1. INTRODUCTION
The last twelve months has continued to see net growth for the amicus Health Sector. However there has been continued frustration with the pace and sometimes the direction of change in the NHS. Our national team of Officers and staff working with Regional Officers (ROs) and senior lay members continues to meet a number of challenges, showing great creativity and flexibility in responding to these. We are confident that that provided we continue to reform our structures we will see continued progress in the year ahead that will put us in good stead for creating a vibrant Health Sector as part of the new fully integrated Union. All involved should be congratulated for the contribution that they have made.
2. MEMBERSHIP GROWTH
5586 new members were recruited in 2001. Net growth continues, presently 1676 net in the nine months to September 2002 and we are hoping to exceed last years total of 2211 members this year.
This growth in membership does not come easily. It is the result of a great deal of hard work from members, reps and officers, Regional and Professional. Recruitment and growth are our lifeblood. The income sustains and enhances our resources, the sheer numbers impress on employers and the DoH our significance and activity shows employers and other unions that our policies are attractive to health staff.
All parts of the union are expected to achieve a growth of 1% per month, which we are close to attaining over the year. Further we have established within the Health Sector a target for net growth, after losses, of 0.5% (6% per year). Some regions have achieved both others have some way to go. It will be a priority for next year.
We continued to consolidate in new areas with noticeable growth amongst Medical Laboratory Assistants, Community Nursery Nurses, Community Psychiatric Nurses, School Nurses and some Medical Technical Officer groups.
We have successfully achieved a partnership arrangement with the National Association of Theatre Nurses and were represented at their Annual Conference in October last. There are a number of other organisations who wish to follow a similar route. We continue to invite the smaller professional bodies to our major events. These arrangements make new groups of members available but in some areas we have opportunities in existing groups which we have not fully exploited. It is still true that the main reason for workers not joining is that they were not asked.
In anticipation of a campaign over Agenda for Change, a suite of membership leaflets have been prepared which should be available before Christmas.
3. MAINTAINING OUR ORGANISATION
The pressures on our local representatives have increased. Despite a growing number of reasonable facilities agreements, this must remain the top priority for local negotiation, not least as a pre-condition for agreement on Agenda for Change (AfC) and the wider modernisation agenda. We have provided model guidelines on facility agreements but not all reps have yet sought to implement them. At the same time, we managed to maintain our outstanding network of local representatives, widely recognised as being amongst the best in the NHS at a time when other organisations are losing theirs.
We have increased the frequency of which Reps Direct is produced in order to assist Reps carry out their role effectively and give us the information that we are seeking to represent you at a national level. The effectiveness of our network of Reps was given evidence by the fact that our Union produced by far the most comprehensive commentary on the applicants for Early Implementer (EI) status under AfC.
A particular problem will be supporting representatives in the face of a massive programme of work around the implementation of AfC and the need to increasingly involve (and better support) representatives playing national and UK roles. Over £50,000 has been raised from Regions/Branches for an additional research/organiser to help co-ordinate our response to AfC. The GPFC will make a decision on the appointment on 15th November.
At the same time we need to amend our organisation to reflect changes that are taking place in service provision in order that we can organise NHS staff to our full potential. We have grown rapidly by proving an attractive home for organisations seeking to have comprehensive labour relations support whilst maintaining the professional autonomy of each particular group. This is a strength for the Union but sometimes we have failed to be more than a sum total of our parts and we can deliver better outcomes for our members if there was further organisational change.
There have been substantial discussions on the structure document and we should now move forward in the year ahead to implement agreed changes. We welcome the changes that have already been adopted in pathology and in wider healthcare science, pharmacy and community nursing.
We are seeking to set up inclusive structures across discernible service areas and co-ordination through Trust wide structures whilst protecting professional autonomy. In PCTs there is an immense opportunity for us to take a leading role thanks to our network of CPHVA LARs.
We have also organised a parallel process of working with a range of professional bodies to our advance our common interests. As a result a number of these bodies are seeking more formal closer working relations with amicus. We particularly want to welcome the National Association of Theatre Nurses (NATN) into the amicus family of professions.
4. RELATIONS WITH GOVERNMENT
We have sought and received a partnership approach with the DoH and much of the time it works well. This has entailed closer working on a range of issues of great benefit to our members and an ability to resolve issues, particularly rumours, quickly. The flip side of this is for our criticisms to be made out of the public arena until it becomes clear there is a fundamental difference with which we cannot live. This in itself produces the advantage of there being pressure on the DoH to seek agreement with Amicus so our disagreement will not be made public.
