I’m a member of staff in an NHS provider. I provide a service that is identified as a priority for extending patient choice (eg podiatry). What might the implications be?

• AQP encourages an increase in the choice available for patients, through a wider range of providers offering services and different models of care to address patient need. AQP enables commissioners to set local service specifications and, where a tariff does not exist, set an appropriate price for these services.
• If you are working for a provider that is delivering any service (not just one commissioned under AQP), it could be the case that your provider changes the way it currently meets patients’ need, how it responds to the specification, or changes its practices to respond to patient feedback. This could, over time, result in changes to the way you do your job or the location of your service. This is something you, supported by your trade union representative, and your employer should agree together.
• The way a provider sets itself up to meet the commissioning challenge is not specific to AQP. All providers will, over time, need to make changes to respond to patients evolving needs and as innovation and new practices are introduced into the services you provide.

If I stay with my current NHS employer, how will this impact on my terms & conditions and job security? 

• As an NHS employee, extending choice of provider to your service has no direct impact on your pay and terms and conditions of employment. As is the case now, as providers change ways of working to keep pace with patient demand and clinical practices, there may be the potential for role changes or ways of working, and possibly some job losses alongside potential opportunities in alternative providers.
• Any changes which impact on your employment or working arrangements will require consultation and, where necessary, agreement with you and your trade union.

 If the service where I work is an AQP service and is not chosen by patients, or my employer informs us that they are not able to provide the service at the set tariff, what happens to me?

• AQP is about encouraging an increase in the choices for patients from a wider range of providers delivering services. We would not want to see current providers simply replaced by new entrants to the market, as this would not lead to an increase in choice for patients. 
• We would expect local commissioners to work very closely with the range of existing and potential providers in setting an effective price, making use of national currency guidance, to reflect quality requirements.  We would not expect to see existing providers being forced to shut down services as a result of a tariff set too low.  However, we do expect existing and new providers to be working closely with commissioners on developing new pathways and improved access, to respond to patient needs.
• As discussed above, AQP, as with any other commissioning route, does have the potential to cause providers to respond in ways that may impact on your employment and ways of working, but any changes should be developed in consultation and, where necessary, agreement with you and your trade union.
• If your provider is unsuccessful at maintaining services that you deliver, and the activity goes to other providers under Any Qualified Provider, protections under TUPE regulations are unlikely to apply. Whilst each possible TUPE situation has to be considered on its own merits, current legal advice suggests that there will be no “transfer of undertaking” to a new provider where referral patterns shift under AQP.  This means that if your employer is no longer able to provide your particular service, your job is unlikely to transfer to a different employer.
• Employers should always seek to redeploy staff and offer suitable alternative employment, but job security cannot be guaranteed. You can of course apply for a job with a different AQP provider, but your pay, terms and conditions may vary depending on if you are recruited by another NHS organisation or an independent sector provider.

If I lose my job or decide to change jobs, and then move to a position at another NHS employer, will I be able to transfer my terms and conditions? Will I lose my pension?

• If you move to another NHS organisation, you can retain access to the NHS Pension Scheme and in most cases NHS terms and conditions. Agenda for Change provides for redundancy, maternity and holiday pay entitlements to be carried forward when staff move between NHS employers.

If I lose my job or decide to change jobs, and then move to a position at an independent sector provider, will I be able to transfer my terms and conditions? Will I lose my pension?

• If you are recruited to an independent sector provider (for example, a social enterprise) you will be offered an employment contract based on the new employer’s terms and conditions of service including pension provision. Independent sector providers will offer their own reward package with a range of benefits to allow them to attract and retain quality staff. These may vary from NHS terms and conditions.
• All providers of NHS services are also encouraged to adhere to the Government's ‘Principles of Good Employment Practice’, which is a statement of good employment practice for government, contractors and suppliers. The statement encourages suppliers to provide new entrants with fair and reasonable pay and terms and conditions. Providers are also obliged to have regard to the staff pledges within the NHS Constitution, and are encouraged to consult with their recognised trade unions on the terms and conditions they offer new entrants.

If I get a job with an independent sector provider, and then move back to the NHS, will my time spent outside the NHS count as ‘reckonable service’ for the purpose of NHS terms and conditions?

• ‘Reckonable service’ for the purpose of benefits such as redundancy pay, maternity, sick pay and annual leave is based on continuous NHS employment. However, subject to employer discretion continuous NHS employment can include periods of employment with employers outside the NHS where these are considered relevant to NHS employment. This should be discussed with your new NHS employer before starting the post. You may also wish to speak to your Trade Union representative.

If I am working for an independent sector provider, will I still get access to education, training and personal development?  

• The Government’s proposals for education and training make clear that the responsibilities for planning and developing the workforce apply to all providers of NHS funded care and builds on the pledges set out in the NHS Constitution.
• The NHS Constitution gives employees rights to have personal development, access to appropriate training for their jobs and line management support to succeed.  The Government’s proposals aim to support these principles with the intention that all individual healthcare providers will develop their workforce by promoting staff engagement and partnership working, providing continued professional development and supporting improvements in staff well being.
• The Government has accepted the NHS Future Forum’s recommendation that we will consider the way in which continued professional development (CDP) is provided and ways of ensuring greater transparency for investment in CPD.

I value my NHS pension very much. What are the implications for pensions under AQP?

• While you remain employed by an NHS organisation you will continue to have access to the NHS Pension Scheme.  If you change jobs, you can only stay in the NHS Pension Scheme if you secure a job at another NHS provider. If you secure a job with an independent sector provider, you are unlikely to receive a “comparable” pension.  However, your new employer may provide pension arrangements as part of an overall reward package designed to recruit and retain staff.
• Between 2012-16 employers will be required by law to provide some or all of their staff with a workplace pension. Larger employers will be affected in 2012, with medium and smaller employers needing to comply later.

I currently undertake or support research as part of my role in the NHS.  Will I be able to continue to do this if I move to a new provider and what requirements will they have to provide the necessary facilities and access to patients?