Unveiled: how Agenda jobs will be defined

NHS jobs will be judged against 16 criteria - including responsibility for patient care, physical skills and emotional effort - to determine where they sit on the eight new bands in the Agenda for Change pay system.

A series of crucial job profiles have still not been agreed between unions and employers, with some sources predicting they will not be finalised this month, despite the Department of Health's pledge that these would be available in January.

And signs of discontent with the package are beginning to emerge among union members, against a background of uncertainty about how many and which staff stand to gain or lose from the new system.

But draft documents seen by HSJ detail the 16 factors, each with up to eight levels and some with sub-levels, against which jobs are being assessed (see box).

Jobs scored at higher levels will fall into higher pay bands.

Managers look likely to do well from the scheme, with the top levels of factors such as 'responsibilities for information resources' and 'responsibilities for human resources' apparently reserved for those with 'corporate responsibility' in those areas.

But this means an effective ceiling at a lower level for senior clinical and practitioner jobs, whose job profiles are understood to be among the most contentious.

The document shows that the 'emotional effort' factor would be used to recognise the distress involved in work such as breaking news of terminal illness, death or child abuse.

'Working conditions' covers exposure to dirt, hazards, fleas and lice, body fluids, violence and road accidents, while 'physical skills' covers everything from driving or typing skills (level two) to keyhole or laser surgery at level five.

Although it is unclear how much progress will have been made in finalising the outstanding job profiles, Agenda for Change negotiators were set to meet on 16 January, with an announcement likely shortly afterwards.

But discontent over the proposals is surfacing within the unions.

Motions submitted to Unison's health conference in April include a call from South Manchester Hospitals branch to 'reopen negotiations on specific aspects rather than having to accept all or nothing', while Newcastle City Health branch urges rejection of the link between Agenda for Change and a 'derisory' three-year 10 per cent pay offer.Amicus's London health service advisory group has also come out against the deal.

Sweet 16: criteria against which jobs will be assessed

Communication and relationship skills.

Knowledge, training and experience.

Analytical and judgmental skills.

Planning and organisational skills.

Physical skills.

Responsibilities for patient/client care.

Responsibilities for policy and service development implementation.

Responsibilities for financial and physical resources.

Responsibilities for human resources.

Responsibilities for information resources.

Responsibilities for research and development.

Freedom to act.

Physical effort.

Mental effort.

Emotional effort.

Working conditions.