Consultation with Amicus and contact at the highest levels has improved dramatically. Members have directly benefited from this and continue to do so. A number of meetings have been held with the Secretary of State, lay members present have been able to ensure members concerns are directly expressed and have seen resulting changes. Our influence is enhanced by the fact that Margaret Wall, National Policy Secretary is Chair of the Health Policy Commission.
We have had a series of contact meetings where issues are shared. In addition:
Ministerial contacts have also ensured that we are invited to participate in events that were normally the preserve of professional bodies. Although we still have a number of concerns in this area.
5. AGENDA FOR CHANGE
Amicus identifies AfC as the most effective way of correcting many of the anomalies in the present arrangements. It also provides objectively determined flexibility to reflect the Skills Escalator and Skill Mix. The Job Evaluation scheme provides an objective way of determining pay and minimises pay inequalities.
However the process of reaching agreement has shown weaknesses on the part of the DoH which have created nervousness on our part. It is clear from delays that either HR professionals have not been used and/or consulted or that resources are inadequate. In any event, more professional and experienced staff could have expedited matters. There has been a lack of drive that has left the Staff Side exasperated. We were often being pressed for responses e.g. Early Implementers EIs within 6 days and then having to wait till agreement is reached for the Department of Health (DoH) response.
5.1 Equal Value
Our own difficulties have grown over the past few months partly because of delay, partly because of indications of the new conditions and not least because the principles of JE, equalities and consistency are being breached.
We have already referred to the need for each of the negotiating structures to produce common improvements to all three spines. Now we find that the DoH view is that the Pay Review Body should have the ability to amend grades and progression, presumably applied salaries as well. In addition the concept of allowances for Recruitment and Retention can only be valid if the stock of potential staff is sufficient and the distribution wrong either inside the Health Sector or between health and non health employment. If there are no more workers in a particular sector then such allowances will not create them the Issue that needs to be addressed is one of better recruitment and training. This requires a better pay and conditions structure overall, not a short term and limited fix. If there is a real shortage then allowances will not increase the total other than in the very long term. Further anything other than a short-term allowance, to be withdrawn when it has worked, is likely to provoke equal value claims. Stability and consistency of approach will benefit all in the longer run.
To establish pay levels one has to provide two things: a rational approach to relativities within the employer and a mechanism for relating the pay structure to the rest of the economy. The JE scheme should provide the former. For the latter we need to utilise jobs occurring in and out of the NHS. It is these jobs where R&R problems often occur. If R&R payments are made to them it destroys the possibility of a link and thus protects low pay for those without a link and perpetuates discriminatory practices liable to Equal Value claims.
5.2 Job Evaluation
One further matter that is giving us concern is the recent announcement that the software package for scoring the Profiles will not be available in time for Early Implementers. Although a recent meeting of the Job Evaluation Working Party agreed a revised timetable for tendering, developing and testing the software, all agreed that this timetable had little ‘slack’ for delay. The SoS has been told this will be available in time but we are not confident.
From our perspective we are not prepared to go ahead with any manual arrangement. The EIs are intended to test the system in total not just part of it. In addition the memories of the Clinical Grading scheme and widespread evidence of grade drift are still fresh in every ones mind and the potential inconsistencies of local management implementation are two awful to comprehend.
We are pleased to report that we have been able to extend the range of Amicus occupations bench-marked as part of this process following our intervention.
5.3 Pay and structure
Without full sight of the proposed structure along with pay, it is difficult to know how it is likely to work out. The proposal to have only 8 bands indicates potential difficulties. Placing staff with clearly different levels of responsibility in the same grade will work against flexibility. Putting 5 mini grades into band 8 is nonsensical. If automatic progression is not available then we should be honest and create a 12 grade structure. Thus reducing the points range in each of the bands not just the highest. Further whilst we recognise that extending ranges of bands can reduce losers on implementation, it leads to other problems later. If the difference between two bands is only one increment, then promotion will be of little value and it could take a decade for higher graded staff to catch up with longer serving lower graded staff. Long service based scales are also contrary to the principles of equal value. (Women tend to shorter service) The answer to high numbers of losers is to increase the base of the scales and move more staff upwards.
