Senior staff could be moved out of the Agenda for Change pay framework under proposals devised by NHS Employers, it has emerged.

The body is attempting to secure a national deal with unions to modify the salary scale amid new indications that employers are grouping together on a regional basis to devise their own proposals to cut pay bills.

Under NHS Employers’ plan, trusts would be allowed to set their own salaries for top staff. At present staff obtaining 721 points or more on the Agenda for Change system can be removed from the national pay scale but there is no indication of a clear threshold under the new system.

There would also be an “explicit requirement” that staff meet “locally determined performance standards” before they receive incremental rises.

Any health worker who reaches the top end of each pay band would no longer get a permanent pay increase. Instead they would receive a bonus payment which would no longer be added to their salary. If they fail to hit performance targets they could lose this award.

New starters on band 5 would only be eligible for one incremental increase in their first year, instead of the current two.

Sickness pay would be reduced to only the basic salary, plus the payment of any high cost area supplements, but with no out-of-hours enhancements.

The proposals would also allow trusts to use unspecified alternative performance criteria instead of the existing NHS Knowledge and Skills Framework.

Unions want to see the adoption of good practice principles amid fears many staff could be down-banded.

In a message to human resources directors this week, NHS Employers director Dean Royles said the national system needed to change to help address “the efficiency and quality challenges the service is facing”.

He added: “We think it is important that pay frameworks adapt to changing circumstances. Taking account of these priorities, our initial proposals focus on allowing a clearer link between pay progression and performance and on pay during sickness absence.”

A staff-side consultation on the proposals was launched this week and will last until 27 July. A formal response from the unions to employers expected by early September.

Mr Royles warned unions that a failure to negotiate will result in more trusts exploring their own local solutions. However, both Unison and Unite have said they will not negotiate until the regional groups, dubbed by the unions as “cartels” agree to abide by any national agreement.

The South West and North West have got the most developed regional groupings of trusts attempting to change terms and conditions. Between 10 and 12 large providers in the North West have taken part in this work, including Mid Cheshire FT and St Helens and Knowsley Teaching Hospital Trust.

Gill Bellord, director of employment relations at NHS Employers, said of the North West: “We are aware of discussions in this and other regions but these are being led locally by the trusts themselves.”

HSJ has learned three more NHS trusts - 2gether NHS Foundation Trust, and Devon and Somerset partnership trusts - have paid the £10,000 joining fee to be part of the South West consortium.

The full list of trusts who have joined the South West pay consortium are:

  1. Poole Hospital NHS Foundation Trust
  2. Dorset County Hospital NHS Foundation Trust
  3. The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust
  4. Gloucester Hospitals NHS Foundation Trust
  5. Great Western Hospitals NHS Foundation Trust
  6. North BristolNHS Trust
  7. North DevonHealthcare NHS Trust
  8. Plymouth Hospitals NHS Trust
  9. Royal Cornwall Hospitals Trust
  10. Royal Devon and Exeter NHS Foundation Trust
  11. Royal United Hospital Bath NHS Trust
  12. Salisbury NHS Foundation Trust
  13. Tauntonand Somerset NHS Foundation Trust
  14. University Hospitals Bristol NHS Foundation Trust
  15. Weston Area Health NHS Foundation Trust
  16. Yeovil District Hospital NHS Foundation Trust
  17. 2gether NHS Foundation Trust
  18. DevonPartnership NHS Trust
  19. Somerset Partnership NHS Trust