1. Agenda for change: The Knowledge and Skills Framework
Rachel Palmer 2016
(edited from session by Judy Dyos)

2. Objectives
To understand the banding system for all staff (except Drs) in the NHS
Movement through the bands and increment points
The annual appraisal processes
The Knowledge and Skills framework that guides appraisal assessment

3. Appraisal and KSF
All members of staff, excluding doctors and dentists, should have an annual appraisal against their KSF outline and agree a personal development plan. appraisal process for all staff, (excluding doctors and dentists) includes: 
A review of the members of staff performance and achievements for the last 12 months
A review of their achievement against their Knowledge and Skills Framework (KSF) outline
Agreement of a personal development plan (PDP) 
A wellbeing discussion and action plan.
These actions will ensure that all staff have the training and development required for their post and career progression.
It is a UHS Trust target to improve the quality of appraisals
maintain that 90% of staff have received an appraisal on a rolling year basis.

4. Agenda for Change
Set out in 2004 to create a generic approach to manage pay against skills. All NHS staff use this system except doctors, their professional body refused to be part of the system
Replaced the Whitely council pay system
Three core elements :
Job evaluation
Harmonised terms and conditions
The knowledge and skills framework (KSF)

6. Agenda for Change Pay Structure2 8 7 6 5 4 3 9 1 7 6 5 4 3 2 8
Pay Band
Gateway
Incremental
Pay Points
Development
Development
Here is a diagram of the new simplified pay structure which has nine paybands.
The JE system determines where jobs are placed on the paybands.
Each of the paybands has a number of pay points.
The KSF informs individuals’ development across the paybands - career progression.
The KSF also informs peoples’ development within the paybands - pay progression. This occurs at two key points - the foundation gateway within one year of being appointed to a payband. The purpose is to check that individuals can meet the basic demands of their post.
And at a second gateway which is placed towards the top of a payband - when there is confirmation that individuals are meeting the full demands of their post.
The second gateway is the point where the individual should be fully developed and may wish to consider career development options.
Gateway

8. NHS KSF - Main Purpose
To provide an NHS-wide framework that can be used consistently across the service to support:
personal development in post
career development
service development

9. What the NHS KSF is Not
It does not seek to describe what people are like or their attitudes
It does not describe the exact knowledge and skills that people need to develop
It does not determine job weight or pay band
It is important to be aware of what the KSF does not do as well as what it does.
As the KSF is designed to inform career and pay progression, it does not seek to describe what people are like or the particular attributes they have (eg courage in the face of danger). Rather it focuses on how people need to apply their knowledge and skills to meet the demands of work in the NHS. It consequently relates to behaviour but in the sense of what people actually do - not any underlying characteristics. This is because it would not be fair to make such generalisations to affect people’s pay and career progression.
The KSF is a broad generic framework that focuses on the application of knowledge and skills - it therefore does not describe the exact knowledge and skills that people need to develop. More specific standards/competences would help to do this as would the learning outcomes of learning programmes.
The KSF does not determine job weight or affect the payband that jobs are placed on - that is the purpose of the job evaluation system.

10. Personal & People Development Health, Safety & Security
6 Core Dimensions
NHS
KSF
Equality & Diversity
Personal & People Development
Quality
Service Improvement
Communication
Health, Safety & Security
The 6 core dimensions that apply to every post in the NHS are:
1 Communication
2 Personal and people development
3 Health, safety and security
4 Service improvement
5 Quality
6 Equality and diversity

11. Estates & Facilities EF 1-3 Information & Knowledge
24 Specific Dimensions (in four groups)
NHS
KSF
Health & Well-being
HWB 1-10
Estates & Facilities EF 1-3
Information & Knowledge
IK 1-3
General
G 1-8
The 24 specifhc dimensions are shown in this diagram, split into four groups.
These will relate to some jobs and not others.
For example, dimension HWB6 – Assessment and treatment planning and dimension HWB7 Interventions and treatment are likely to apply to some, if not all, healthcare practitioners.
On the other hand, dimension IK1 Information processing, IK2 Information Collection and analysis and EF1 Systems Vehicles and Equipment are likely to be relevant to health informatics staff.

12. 4 Levels To Each Dimension
Contribute to own personal development
Level 2
Develop oneself and provide information to others to help their development
Level 3
Develop oneself and contribute to the development of others
Level 4
Develop oneself and others in an area of practice.