5.4 24/7 working
The principle of the proposals on 24/7 working are clearly much less than many are already receiving. Regardless of contractual arrangements staff will not be prepared to disrupt their lives for a low level of payment. There has yet to be any hint of understanding on the part of the DoH that reductions in existing levels will reduce rather than increase flexibility. The aim to introduce 24/7 working for more staff at present levels of cost is not going to work. Of course the levels of payment required to work 24/7 will depend in large part on the improvements to basic earnings. This is part of modernisation and the cost should not be included in the pot for AfC.
5.5 Harmonisation
At a time when the EU, Government and the NHS are all seeking to improve working lives and family friendly working, the idea of increasing working hours and reducing holidays is unacceptable. The present range of weekly hours runs from 35 to 42 (some have protected 33). To harmonise at 37.5 will require an increase of up to 4.5 hours per week. To reduce holiday entitlement from 33 days to whatever figure we settle on is again not acceptable. Indeed we are under justifiable pressure from our members to reduce the standard working week in the NHS to 35. With present staffing levels this could not work. However we need to be able to fully protect hours and holidays. We shall be looking for periods of protection to broadly match the period over which we might expect further reductions in the standard 37.5 hrs to 35.
5.6 Allowances
We agree that the number of allowances should be minimised. Where they are necessary, for factors not fully included in the Factor plan, they should be determined at National level. Where allowances are to recompense workers for living in an area of high cost of living (not just the South East of England), then they should be applicable over a large area and not discriminate between individual trusts. Housing is the biggest problem in some areas and non-pay solutions may be a better way of reflecting this.
5.7 Assimilation
On assimilation, those "under-graded" should be placed on the minimum of the new scale to prevent equal value claims. Again it is difficult to identify the problems without access to the new scales and JE results.
From comments above it is clear that periods of protection for pay; hours; holidays should differ.
5.8 Implementation
As a union we are committed to the principles of Partnership and AfC. Whatever success we have in some of the areas above we are likely to face substantial numbers of members who will see themselves as loosing out. The natural tendency of our members to support their colleagues, means that we cannot take a yes vote for granted. We have already raised the need for us to have some seconded reps to help explain the agreement in the first place and then to watch the EIs and subsequently to train reps. The DoH response was that the staff side should address this issue. However we are of the view that it is necessary for Amicus to have their own seconded reps to talk to those professions where we are the appropriate union, it is our members who will vote and determine the Amicus decision on AfC. We are not prepared to see AfC being agreed by the big battalions with our members reluctantly going along, for this is likely to lead to members resisting the agreement and seeking to "bend it", not in the long term interests of stability.
5.9 Conclusion
There is a great deal of expectation being built up amongst NHS staff that we are approaching a new pay settlement. But there is also at the same time a great deal of cynicism and hesitancy whether the changes will be progressive or regressive. We believe that because of the processes we have gone through the system will be fairer. But whether it will be better will depend on the final outcome and the amount the Government invests in underpinning the new structures. We need to convince the Government of the logic of its own arguments contained within the NHS Plan and the Wanless Review.
The objectives for Government for the extra resources should be threefold: boost capacity; boost the basic pay of NHS staff and set up a reward structure for those that take on enhanced roles or greater responsibilities. We ask the NAC to endorse the attached statement on Agenda for Change.
It has already been put to the Secretary Of State in preparation for a meeting with him last week. Discussions and eventually negotiations will accelerate over the coming period. It is therefore proposed that a Pay Reference Group be established made up from a small group of Lay Reps to advise and consult members rapidly on developments.
6. OTHER PAY ISSUES
6.1 2001/2002 Pay Round
All NHS staff received the same general annual uplift of 3.6 per cent. The Pay Review Body (PRB) gave the lead for this level of settlement. This was well above the rate of inflation for the April 2002 and within the upper quartile of pay settlements for the same period. This met one of the bargaining objectives of the Amicus of seeking to restore real spending power of NHS staff albeit in a small way. Public sector pay is increasing at a faster rate than that in the private sector. But as an increase to tackle structural problems in NHS pay we focused our attention on the outcome of the Agenda for Change talks.
Key recommendations for Amicus members of the PRB were:
We were the first Union to point out the possible discriminatory impact that the NVQ linked increments may have on colleagues who have a NVQ equivalent like Community Nursery Nurses. We issued bargaining advice to members and many are winning the increment.
At the same time Amicus-MSF have managed to make additional gains ahead of Agenda for Change mainly through restructuring of salary scales in those groups covered by Whitley Councils. We achieved this by highlighting recruitment and retention problems in key areas and linking this with the implementation of National Service Frameworks.
