Social care for adults faces a period of change every bit as
radical as that going on in children’s services. Except, rather
than education and social care, the main movers in adult services
will be social care in a variety of alliances with health and
housing that cut across the statutory, voluntary and private
sectors. Stephen Ladyman, the health minister, has invited social
care workers to contribute to a new vision of social care, but as
our interview with him on page 14 makes clear the outlines of that
vision are already firmly in place. As if to emphasise the point,
the minister was heard talking last week about an “Agenda for
Change” in social care to mirror the one that takes effect in the
NHS from this October.
Agenda for Change is meant to harmonise pay and conditions across
the health service, rewarding staff in line with the level of
responsibility they take on and the skills required for the work
that they do. Nurses have generally welcomed the initiative because
it is seen as introducing fairness and transparency to pay scales.
Experience with the 12 “early implementer” sites set up in June
last year has shown the importance of partnership between
management and unions, clear job descriptions set against national
benchmarks, and consistency in the way different jobs are
evaluated. The result is that NHS workers will get an average of
12.5 per cent over three years for taking on extra
But even in the health service it has not all been plain sailing.
For example, attention has been lavished on nurses, a political
priority for the government, at what some non-clinical support
staff feel to be their expense. More pay for extra responsibilities
fits well with the increasing professionalism of nurses as they
acquire more tasks previously done by doctors, but it is not always
so easy to see how other professional groups can benefit.
It is even more difficult to see how Agenda for Change could be
made to work in social care, where the multifarious workforce is
spread across 25,000 separate employers, 70 per cent of whom are in
the private sector. Ladyman’s professed aim is to prevent workers
in adult social care becoming the poor relations of their
counterparts in children’s services, where pay and conditions are
already under review as part of the Every Child Matters
green paper. That aim is laudable, but it will take considerable
ingenuity to adapt Agenda for Change for the minister’s new vision
of the future.