this year, unions rejected a national proposal from NHS Employers to accept a freeze of Agenda for Change pay increments in exchange for a pledge not to make compulsory redundancies.

Mid Cheshire’s plan says it is “expected” that “national discussions on pay will not continue in the short term” but talks “may commence when trade unions see movement on local pay negotiations undermining future national negotiations”.

University Hospital of South Manchester Foundation Trust’s plan states that from 2012 onwards its board will consider “proposals for changes to terms and conditions outside of the national framework”.

In the West Midlands, Birmingham and Solihull mental health Foundation Trust said it would complete an options appraisal “regarding a move away from Agenda for Change”, as part of plans to save £2.6m a year on terms and conditions and staff allowances by 2014.

And in the South East Coast region, Royal Surrey County Hospital Foundation Trust has recently completed a poll of staff asking if they would accept watering down their nationally agreed terms and conditions in exchange for fewer job cuts.

Central Manchester University Hospitals’ attempt to withhold pay increments from those with poor attendance is being legally challenged by unions.

Some trusts may find other ways of watering down NHS terms and conditions. Calderstones Partnership Foundation Trust said it had made “substantial progress” towards setting up a social enterprise subsidiary which will employ staff on non-NHS terms and conditions. The subsidiary will initially be used to win new business, but from 2013-14 the trust aims to transfer its existing business contracts to the cheaper entity.

NHS Confederation chief executive Mike Farrar said although some trusts were attempting local deals, he expected more to be done nationally this winter to secure changes to Agenda for Change terms and conditions for 2012-13. He added there was a “huge responsibility” on employers and unions to find ways of saving money on staff costs while protecting jobs.

RCN head of employment relations Josie Irwin warned that while employers might achieve “short term benefits” by moving away from the national deal she was concerned they “haven’t done the cost benefit analysis [about] engaging in those kinds of discussions, with all their potential for industrial disharmony”.

Ms Irwin added the Calderstones plan was “aggressive, threatening and crude”. A Calderstones spokesman said any changes would involve engagement with staff.

Birmingham and Solihull Mental Health Foundation Trust organisational development director Frances Allcock said it was “good management” to assess “all the possible options”.

An NHS Employers spokesman said it was “essential” that employers had discussions with local trade unions and staff about the implications of the financial challenges.