Key features of this approach is as follows:
6.2 2002/2003 Pay Round
We submitted evidence as part of the joint Staff Side submissions to the Nurses and PAMs PRBs. Our own evidence to the Nurses PRB called for:
We are in the process of constructing our claims for the Whitley Councils.
We expressed concern over the postponement by the Officers of the Nurses and Midwives Staff Side of our oral session with the PRB. This followed advice from Lead Negotiators on AfC that agreement was imminent and the DoH had offered the Staff Side a three-year deal as part of the overall settlement thereby seemingly negating the work of the PRB.
There is some scepticism on our part that the November deadline for completing Agenda for Change will be met. The Health Departments in the event of a further delay in Agenda for Change may argue that that agreement is still imminent and the PRB cycle should still be postponed.
There are also some procedural issues. The Joint Staff Side of Agenda for Change has no authority over the Whitley structures at present. We believe that there are some strategic considerations to take on board regarding any further delay and our attitude towards a three-year deal.
We have formally written requesting that the decision to postpone the normal PRB cycle is reviewed by a full meeting of the Staff Side.
6.3 Moving Forward
Amicus is looking at how we can develop with a range of professional bodies enhanced or changed roles in order to access further advances. The most recent example of such an approach is a development of the Advanced Practitioner in Cytology.
At the same time we have launched a grading campaign second to none to enforce the clinical grading criteria. This has been particularly focused around School Nurses (from E or F to G), Community Nursery Nurses (from A or B to C), Community Psychiatric Nurses (from E or F to G) and for Speech and Language Therapy Assistants. We have also sought to promote practice where MLAs are moved onto MTO scales and natural progression for BMS1 to move to 2. We are also aware that some MTO groups are moving onto Clinical Science scales. We are intending to push in the year ahead for qualified MTOs to be on a minimum of grade 3.
This has brought organisational benefits to Amicus. At present rate of growth we will be the only union for School Nursing within two years. This is combined with a radical agenda that seeks to improve practice through professional development of our members and using this as the basis for grade advance. This will put us in good stead for the new pay template being produced under AfC.
We have three key objectives on non-AfC pay issues:
7. KEY POLICY AREAS
7.1 Private Sector involvement in NHS
There is clear and unequivocal policy from amicus MSF conference in this area. We have successfully argued for PFI/PPP criteria to exclude the large majority of services provided by Amicus members. Indeed the past year has seen, for various reasons the non-renewal of the contracts of all existing private sector providers of pathology services and the service returned to the NHS. However we are aware that Pathology remains on the ‘front line’ and future threats much depends on the pace of service modernisation addressed elsewhere. We remain vigilant and will devise tactics that can both deliver the service improvements that Government is seeking whilst protecting the interests of our members.
The TUC lobby of Parliament on 4th December drew little support from MSF members most regions not being represented. However our policy of opposition to PFI has been pursued with a number of appropriate Government Departments with some success.
Discussions with the DoH have made clear our opposition to significant Private Sector involvement in Pathology and Imaging (NHS Plan) and made clear our opposition to the Retention of Employment model as it stood. However, the model was eventually agreed by Unison following a consultation with its members.
At a trust/multi-trust level we have successfully proposed alternatives to the use of the private sector. Amicus presented written and oral evidence to the House of Commons Health Select Committee. We have met with Trust management over PPP in Teeside (Tees Path) and Lincolnshire (Path Links). The Head of Health gave a presentation on alternatives to PPP in North Manchester when Quest Diagnostic became involved. We also made a submission to the consultation on Pathology Modernisation.
Nevertheless it is clear that the Government are looking for change, believing there is insufficient capacity in public service management to deliver it. Unfortunately this is partly confirmed by the lack of progress in Greater Manchester despite hard work from our members involved in the proposals for reconfiguration. However, we shall continue to prevent further incursions of the private sector into this area, and the NAC firmly believes that, should we have members in a PPP scheme, we must continue to protect their interests. Instead we believe that management should take its responsibility and work in partnership with Amicus on a viable proposal for reconfiguring services without private sector involvement.
Also in financing capital investment in the capital stock of the NHS the Government has reiterated that will continue to use private sector finance through PFI in the acute sector and LIFT in the community. We have questioned whether this constitutes good value for money and the effect of such funding mechanisms has on future public investment in the NHS. We supported the motion demanding a review at Labour Party Conference. We are also arranging meetings at appropriate levels within Government to reflect the policies adopted at Amicus MSF annual Conference and the NAC.
