Sixteen NHS trusts in the South West have banded together in a bid to make “radical” changes to staff pay, terms and conditions outside of the national Agenda for Change agreement.

The consortium of trusts is considering a suite of proposals to reduce workforce costs by 8 per cent across the region.

The South West pay, terms and conditions consortium, led by Poole Hospital Foundation Trust chief executive Chris Bown, is aiming to agree new terms with staff on a collective basis.

But a project document drawn up by the consortium and seen by HSJ reveals that, if a deal cannot be reached, trusts may consider dismissing staff and rehiring them on the new terms in order to force through the changes.

Plans include changes to working hours, annual leave entitlements and pay. The consortium also intends to look at “attractive, performance-driven approaches” to pay and conditions which it hopes will be more appealing.

The document recognises the likelihood of opposition from staff and unions. It says: “Unless ‘voluntary’ agreement could be secured… it is likely that trusts would be obliged to dismiss and re-engage staff to secure such changes.”

According to the project document, reducing use of agency staff and changing skill mix will not save enough to make services affordable, and more “radical” measures are needed.

It says the overriding objective is to “future-proof services”. Members are hoping to develop the plans in coming months.

Each member trust has been asked to invest £10,000 in the programme. Only a small group of providers in the South West have not signed up as members.

Mr Bown said: “We recognise the many benefits national pay systems such as Agenda for Change bring. However, we are exploring potential changes… which would allow us to operate more efficiently while ensuring staff are engaged and motivated to provide an exceptional service.”

The move, made public by unions last week, comes as national discussions on changing NHS terms and conditions appear to be making little progress.

NHS Employers – which is seeking a national agreement – warned that delays to achieving it make local and regional changes more attractive.

NHS Employers director Dean Royles told HSJ: “We have always made it clear to the unions that the best way of retaining national pay bargaining arrangements is to bargain. The longer this takes, the more attractive local solutions look to employers.”

He added: “Time is of the essence. Refusing to talk at a local level doesn’t make the issue go away. Like trade unions, employers recognise there is strength in numbers.”

Wrightington, Wigan and Leigh Foundation Trust chief executive Andrew Foster, who was previously NHS workforce director, warned disagreements between the government and unions over other issues such as pensions will make a national agreement on pay and conditions more difficult to achieve.