A pay modernisation programme for NHS staff in England has been in place for almost three years but has so far failed to result in widespread changes to the way they work, according to a report.
More than a million NHS staff - excluding doctors, dentists and senior managers - are covered by the Agenda for Change, which was brought in between 2004 and 2006.
The programme was intended to provide a streamlined pay system and give a boost to staff training and development.
However, a Commons Public Accounts Committee report says that there is no evidence that the government's predicted £1.3bn of savings have been achieved, or that system-wide changes in how staff work have been implemented.
"Agenda for Change has not yet brought about service-wide changes in the ways in which staff work despite the new pay system having been in place for nearly three years," the report said.
"No reliable figure is available for the extent to which the £1.3 billion net savings promised by Agenda for Change have been achieved."
But the Royal College of Nursing general secretary, Dr Peter Carter, argued: "There is plenty of evidence to show Agenda for Change has made the NHS a better place for patients and for staff."
"I am in Australia and am having the same problem with doing a return to practice course as a Div 1 RN. In fact, if I did the course which costs $5500, I will earn less than a grad nurse, so I just can't do it" - JR, Australia
"I have been a healthcare assistant for 6 years in the same GP practice. I have been a band 3 for 3 years, I did the NVQ3 and did not get any rise in band or pay. I have now done the assisted practitioner foundation degree and have been told that, again, no rise in band or pay, and they have moved my KSF so that although I think I am working above a band 3 by moving levels to what a band 3 has to work to, I cannot get any further. I am a single person and pay all my bills so cannot afford to do the nurses training, so where do I go from here? Supermarkets pay better. Anyone have any answers? I don't think Agenda for Change has worked in my favour" - Yvonne Tremain, Essex