Review of Agenda for Change in NHS Scotland – Equality Impact Assessment

Decision Making and Monitoring

Identifying and establishing any required mitigating action

Impacts Identified for Equality Groups

The potential impacts and identifying opportunities to promote equality for each of the protected characteristics have been considered and each of the identified policy or process changes have either a positive or neutral impact. There are no identified negative impacts.

The Reduction in the Working Week is the only area with policy reform and the purpose of the Review of Agenda for Change is to ensure all staff will benefit equally. The Reduction in the Working Week provides a proportionate percentage uplift for all staff equally as a healthy work life balance for is essential for NHS AfC staff who provide high quality of care to the people of Scotland.

Consideration of the Equality Act 2010

Pay and Reward will be considered in future pay negotiations and is subject to the Equality Act 2010. The current AfC pay spine was established in accordance with the Equality Act 2010 that legally protects people from discrimination in the workplace and in wider society and the Equality and Human Rights Commission (EHRC) statutory code of practice on equal pay.

The Review of Band 5 is being progressed within the provisions of the nationally negotiated and agreed UK Job Evaluation Policy which has been the subject of a separate equality assessment.

Protected Learning Time is not within the scope of policy amends and was compliant with responsibilities as set out in the National Health Services (Scotland) Act 1978 at section 12II as revised through Section 4 of the Health and Care (Staffing) (Scotland) Act 2019.

Reduction in the Working Week was subject to review challenge by both STAC Secretariat and full STAC both of which include consideration of the protected characteristics and equality of treatment for all staff within the workforce. Wider socio-economic considerations were made as part of the Fairer Scotland Duty commitment.

Equality Impact Analysis Shaping the Policy Making Process

The only area of work that has initiated policy changes is the reduction of the working week. As previously identified, wider socio-economic considerations were made as part of the Fairer Scotland Duty commitment.

This reduction in the working week presents an opportunity to modernise how staff are rostered and work, ensuring that NHSScotland is a leader in flexible and family friendly working practices, and that it remains an employer of choice for health care staff.

The outputs of this working group were agreed on a tripartite basis. All suggestions from the working group were subject to review challenge by both STAC Secretariat and full STAC. Both of which include consideration of the demographic characteristics such as race, gender and disability are explicitly linked to socio-economic disadvantage within the workforce.

It is expected that these groups will continue to work in partnership throughout the implementation process.

While there are no direct costs associated with the compilation of the EQIA, the recommendations the AfC Review come with a significant cost attached. The Cabinet Secretary confirmed that £200 million was allocated to Health Boards in 2024/25 in order to support the delivery of the reform commitments, with a further commitment of £150 million in 2025/26. Further funding will be provided to NHS Boards in the financial year 2026/27 to support final hour reduction. All costs will be recurring on an annual basis.

Consultation feedback highlighted that the need for a reduction in the working week to 36 hours without loss of earnings (pro rata for part-time staff) is profoundly gendered. Women’s propensity to have caring roles means that they require flexibility in the workplace to combine their caring role with employment.

As 42% of AfC staff fall below the median household disposable income in the UK, reducing the number of hours to 36 hours per week will assist in addressing women’s low pay, tackle women’s poverty and child poverty, and close the gender pay gap.

A parents’ ability to increase working hours is often dependent on the availability of flexible working and affordable childcare and low pay and the number of hours worked by households been identified as key factors that influence working poverty.

The working group considered the data and consultation feedback and made the following assessment:

• As a major employer with 78.8% female workforce in NHSScotland, this policy will support a significant number of women with their caring responsibilities and access to affordable childcare.
• This policy is applied in a uniform manner to all AfC staff with no detriment to basic pay, therefore there is no negative socio-economic impact. In fact, the reduction from 37.5 to 37 hours represents a 1.35% increase in hourly rates with a further 2.78% increase on 1 April 2026 when the 36 hour working week is implemented for all staff.
• The intention of this change is to allow all staff to improve their work life balance.
• The policy has the scope to support employment opportunities by reducing or removing barriers to access or increase work (intensity).
• The policy may have a positive impact in keeping people in work. By reducing the number of hours of required employment, it recognises that the need for flexible working may occur at any age during someone’s career. For example, looking after children or elderly parents.

Monitoring and Review

The analysis of the initial 30-minute reduction to the working week implemented on 1 April 2024 indicated that delivering the remaining hour in one tranche was the safest approach. This will mean rosters and broader working schedules will only need to be re-configured once more to reach their final form. It is crucial to deliver any further change in a way that is safe for patients and staff, supports the continued recovery of services and avoids any extra burden for the workforce.

NHSScotland Health Boards completed outline plans for Reduction in the Working Week implementation (1 May 2025).

NHSScotland Health Boards finalised full and final Implementation Plan (1 October 2025).

The Cabinet Secretary is in regular communication with NHSScotland Health Boards and Staff Side as he focuses on continuing to work in partnership to ensure that all AfC staff will move to a 36-hour working week on 1 April 2026.

The outputs of the working groups have been agreed on a tripartite basis. Both STAC Secretariat and full STAC monitor progress and address any issues regarding the implementation of the Review of Agenda for change. Any issues that may impact consideration of the protected characteristics and equality of treatment for all staff within the workforce will be addressed via these partnership organisations.