The knowledge and skills framework of Agenda for Change offers great opportunities for both employers and staff, yet it is not being used to full effect in the NHS. But what can it offer, why is not being used consistently, and what can we do about it? Alastair Henderson explains

Affecting around 1 million NHS staff on Agenda for Change terms and conditions, the knowledge and skills framework helps health employers achieve many priorities. It supports them in innovative service redesign, as well as in developing and retaining their workforce and engaging with their staff.

The framework enables employers to directly link the work their organisation needs to be done with the skills and competencies of their staff. By ensuring staff are competent, the framework provides an audit process that supports clinical and corporate governance. It should also stop automatic pay progression where staff have not gained the necessary skills.

The benefits for staff are also great. The framework ensures career and pay progression and can improve morale and teamwork by giving staff a clearer understanding of how they fit into the organisation and how they affect its performance. It shows staff what they have been employed to do, reviews their knowledge and skills and identifies any gaps to be addressed as part of an annual system of review and development.

Patchy uptake

But for many people, implementing the framework has seemed a chore, not an opportunity. It seems to them a complex and bureaucratic process. Faced with recent financial pressures, some organisations were not able to prioritise embedding the framework.

The National Social Partnership Forum, which comprises NHS Employers, trade unions and the Department of Health, believes organisations are missing out by not realising the framework's benefits.

The forum's programme to embed the framework, launched at the NHS Employers annual conference, has three key messages. First, the framework can benefit employers and staff alike. Second, it has national support but needs local leadership and championing within organisations to be a success. Finally - keep it simple. You can make it work without making it over-complicated.

From 18 October to 6 December 2007 there will be events held in each strategic health authority to promote the framework. At these sessions, SHAs will share with their trusts case studies showing how others have implemented the framework simply and successfully and the benefits they have gained. To support these events, trusts have been given a DVD with examples of effective use of the framework, as well as literature for boards and staff produced in partnership with NHS trade unions.

We hope these initiatives will raise the framework's profile and remind senior NHS leaders that the framework needs board-level support to be a success.