Published: 05/08/2004, Volume II4, No. 5917 Page 26

Projects to bring in Agenda for Change must include the whole organisation, says Mike Pyrah

As a chief executive of an Agenda for Change early implementer trust, I have recently given presentations at both the HR in the NHS and the NHS Confederation conferences.As president elect for the Association of Healthcare Human Resource Management, I have also had plenty of opportunities to speak to human resources professionals throughout the UK.

As always, positive and negative themes are emerging as we prepare the wider NHS for Agenda for Change. On the positive side there appears to be a clear recognition that the systems work well and that the early implementer sites are working through the inevitable glitches.There is also now a real understanding that the new pay system will help to build on effective partnership-working (between managers and staff partners) to create a very different culture in the NHS.

On the negative side, a strong view is emerging from HR managers that this is seen as 'their'project.There are two potential difficulties in this.First, I do not think we should see Agenda for Change as a project. It is fundamental to how the NHS will work in the future and therefore will not finish.

It really worries me when I see advertisements for Agenda project managers because my view is that trusts should appoint their best middle manager as the implementation manager, and seek to backfill this post.

It is vital the new system is embedded in the organisation's culture.

Second, if it is seen as an HR task, there is a real danger that other leaders will not own it.One of our errors was not ensuring that all our leaders and managers fully understood the processes, which meant some managers 'enhanced'evaluation questionnaires to get the best deal for their staff! It is difficult to maintain a fair process if the organisation's leaders are distorting it.

I also worry about the NHS's ability to integrate Agenda for Change into other initiatives. I believe this is our most important challenge.The obvious example of integration is in the relationship between the new pay system and service modernisation and role redesign.

Early implementer sites inevitably concentrated on the need to set up partnerships and to test out and run the various systems.The rest of the NHS must use Agenda for Change as a tool to modernise services and redesign roles.

This is a wonderful opportunity which will be lost without effective leadership.

Ask yourself one question: are you seeking to get through the project by April? Or are you implementing a reward and development framework which will enable you to improve services and patient care?

Mike Pyrah is chief executive of Central Cheshire PCT.