1. Meeting with John Hutton MP Minister of State for HealthThe pay offers for non-PRB staff all provided for the same basic increase of 3.6%. In addition a number of offers provided for further increases especially for lower graded staff, many specifically asked for by Amicus-MSF. In a number of cases we sought to pursue the outstanding areas with the DoH. This culminated in a recent meeting on Wednesday last with John Hutton Minister in the DoH. A brief on the major outstanding issues was provided and a copy is attached. In the meantime UNISON announced their acceptance of this years offers thus making it difficult for the Minister to respond more positively where we wanted further improvements. Balloting or decisions by Occupational Advisory committees is now taking place on these offers. The meeting with John Hutton was helpful and provided us with an opportunity for emphasising a number of outstanding issues including the compression of scales and the need for alternative recruitment and career paths. Most of these would be addressed by Agenda for Change. We did point out that the recruitment and retention problem needed some urgent attention and could not wait until all staff were placed within the new structures. The R&R problem was the core of our argument concerning pay and he was unable to do more at present because of the imminence of a new pay structure which early changes could distort. What we did agree was to illustrate problems the Government would face in the delivery of the NSFs without the requisite professional staff. As a result we shall be putting together a paper identifying each NSF and our members contribution; the staffing implications compared to existing levels and possible solutions to the problems. These solutions will inevitably include pay but career progression, CPD; removing barriers between professions and within should all be presented. Colin Adkins will be drawing up the paper within the next two weeks. Your contributions will be essential to this. Colin will be circulating a request to all secretaries’ of OAC's later today, in the meantime please ensure you are working on the responses. This is a chance for us to have a direct influence on the staff shortages, which give us as much of a problem as the patient. There were a number of issues on which we agreed to work together to resolve.
The pay offers for non-PRB staff all provided for the same basic increase of 3.6%. In addition a number of offers provided for further increases especially for lower graded staff, many specifically asked for by Amicus-MSF. In a number of cases we sought to pursue the outstanding areas with the DoH. This culminated in a recent meeting on Wednesday last with John Hutton Minister in the DoH. A brief on the major outstanding issues was provided and a copy is attached.
In the meantime UNISON announced their acceptance of this years offers thus making it difficult for the Minister to respond more positively where we wanted further improvements. Balloting or decisions by Occupational Advisory committees is now taking place on these offers.
The meeting with John Hutton was helpful and provided us with an opportunity for emphasising a number of outstanding issues including the compression of scales and the need for alternative recruitment and career paths. Most of these would be addressed by Agenda for Change. We did point out that the recruitment and retention problem needed some urgent attention and could not wait until all staff were placed within the new structures.
The R&R problem was the core of our argument concerning pay and he was unable to do more at present because of the imminence of a new pay structure which early changes could distort. What we did agree was to illustrate problems the Government would face in the delivery of the NSFs without the requisite professional staff. As a result we shall be putting together a paper identifying each NSF and our members contribution; the staffing implications compared to existing levels and possible solutions to the problems. These solutions will inevitably include pay but career progression, CPD; removing barriers between professions and within should all be presented. Colin Adkins will be drawing up the paper within the next two weeks. Your contributions will be essential to this. Colin will be circulating a request to all secretaries’ of OAC's later today, in the meantime please ensure you are working on the responses. This is a chance for us to have a direct influence on the staff shortages, which give us as much of a problem as the patient.
There were a number of issues on which we agreed to work together to resolve.
2. Briefing note:
Amicus MSF wishes to put on record our appreciation to Government for ensuring that NHS Professional Staff not covered by a Pay Review Body (PRB) will enjoy the same level of salary uplift (3.6 per cent) as Nurses and Professions Allied to Medicine (PAMs) from 1st April 2002. However, traditionally the recommendations of the PRB also cover salary restructuring to address salary anomalies, career progression, recruitment and retention.
Amicus MSF has sought to address these latter issues through the Whitley Councils in the current pay round. The Department has responded in part to some of our concerns and the purpose of this brief is to detail where we believe further steps are needed in order to address recruitment and retention issues and help meet the targets set within the NHS Plan. We understand that as Agenda for Change approaches, any further steps need to be compatible with the principles underlying pay modernisation.
We can supply more extensive documents to back up the case that we are making.
3. Whitley Council PTB
This covers Amicus MSF members in Pathology, Medical Technology and Estates.
Issue One: We would further urge you to reconsider the proposal that a senior Medical Laboratory Assistant grade is created. Such a development would also put a grading scheme in place that would facilitate entry into the service by school leavers and prevent the abuse of the Medical Technical Officer structure.
Issue Two: A number of Medical Laboratory Scientific Officer at grade 4 will be retiring over the next two years. While there will be plenty of grade 3s willing to step into their shoes, as the differential between the top of the 2 and 3 no longer exists filling MLSO 3 posts is going to be very difficult. Given their position as a key supervisory grade, running a service is going to be exceptionally difficult in these circumstances.