We believe that emotive arguments around protagonists in this debate seeking to stop hospital building programmes are offensive and fall wide of the mark. However, the size of the rebuilding programme does make a strong case for this maybe being beyond the capacity of the NHS to manage alone or at least the programme can be accelerated with outside assistance. We have urged the Government to make a case based on evidence not dogma. Instead it is clear to many that PFI appears to be the preferred and possibly the only route for the whole programme.
We are slightly more convinced that the nature of the recent improvements to facilities in the community would not have taken place without LIFT. This not because LIFT provides better value for money or is more superior than PFI but rather because of the failure of most health centres in the community to build capital reserves to invest because of their understandable priority to support front line services. Many of the proposed LIFT arrangements provide for cross departmental presence. Local authority, community health and acute. Traditionally health centres, where they existed, were spin off’s from premises owned and run by doctors. A proposal to oppose LIFT was rejected by this year’s amicus MSF conference.
At a policy level we have been seeking to clearly define the clinical boundaries between the NHS and the private sector, outlining where we believe the private sector can make a contribution, particularly at the cutting edge of science and technology and provision of technology. We believe that the Government has dug itself into a hole, however, we have a responsibility, through partnership, to help the Government out of that hole.
Our approach has won us recognition as the 'thinking' Union but more importantly we have won results for our members. Not one member has been transferred to the Private Sector. However there are difficulties ahead and these should not be underestimated. We are in the process of discussing with the Director of Education on how the joint issues of modernisation and private sector involvement in the NHS can be addressed at Whitehall College based on best practice.
This is also an issue of the ability for the NHS to assimilate the extra capital allocated by the Chancellor. Already the DoH is under-spending its budget allocation. The Chancellor has tied the extra funds to a body to ensure that they are spent wisely. There is a danger that these monies will not result in any discernible improvement in healthcare by the time of the next election unless they are spent effectively. This is a political imperative.
The 1 per cent increase in National Insurance (a 1p in the pound increase in tax by any other name) to fund increased NHS expenditure represents a decisive break with the Thatcherite past of seeking to cut public expenditure as proportion of GDP and a move towards a European social model. There is a political imperative to achieve change in order that a third term Labour Government will be able to sustain and even increase levels of investment. That is why the Government is intent on involving the private sector in the modernisation process as they doubtful whether the NHS alone can achieve this.
This places great onus on us as a Union committed to Labour’s objectives in increasing investment in healthcare to be advocates for modernisation of the NHS using public resources and become actually engaged in this process as an alternative to the involvement of the private sector. The stakes for Labour, the NHS and us as a Union should not be underestimated.
7.2 Workforce Issues
The 2002 Budget announced the largest ever-sustained increase in NHS resources. A 3.4 per cent average annual terms real growth in UK NHS spending for five years, putting the NHS on a sustainable long-term financial footing with spending to grow by 10 per cent in cash terms or by 43 per cent over the period.
Over the same period the Government has set ambitious targets for increasing the numbers of nurses, allied health professionals and doctors. However, whilst these targets are welcome, it appears that too little workforce planning has been done on how this figure should be distributed throughout the various NHS professions. Maybe this is an indeterminable objective. The CPHVA has met huge obstacles in trying to develop a robust model for the community nursing. However, we are convinced of need to boost capacity in order to meet Government health targets and improve healthcare in the long term. This much was outlined in the NHS Plan.
We also fear that pressure will come to direct these extra resources to service provision at the expense of a new pay settlement for NHS staff via AfC which addresses the historic decline in the spending power of NHS staff. This has only in recent years has just begun to be addressed. Firstly, this view ignores that in a people centred service such as the NHS the contribution of staff cannot be ignored. Secondly, in an era of relatively low inflation the NHS can use these greatly expanded resources to both improve the salaries of NHS staff and whilst at the same time investing directly in other aspects of service provision.
At the same time there is a drive for nurses and allied health professional to take on enhanced roles to enable the NHS to become compliant with the Working Time Directive for doctors. Once again we are confident that this is an opportunity and challenge that staff will meet as they have done in the past.
The NHS is increasingly becoming a graduate level labour market. However, the need for the NHS to recruit significant numbers of graduates to meet its recruitment targets is one of the key challenges for the period ahead. Indeed most reasoned observers believe that the targets cannot be met from newly qualified graduates or those returning to practice alone. This requires the service to look at two possible means by which this can addressed. Firstly by looking at issues relating to skill mix and secondly, looking at service reconfiguration.
