The Department of Health and Social Care has rejected calls from many in nursing for a new pay spine to be designed solely for nursing staff employed in the NHS. The department said it had not been swayed by evidence presented in a consultation on the issue, and said such a pay spine would create legal and financial risks. Opponents of the idea, which was put forward by the RCN, argue that splitting off nursing staff pay would undermine Agenda for Change (AfC) and open up disunity in the NHS workforce. The RCN believes the current AfC structure stifles nursing staff’s career progression and fails to recognise how the modern nursing profession has evolved.