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Published: 24/10/2002, Volume II2, No. 5828 Page 10 11 12

Delegates to the Association of Healthcare Human Resource Management conference were treated to what one speaker described as 'a little flash of the Agenda for Change thigh'. Tash Shifrin watched the floor show

Now is the time for a million or so NHS staff to keep their eyes peeled. For although the naked truth about the NHS's long-awaited new pay system has yet to be revealed, human resources managers were last week given what the NHS Confederation's Alastair Henderson dubbed 'a little flash of the Agenda for Change's thigh'.


Mr Henderson, along with NHS head of pay Ben Dyson and Royal College of Midwives negotiator Jon Skewes, chose the annual Association of Healthcare Human Resource Management conference in Chester to offer the tantalising glimpse of flesh.

And a good job, too. NHS chief executive Nigel Crisp and HR director Andrew Foster had been noticeably coy about the details in their keynote speeches, though Mr Foster certainly delivered entertainment along with a message about shifting the HR agenda from 'strategising to implementation'.

Poor Mr Crisp, always the warm-up man. This time Mr Foster refused to repeat the balletic cross-stage leap he performed at July's 'HR in the NHS' conference 'for insurance reasons', but his imitation of health secretary Alan Milburn helped make up for it.

Mr Foster revealed that Mr Milburn and relevant officials are summoned to see Tony Blair once a month for 'what's called a Number 10 stock-take'. The 'slightly adversarial' proceedings in the Cabinet room begins when 'the prime minister's entourage sweeps in'.

Then comes a passable imitation of Mr Milburn's North East accent: 'Well prime minister, what's your biggest worry about the NHS today?'

Mr Foster switched back to his usual tones to reveal that Mr Blair then turns to his special adviser to ask what his biggest worry was, with the advisor replying: 'It is the workforce, prime minister.'

But the key points of Mr Foster's speech concerned using the threeyear finance allocations to bring in new staff and boost capacity in a planned manner at, or before, the beginning of the year, rather than the traditional end-of-year rush to meet targets; integrating workforce data so the same information can be used for local needs and national monitoring; and building up HR management capacity.

He told delegates that the Department of Health was going to set up a central management capacity unit to plan and deliver HR capacity, raise the status of HR management and mainstream its work, and to offer training geared to different career levels as well as particular topics.

A core team would be appointed from next April, he said.

On Agenda for Change, however, Mr Foster would only go as far as suggesting that the end of four years' negotiations would come 'in weeks rather than months'.

Messers Henderson, Dyson and Skewes were more revealing - though not without differing emphases, reflecting their different constituencies.

Negotiators were 'currently looking at eight pay bands' and a set of nationally agreed job profiles, with 'a couple of gateways within the pay band' as a way of 'making sure staff are fully trained and qualified for the job they are doing', said Mr Dyson.

Mr Skewes' version is that there will be eight or nine pay bands.

The gateway system has 'not been decided yet' and 'the unions remain to be convinced that the normal system of incremental progression is not better'.

Extra sums to cover the cost of living in a high-cost area and recruitment and retention premiums are also under discussion, with the possibility of having a mechanism to take account of long-term factors and another - possibly a one-off payment - to cover short-term situations.

The negotiators are also seeking to rationalise the system of unsocial hours rates, looking at averaging unsocial hours worked over a period of time and using banding so, in Mr Dyson's words, 'staff working a broadly similar number of unsocial hours will have the same percentage support'.

Mr Skewes pointed out that this is 'harmonisation at the very edges of disharmony', with difficulties reconciling the situations of different groups of staff, often breaking down on gender lines.

Mr Henderson focused on managing expectations - both of staff and of managers - about what the new system will deliver.

'There will be huge criticism, ' he said cheerily. 'That is what new pay systems are for... after four years everyone's dying to have a go.'

But he stressed that 'delivering huge pay rises for all staff 'was not what the new system was for.

Instead, the aim was to allow the NHS to 'create and reward' the types of roles NHS organisations needed.

Management expectations that Agenda for Change would solve all their problems also had to be deflated. 'It is an enabler and a tool for other things, not a solution in itself, ' he said.

And the new system was a tool for entire management teams, not just 'the anoraks in HR' - a 'term of affection', he clarified.

Mr Skewes' emphasis was - again - subtly different. The new pay system was not just there to support the NHS's future HR strategy, which the unions do support, but it 'has also to address the concerns of staff '.He also pointed out that the unions have some 'bottom lines'.

A few tense weeks are clearly in store for the Agenda for Change negotiators.

What a pity the pay talks are unlikely to replicate the knockabout fun that was the 'meet Amos and Abberley' conference session, featuring the perhaps unlikely double-act of Unison assistant general secretary and former hospital porter Bob Abberley and NHS deputy HR director David Amos.

Mr Amos regaled the conference with tales of his first day in NHS management, when the chief executive called him in to say the head of portering had just resigned and he was to take over. There was the young Mr Amos, 'fresh from public school and university with 27 Bobs to deal with...' Mr Abberley produced an even greater effect when, asked to describe an NHS hero, he told of the consultant anaesthetist who came in one day and said, 'Today, I am going to do your job.'

By pushing trolleys himself, 'he showed me my job was important, ' said Mr Abberley.

Amid the Amos 'n' Abberley jokes and banter in a session that had the delegates laughing, that was something of an eye-opener.

New ways of working for the HR professionals to go home and think about. l 'I am it'- HR in primary care trusts Primary care is meant to be at the leading edge of the modernised NHS.But when it comes to human resources capacity, the new organisations - and their small supply of HR managers - are struggling bravely to keep up.

Rochdale primary care trust HR manager Jennifer Fisheris quick to identify the main issue for HR managers in PCTs - resources.'I am it, single handed. I am one third of the structure and have been for six months now. It is very, very difficult.Things move very slowly.'

Ms Fisher says all the administration and paperwork is landing on her desk.The PCT has 'had a temp in', but not someone who could answer staff queries about their holiday entitlements.'We are doing really basic things as well as strategic ones - That is a bit uncomfortable, ' says Ms Fisher, who joined the NHS from the private sector.

Lesley Moschogianis, HR director at neighbouring Heywood and Middleton PCT, says a key issue at her PCT is having staff come in with 'lots of different terms and conditions and the whole process of trying to harmonise those and bring people into line within the identity of the PCT'.

She says: 'People have been subjected to a lot of change.They're unsettled, some are on fixedterm contracts.There is a lot of work for us to do.'

There is 'a lot of joint-working' between her PCT and Ms Fisher's, though 'We have not yet got trust headquarters'and Ms Moschogianis stresses: 'We both like our jobs very much.We are optimistic.'

But she says: 'We are missing out on doing the important developmental stuff we really need. It is uphill at the moment.'

Sally Storey, who has recently moved from a community trust to become HR and organisational development director at Queen Elizabeth Hospital trust, London, warns that shared services are not a panacea for PCT HR managers.'I am finding shared services are going beyond the economies of scale in transactional services - payroll and so on.Too many PCTs are at a critical stage of their development and are relying on shared services covering them.At my last trust, there is an HR director who covers three trusts and can't physically get to all the board meetings and exec meetings to provide the strategic input.'

More junior HR managers are 'taking the primary responsibility', she says, but 'do not carry enough weight at board or exec level'.

'At a critical stage of their organisational development, the organisations that need strategic HR the most are getting least.'

Ms Storey says: 'HR managers in that position are getting hacked off and getting out.'

And she urges that strategic capacity must be developed locally rather than left to directors in shared services who 'do not have the contact with people that enables you to influence strategically'.