We have sought to start debates around issues relating to skill mix via Reps Direct and the professional journals associated with Amicus. We have taken a progressive approach that both recognise the potential for skill mix both vertically and horizontally whilst seeking to ensure standards and the professional integrity of our members. Some excellent work is taking place vertically with Medical Laboratory Assistants, Speech and Language Therapy Assistants and Community Nursery Nurses and horizontally in theatres.
We need national work to be undertaken by the Department of Health on targets in the National Service Frameworks looking at workloads and the skill mix required to meet these targets and whether this can be achieved within the available resources. Instead the approach is to initiate pilots through the Workforce Confederations which whilst being an interesting area of endeavour often throw up questions relating to appropriate professional boundaries and skills depletion and is no substitute for the whole service approaches outlined above.
Likewise we need to develop a considered view on service reconfiguration. At present the Government remains chastened by the Kidderminster experience. However, drivers like the need for service modernisation, continued staff shortages and the Working Time Directive will force this onto the agenda. We need to take a more proactive approach in order that we can shape in advance the nature of any proposals in the areas that our members work. In some senses this is already on the agenda with the Pathology Modernisation project. But change is slow and piecemeal. A managed network in the public sector is by far our preferred route. We are lucky to possess by far the best experience in this respect of any trade union. But whilst most members agree with the logic of this approach many also believe that they should remain unaffected by any consequential change. Alternatively some professional groups seek to want to keep hold of their ‘empires’. Both these approaches should be opposed, as it will make it more likely that the Government will seek to involve the private sector in overcoming obstacles to desirable change.
Our alternative is to promote a full-blooded and genuine partnership approach to discussing issues of service change. Whilst there exists some good models of practice in the NHS all too often these are few and far between. Amicus has been continuing with its partnership programme at Whitehall College which is funded by the DTI. A conference to help take this issue forward is to take place on 20th November 2002.
7.3 Quality, CPD, careers
During the next year arrangements on professional self-regulation will be finalised for the NMC and the HPC. Amicus made submission to consultations on: NMC (via the CPHVA) and the HPC. Amicus campaigned against the proposal contained within the HPC consultation documents to hike up registration fees from £22 at present to between £65 and £85 per annum. Ten thousand campaign postcards were circulated around members.
As a result of the campaign and raising our concerns with the Secretary of State Amicus MSF representatives met the HPC. The HPC were very conscious of the scale of concern over fees. The increased scope of their responsibilities has led to the proposed rise in fees. They will shortly be publishing a summary of the consultation responses. Afterwards they will respond and identify areas where others, ie not the HPC, would have to act and it is of course likely that fees would be such an issue. It will then be for Amicus to take those concerns to the DoH, which we are preparing to do.
We also raised concerns regarding recognition of the role of trade unions, new registrant professions and those self-employed or employed in the private sector. We were pleased with the openness and understanding of the HPC, which augurs well for the future.
The likely increase in fees from the NMC, due to their financial over run, raises the issue of principle for those who are employed, for the employer to pay the fees as already happens with teachers. With the support of the NAC we shall pursue this policy for all our members covered by Professional regulation. The situation is much more complex for the self employed. Here we are looking for volunteers to staff an email network to try and develop policy which might help them.
For Amicus there are a number of broader challenges. Where we already provide the professional role, e.g. CPHVA, there is no change. Where we have a close relationship with the professional body, e.g. IBMS, we need to cement that relationship and develop it further. Elsewhere we are exploring partnering existing organisations, or in some cases using amicus as the focus for consolidating a group of professional bodies.
We need to address groups not covered such as psychologists, and non-registered support and technical staff and for other groups including chaplains, sexual health advisors, perfusionists and audiology staff.
Clinical governance and skill mix will combine to change career paths and improve CPD opportunities. The occupation specific HR strategies (PAMS and Healthcare Scientists) demand a specific response and will in turn have implications for pay and grading structures.
Professionally Amicus must realise our potential. Under the new pay template, advancing relative pay levels will come from promoting skill intensive changes in clinical practice and developing education and training programmes to meet them.
Amicus has a distinct advantage over often-narrow professional groupings in making a contribution to the delivery of improved healthcare. Being multi-professional we can take a 'joined-up' approach to policy formulation on service delivery. This allows us to help shape the skill mix required in a particular area of the service and prevent non-clinical driven grade mix.
Statement on Agenda for Change