Unison has become the latest health union to accept proposals to dilute the Agenda for Change pay framework, marking a significant step towards their introduction.

It is understood that Unison’s health executive committee met yesterday and agreed to accept the proposals from the NHS staff council to alter the AfC agreement for staff in England.

It follows a consultation exercise with union branches and members.

Under the proposals, the national AfC pay framework will be altered to end automatic incremental pay rises, scrap enhanced out of hours sick pay, and bring an end to band 5 nurses receiving two increment rises during their first year after qualification.

Senior staff on higher pay bands could also be removed from Agenda for Change entirely and paid an individual spot salary.

The Royal College of Nursing council decided on 23 January to accept the proposals, which were put forward by NHS Employers last year.

The government and managers are seeking changes to the national agreement in order to make major cost savings.

Only Unite has so far rejected the proposals. It said it will fight any attempt to reduce terms and conditions of staff. However, it has significantly fewer NHS members than either Unison or the RCN.

Before they are officially accepted, the proposals will have to be discussed and voted on by all the staff side unions at the staff council on 26 February.

Unions are separately fighting a so-called “pay cartel” of 16 hospital trusts in the South West, which aims to break away from AfC and make their own cuts to terms and conditions to reduce the regional pay bill by 8 per cent.

The cartel has said it is waiting for the formal staff council decision on the national proposals before it decides whether to continue with its local plans.