The new government has an ambitious ten-year plan to transform the NHS by shifting care closer to home and tackling the UK’s poor record on public health and prevention. But with multiple short-term challenges and little money to spend, ministers will need more than goodwill and good intentions if they’re to turn those ambitions into reality.

Agenda for Change, introduced 20 years ago, was supposed to put an end to inconsistency and unfairness in how NHS staff are paid. But staff shortages and tight budgets mean many staff are now graded below the level of the work they’re doing. It’s time to modernise the system, says Rhys McKenzie.