Most managers and some staff strongly believe local pay flexibility has improved patient care by making team work easier, according to a report.

Ten trusts with local pay systems for non-medical staff were examined in the report published this week by the work and employment research unit of Greenwich University.

It concludes that such approaches have chipped away at professional boundaries and supported new working arrangements. Eight of the ten trusts had replaced service-related increments with performance-based pay progression.

But while highlighting the benefits of local pay - including changes in working hours and multi-skilling - it warned that the issue was 'not unproblematic'.

When agreement is reached on the Agenda for Change proposals, evidence from the case studies will be used to promote best practice.

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