Health unions and NHS Employers have agreed a landmark deal to reduce the pay, terms and conditions of almost one million NHS staff.

A meeting of the NHS Staff Council, involving 15 NHS unions and employers, today backed changes affecting nurses, allied health staff, scientists and support staff.

The deal will see an end to automatic incremental pay rises, with staff instead having to meet local performance requirements.

Sick pay will be paid at basic salary levels, without any allowances or payments linked to working patterns such as out of hours shifts. This change will not apply to staff absent due to work-related injury or disease.

New-starters at band 5 level will no longer receive their second preceptorship payments.

Pay progression for senior staff moving into the last two points in their band for bands 8C, 8D and 9 will be treated as an annual bonus, which can be withheld if performance reduces.

Staff at band 8C and above could also be removed from Agenda for Change and offered a spot salary instead.

However, employers have also committed to issuing new guidance on job re-profiling, following concern over increasing attempts to down-band large numbers of staff.

The changes come into effect on 31 March this year.

The biggest health unions the Royal College of Nursing and Unison backed the deal, but it was opposed by Unite.

Employers have argued the changes are necessary to safeguard national pay bargaining.

Christina McAnea, head of health at Unison said: “This was a difficult decision taken in difficult times. Unison believes this is the best way of preserving national conditions which bring stability and fairness to staff and which benefit patients.

“The key now is to ensure the changes are implemented in a fair and transparent way across local hospital trusts.”

Unions have warned they will resist any attempts by individual trusts to introduce local pay.

Dean Royles, chief executive of the NHS Employers organisation said: “The negotiations have been understandably challenging, coming as they do on the back of industrial action, changes to pension schemes and a significant reorganisation of the NHS.

“This deal will increase the health service’s confidence in the usefulness of the national pay arrangements, which continue to help the NHS support and manage an effective workforce.”

Health minister Dan Poulter said the deal was “an important step towards ensuring that national staff frameworks in Agenda for Change are kept fit for purpose”.

He added: “The revised contracts will mean that NHS staff working at night will now be paid the same sickness absence rate as staff working during the daytime.

“Hospitals and other NHS employers will now also be able to develop their own local staff performance arrangements, which will help to ensure that annual incremental pay progression can be directly linked to delivering high quality and compassionate patient care.”