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Agenda for Change is the biggest reform of staff pay in the UK National Health Service (NHS) since it began in 1948. As well as introducing a standardised pay structure; it also aims to improve recruitment, retention and staff morale. The aim of this study is to look in‐depth at the experiences and opinions of a range of estates and facilities staff surrounding Agenda for Change during the implementation period.

Focus groups were used as the primary method of data collection in an attempt to tap into the views and opinions of staff working at operational positions in a wide range of trusts.

One of the most important and common themes, which reoccurred throughout the focus groups, was the view that the Agenda for Change framework was designed around the needs of nursing staff. Therefore, the framework did not adequately cater for the needs of estates and facilities staff. Specific concerns related to this included; the role or contribution of estates and facilities staff during patient care was not fairly reflected; trade qualifications were not recognised, particularly in comparison to academic qualifications; members of the job matching panels did not have the appropriate knowledge to make decisions surrounding estates and facilities jobs; nurses were more likely to make progress through the bands than estates and facilities staff.

This paper would be of use to NHS estates and facilities managers who are currently implementing Agenda for Change or as a general case study on change management.

Agenda for Change is set to be the biggest reform of pay since the National Health Service (NHS) began in 1948. As well as introducing a standardised pay structure; it also aims to improve recruitment, retention and staff morale. Staff groups identified as having recruitment and retention problems include estates/works officers, qualified maintenance crafts persons and qualified maintenance technicians. The object of this research was to investigate recruitment and retention problems for estates and facilities staff currently experienced by Trusts.

Focus groups were used as the primary method of data collection in an attempt to tap into the existing expertise of staff working at strategic and operational supervisory positions in a wide range of Trusts.

Although our findings suggest that the main recruitment and retention issues fall into four main themes: social, financial, environmental and political; recruitment and retention of estates and facilities management staff is a complex problem involving a wide range of issues and these can vary from location to location. Furthermore this should also be seen as a series of issues that varies across employment groups including: domestic/housekeeping, trades, managers/officers and facilities directors, which need to be distinguished.

There is a continuing need to raise the profile of estates and facilities management staff in the NHS to those levels enjoyed by Human Resource (HR) and Financial Management. Furthermore perceptions surrounding both recruitment and retention issues and the nature of work within estates and facilities management staff in the NHS can lead to a negative and self‐perpetuating “cycle of failure” where there is an assumption of loss of control. However, there are some initiatives being undertaken that suggest it is possible to concentrate on internal matters such as more appropriate and flexible recruitment processes, improved support services for staff and greater flexibility within the job and that these can generate “cycles of success”.

The paper looks in‐depth at the current recruitment and retention problems for NHS estates and facilities staff. The paper would be of use to NHS estates and facilities managers who are currently investigating workforce issues, particularly surrounding recruitment and retention of staff.

The aim of this study is to examine 15 NHS acute trusts in England that achieved high scores at all their hospitals in the first four national Patient Environment audits. No common external explanations were discernible. This paper seeks to examine whether the facilities managers responsible for the Patient Environment displayed a consistent leadership style.

Overall, six of the 15 trusts gave permission for the research to take place and a series of unstructured interviews and observations were arranged with 22 facilities managers in these trusts. Responses were transcribed and categorised through multiple iteration.

The research found common leadership and managerial behaviours, many of which could be identified from other literature. The research also identified managers deliberately devoting energy and time to creating networks of conversations. This creation of networks through managing conversation is behaviour less evident in mainstream leadership literature or in the current Department of Health and NHS leadership models.

The findings of this study offer managers (particularly those in FM and managers across NHS) a unique insight into the potential impact of leaders giving an opportunity to re‐model thinking on management and leadership and the related managerial development opportunities. It provides the leverage to move facilities management from the role of a commodity or support service, to a position as a true enabler of business.

Original research is presented in a previosuly under‐examined area. The paper illuminates how facilities management within trusts achieving high Patient Environment Action Team (PEAT) scores is led.

The purpose of this paper is to investigate the possible common factors in 15 Acute Hospital Trusts in the UK that achieved excellent scores at all their sites in four years of national Patient Environment audits.

A desk‐based study tested for external factors, organisational commonalities or particular contractual arrangements which the sample might have in common. A second piece of work was then undertaken; an ethnographic study that examined the behaviours exhibited by 22 managers in six of the trusts. The second phase of research will be described in a separate paper.

The research found that no external, organisational or contractual commonalities could be identified as shared by the trusts that formed the Research Group. This led the researchers to ask further questions as to the management/leadership of the FM Managers who had achieved consistantly high standards of Patient Environment over the four year period.

The research reveals that the trusts which achieved high standards of Patient Environment had no shared advantage in terms of external, organisational or contract characteristics. Thus, it should be possible for all trusts to achieve consistently high standards.

This is believed to be the only study looking at influences and characteristics that are outside the FM Managers' control and impact on the FMs' ability to deliver consistantly high standards.

This article reports the findings of a national survey of the consultation of people with learning difficulties by social services departments in the development of adult protection procedures and guidelines. The survey also considered the consultation of other service users, carers and family, and staff. Despite the rhetoric of user involvement in adult protection literature, low levels of consultation for people with learning difficulties were found.