Issue Three: Amicus MSF welcomes the proposals to restructure the salaries of Medical Technical Officers. However, in certain areas this will not address immediate recruitment and retention problems. We are already aware of localised shortages in key areas and we believe that this delay which is in some case equivalent to the training period of some MTO professions is not sustainable if the government wishes to deliver the cancer and coronary frameworks on schedule. We need clearer guidelines on the use of local pay flexibilities for MTO grades.
4. Whitley Council PTA
This covers Amicus MSF Clinical Scientist members in Medical Physics and Biochemistry.
Recruitment and retention is the main issue concerning this group of staff. In the Hospital Physicists Association’s most recent survey of advertised posts in Medical Physics, 55 per cent of posts were unable to be filled. The situation is particularly acute in radiotherapy where the National Cancer Plan has increased pressure on staff and equipment with 65 per cent of advertised posts not being filled. Another worrying trend is that in 2001 32 per cent of appointments were made at a lower grade than advertised, thus indicating that there is a lack of suitably qualified candidates for many vacancies.
The use of local pay supplements to aid recruitment and retention has been used in some areas in the past, particularly in London, but this provision would appear not to have made a significant impact on the vacancy rates throughout the country in the past few years. In a sense, this practice has merely moved the problem around the country.
We would argue that a more radical solution to the problems of recruitment and retention needs to be addressed in the present pay round without waiting for the undoubted benefits resulting pay modernisation.
5. Family of Psychology
This covers Amicus members in Clinical Psychology and Child Psychotherapy.
The Department has proposed a slight restructuring of the Clinical Psychologists scale (one point of the bottom of the Assistants scale). Amicus MSF has proposed a more radical approach which by abolishing Appendix A of the scales will result in the alignment of the Clinical Psychologists and Child Psychotherapists scales and career structures. This would be in line with notions of equal value being promoted by pay modernisation.
The Recruitment and Retention issue is that as Trainee Clinical Psychologist posts are expanded, the number of Assistants are declining. Assistants make a valued contribution as part of a skill mix team in mental health and the more radical approach (abolishing Appendix A) will expand overall numbers in Clinical Psychology, boosting capacity and helping the NHS meet the mental health National Service Framework.
6. College of Healthcare Chaplains
Anomalies exist largely around the treatment of part-time employees. Some trusts have employed best practice and have ceased sessional payments in favour of pro-rata part-time payments but many trusts are still paying sessional rates, some at the 1999 rate, while expecting post holders to carry an on-call commitment, be a full member of the chaplaincy team and attend team meetings (sometimes in their own time). The sessional rate carries no built in element for on call responsibility but these individuals receive no remuneration for this extra work.
All chaplains are affected by these anomalies but minority faith and free church chaplains more so and there are real dangers of creating discriminatory elements in employment as a result of this. This issue is ‘fudged’ in the Advance Letter.
7. Nurses and Midwives Advance Letter
The Pay Review Body recommended an extra increment tied to attainment of National Vocational Qualification (NVQ) level 2 for Grade A nurses and NVQ level 3 for Grade B nurses. The Department of Health is proposing a literal translation of this recommendation which in effect will exclude those who possess other qualifications at that level from receiving the extra increment. This may detrimentally affect Community Nursery Nurses.
This will not improve standards of healthcare. The relevant NVQ was never envisaged as a replacement for the CACHE Diploma or BTEC. Many CNNs have expressed the view that the NVQ was not suitable for their role in the community. Therefore a literal interpretation will force CNNs to take a less relevant qualification in order to gain the extra increment and this will not improve standards of practice.
The CPHVA has led by seeking to persuade health visitors that CNNs were a valuable part of skills mix in the community rather than an attempt to introduce ‘health visiting on the cheap’.
Roger Spiller,
Head of Health
10th April 2002
8. Amended PCT Governance Arrangements
Below is the text of a letter sent by Nigel Crisp, Chief Executive of the DoH & NHS, to the Chairs of all PCTs.
I would like to draw your attention to the enhanced Nurse Professional Leadership,the increase in remuneration and allowances for board and executive committeee work,but point out that the requirement for at least 2 nurse seats on the professional executive committees has been reduced to a minimum of 1 seat ; Reps LARS need to resist any attempt to reduce nurse representation on pecs - many of these seats are filled by cphva members.
Dear Chairman
SHIFTING THE BALANCE OF POWER: PRIMARY CARE TRUSTS – GOVERNANCE ARRANGEMENTS, REMUNERATION AND ALLOWANCES
Following publication of "Shifting the Balance of Power: Securing Delivery" a review of the governance arrangements of Primary Care Trusts was undertaken. Building on the comments and advice received from representatives of Primary Care Trusts and the relevant national professional organisations, a number of significant changes have been made to maximise local flexibility in line with the general policy direction. These are summarised below. Further details are contained in Annex A.
In view of the increased roles and responsibilities of PCTs, we have also undertaken a review of the level of remuneration and allowances paid to Board and Executive Committee members. A summary of the changes is set out below, and further details are contained in Annex B
The full document including Annex A & B can be found in the Health Website
http://www.msfhealth.org/members/amdended pct governance - 15apr02.pdf