13. Personal & People Development, Level 2:
Examples of Application:
Develop own skills and knowledge and provide information to others to help their development:
Takes responsibility for own personal development and takes an active part in learning opportunities
Offers information to others when it will help their development and/or help them to meet work demands
Indicators:
Offering information to others might include:
During induction
During ongoing work
When changes are being made to work practices
This illustrates what the indicators and examples of application look like.
It shows the start of the indicators for the level 2 descriptor in Core Dimension 2 Personal and People Development.
The level descriptor is ‘Develop own skills and knowledge and provide information to others to help their development’.
The first example is about ‘taking responsibility for own development’; the second is about ‘providing information to others where it will help them to meet work demands’.
There are 4 further indicators for this level descriptor, which can be found on page 59 of the NHS KSF 2004.
The examples of application are designed to illustrate how the dimensions and level descriptors could be applied across the NHS. The example we have here relates to ‘the others’ to whom information is provided. You can see that this might take place, for example, during induction, during ongoing work and when changes are being made to work practices.

14. The KSF & Personal Development - Lifelong Learning
Commitment to annual development reviews and development of all individuals
Everyone to have a personal development plan
Everyone is expected to learn and develop within their job role
Enshrined in the AFC Agreement – part of everyone’s terms and conditions
We are now going to move on to looking at how the NHS KSF links to a number of other commitments in the NHS. First of all lifelong learning.
Within the Agenda for Change agreement, and specifically through the NHS KSF, there is a commitment t annual development reviews for all staff and a commitment to the development of all staff.
Everyone will have their own personal development plan - developed jointly in discussion with their manager.
Everyone is expected to progress and develop. That is, everyone is expected to learn and develop throughout their life working in the NHS. There is a normal expectation of progression for everyone.

15. The NHS KSF - Summary
Identifies the knowledge and skills that people need to apply in their post
Helps guide development
Provides a fair and objective framework on which to base review
Provides the basis of pay progression in the service
So in summary the NHS KSF is designed to:
identify the knowledge and skills that individuals need to apply in their post
help to guide the development of individuals in their post and throughout their careers in the NHS
provide a fair and objective framework on which to base the review of staff
and provides the basis of pay progression within paybands at the foundation and second gateways.

16. What is a full KSF Post Outline?
Identifies the KSF dimensions and levels that apply to a post in the NHS – a broad outline
Puts the outline in context through identifying the specific areas/activities to which the dimensions and levels are applied
Sets out the ‘foundation subset’ as well as the full outline for the post
Agreed in partnership
A NHS KSF post outline identifies the KSF dimensions that apply to a particular post in the NHS. This combination of dimensions and level descriptors gives you a broad outline for a post.
A full KSF post outline also adds the specific areas /activities that are relevant to that post - those aspects of work that the dimensions and levels apply to for that particular post. As you will remember the NHS KSF gives you examples of application to which the dimensions and levels apply, when you create a KSF post outline you need to identify the specific ones that are relevant for that post.
For example, the specific areas of application/activities that a nurse undertakes in addressing health and wellbeing needs are likely to be different from those which a physiotherapist uses, although they might of course have one or two in common.

17. Outlines - Dimensions All core dimensions must be included
Specific dimensions should reflect the major areas for development within the post
The number of specific dimensions should be kept to the minimum necessary to cover the post
KSF Dimensions do not influence pay bands

18. KSF Post Outline Catering Assistant CORE
HWB10 Products to meet health and
well-being needs
This is another example of a post – this post has one specific dimension alongside the 6 Core. The next three slides will show how this would apply to a post.
Catering Assistant

19. KSF Post Outline A Healthcare Practitioner CORE
HWB6 Assessment & treatment planning
HWB7 Interventions and treatments
Ik2 Information Collection & analysis
G6 People Management
This is an example of which specific dimensions might apply to a post. This post has 4 specific in addition to the 6 core Dimensions.
A Healthcare Practitioner

20. KSF Post Outline - Nurse Band 5
Once the levels for the post are agreed in partnership, it is the annual development review which will give individual postholders feedback on how they are meeting the KSF outline for their post.
The blue squares are showing us where this person is meeting or above the required level for the post. You can see that in Core 3 Health Safety and Security this person is above the level required for the post, this may be because because they are a health and safety representative.
The pink squares show us where the postholder and their reviewer agree that there is a development need as they progress towards the second gateway. This becomes the focus of the personal development plan for the coming year.

21. Purpose of a Foundation: Gateway Subset
To focus development in the first year on enabling the individual meet the essential demands of the post
To check that the individual is likely to develop to meet the full demands of the post over a number of years
To inform recruitment and selection processes
We are now going to look particularly at creating subsets of KSF post outlines for Foundation Gateways.
The purpose of a subset is to be clear about how individuals are applying their knowledge and skills after the first year in post and then being sure that they are at that point.
This will help to focus development in the first year in enabling the individual to meet the essential demands of the post. It will also provide a check that the individual is more than likely to develop to meet the full demands of the post over the next few years.
What is included in the subset of the KSF post outline for the Foundation Gateway should also of course inform recruitment and selection into the post.

