Agenda for change in emergency care settings.

In 2004, the NHS Knowledge and Skills Framework (Department of Health 2004) was launched as part of Agenda for Change, the new terms and conditions for most NHS staff. Five years on, it has been introduced across the U.K. with varying degrees of success. This article describes the fundamentals of the KSF appraisal system, its use as a staff-assessment tool and its application in emergency care settings.