22. The NHS KSF and Development Review
KSF outline developed for each post
Individual is matched against the KSF outline for their post
Personal development plans jointly agreed and supported
Individual supported to learn (in a variety of ways)
Joint evaluation of learning
Now we have looked at the design of the KSF, we move onto how it is put into practice.
The first stage is to develop a KSF outline for a post. As it says the focus of this stage is the post and not an individual. It involves identifying the dimensions, levels and areas of application for the post concerned.
The second stage is matching an individual postholder to the KSF post outline - this shows the individual’s strengths and where there are areas for development within the post.
An Personal Development Plan - PDP - is then developed for the individual - this is a joint process between the individual and his/her manager.
The individual is then supported to learn through different learning opportunities - this learning could take place in a variety of ways such as learning on the job, shadowing, mentoring, formal training courses etc.
The final stage is the evaluation of learning and how it has been applied to the individual’s work.

23. Development Review Process
Jointly produce Personal
Development Plan
- identify needs
& agree goals
Joint review of individual’s
work against the NHS
KSF outline for the post
Joint evaluation
of applied
learning and
development
Individuals undertake
supported
learning & development
This can be shown in the form of a learning cycle - which most of you will no doubt be familiar with - where the four stages are shown i.e.
1 joint review of work against the demands of the post as detailed in the KSF outline
2 jointly producing a PDP identifying learning and development needs, goals and how these will be met
3 learning and development by individual supported by their manager
4 joint evaluation of learning and development and its application.
One of the common features of all stages of the development review process is the commitment to partnership throughout.

24. Development Review Process
The development review should be a focussed discussion about how the individual is doing against the appropriate outline for their post
The emphasis should be on development – what has been achieved in the past year and what needs to be achieved in the next year
Most of the ‘evidence’ provided will be verbal – part of the discussion process, based on the manager and individual’s views of how they are getting on at work
Each development review will result in a personal development plan (PDP) setting out the individuals development needs and how these will be met

25. Gateway Reviews Same process as other reviews
Build on the information gathered over time i.e. not isolated incidents but assessments which review the information gathered
Information at gateways can be from others (besides individuals and their managers) e.g. 360o feedback if available, information from colleagues
Gateway reviews follow the same process as all other reviews.
The information used at gateways should build on information that is gathered over time (particularly for the second gateway). The gateways are not intended to be unusual tests of the individual. Rather they are a point at which information from a number of sources is bought together and a formal decision about pay progression is made.
The guidance suggests that good practice would be if the information used at gateways is triangulated - this means that it comes from three or more sources, such as the individual, their manager and colleagues. Organisations that have already started to use 360o feedback will be ideally placed for this approach.

26. Foundation and Second Gateways
Foundation gateway review against subset of full KSF outline for the post
2nd gateway review against full KSF post outline
The Foundation subset contains the elements of the outline that are essential for all postholders within the first year of appointment.
The Foundation Gateway review takes place after a year in post. The review is based on a subset of the full KSF outline for the post - essentially this means the fundamental things that an individual would be expected to do in this post given that they will develop into the post over time.
The Second Gateway review is against the full KSF post outline. The Second Gateway occurs towards the top of a payband as set out in the Agenda for Change agreement.
There should be no surprises for individuals in pay progression.

27. Responsibilities in the Review
There is a responsibility on both the individual member of staff and their manager to review how the individual is applying their knowledge and skills to meet the demands of the post as described in the KSF outline
It is important that both managers and staff prepare in advance by thinking through whether there are any likely development needs and how these might be met.
Both individuals and their managers have responsibilities in the process. Both have to review how the individual is apply their knowledge and skills to meet the demands of the post as described in the KSF post outline.

28. Manager’s Responsibility
Regular informal discussions with individual staff member throughout the year
Providing constructive feedback on the individual’s work and related development
Any issues with the individual’s work must have been discussed prior to the formal review meeting – ‘no surprises’
Managers have a responsibility to:
- have regular informal discussions with individual staff members throughout the year so that the individual gets feedback on how they are doing
- provide constructive feedback on the individual’s work and the individual’s development
- discuss any issues with the individual’s work prior to the formal review meeting.
The whole system is based on the principle of NO SURPRISES

29. Good Sources of Information
NHS Careers
Unions – RCN and Unison

30. Revalidation Practice hours Practice related feedback
Continuing professional development
Practice related feedback
Reflection and discussion
Health and character
Professional indemnity arrangement
Confirmation from a third party