RepsDirect No 169 - 3 March 2003

From

Head of Health, Roger Spiller

General Secretary, Roger Lyons

Agenda For Change

As previously indicated the Health National Advisory Committee met on Thursday 27th February and decided not to take a decision on Agenda for Change. Meeting the previous day, the representatives of each Occupational Advisory Committee received an update on job profiles from Colin Adkins. Although more had been completed we were still looking for tens of profiles to be completed before we were in a position to take a definitive position.

Before the meeting we were looking at how we could get over the problem of inadequate information on which members would have to take a decision. As a result a number of things happened:

1.	The DoH have agreed a similar process for pathology
2.	A list of all jobs where profiles are being prepared is below.
3.	One of the reasons for going through the Early implementer process is to continue to develop jobs which have a small population or are at intermediate levels, filling the gaps. Of course this means that we shall not know where these jobs fit until after we have agreed to AfC.
4.	The NAC properly expressed concern over this and sought the prospect of a postponement of the ballot from April. We had already sought advice on this from the balloting organisation colleagues and, after consulting the Chair of the NAC, can now confirm that the ballot will take place in the first two weeks of May.
5.	After early implementation, there will be a review of the process and implementation when we shall be able to redraw, for example any unacceptable features of the Job Evaluation Factor Plan. We know there are problems with it especially Knowledge and Skills failing to have sufficient levels and failing properly to take account of scientific knowledge and cognitive skills. The DoH recognise the need to further address these issues and in addition have agreed in principle to a Band 9 which will capture those of our members who already exceed 720 points and those, after the review, who would do so.
6.	The On call issue is primarily of major interest for some staff in Pathology. However it may currently provide, in exceptional cases, up to 100% of salary. Its history is complex, deriving originally from payments for being on call, being called in and overtime pay. Over the years we have negotiated improvements and in most cases requires permanent attendance on a rota. In most instances this has resulted in payments for shift working often involving few attendances and few if any additional hours. The overall payment levels have been retained legitimately as an attempt to retain and recruit staff.
7.	AfC is seeking to harmonise all payments other than salary. To do so in pathology could theoretically result in losses of up to 8 or 9 thousand pounds per year. Our discussions with the DoH resulted firstly in an agreement to protect the payment for 4 years leaving us time to negotiate new arrangements in the meantime. The whole issue of 24/7 working is gradually being resolved and the Health Care Scientist group had already agreed to set up a working group to look at best practice and how to provide the service for patients within the Working Time Regulations. The DoH have agreed to participate in this and suggested we incorporate those other unions radiographers, Physiotherapists and Unison, which also have on call issues. So we shall be inviting them to participate.
8.	At the same time we suggested an arrangement to the DoH which extracted the AfC payment for the shift/on-call pattern (out of hours; overtime; etc) and treated the remainder as an existing RRP. This old RRP would be added to old salary before calculating the value of the new RRP. Remember the new RRP is calculated by looking at the greatest difference between old and new salary and then applying the one cash figure to all in the group being considered. If there is an RR problem we should address that and not simply protect arrangements based on historic values. The encouraging response from the DoH thought this should be tested during the EI process.
9.	The result of all these progressive moves is that we shall not know the final outcome of assimilation until after the post EI review. Therefore we raised the issue with the DoH two weeks ago and sought their views on Amicus holding a two-stage ballot. Their answer arrived just after the health NAC meeting ended. They are not enthusiastic but in our circumstances, where so many of our jobs can not be profiled, until approaching final roll out and many long term transitional arrangements can not yet be agreed, we have little choice.
10.	So the ballot question in May would be to accept AfC as it stands so it can go through the Early Implementation process, pending a final decision after the settlement of the issues arising from the review and before the full roll out in October 2004.

PROFILES - FILLING THE GAPS

Many members have contacted us regarding the absence of profiles for their own jobs. A great deal of work is going on this area which reflects a number of factors. The main one being that we have a complex task of taking about 25 salary scales with occupational groupings practising at four or five levels and fitting these onto a new salary scale that has just eight bands, all in line with the principles of equal value.

Amicus MSF is not looking for 'fixes' outside the system but for system to be fixed. Here is the latest position by each occupational group.

Nursing

A profile has been produced for a Health Visitor and a Health Visitor Team Leader. We believe that there is a gap for a Community Practice Teacher (a profile has been produced with many errors) and for a specialist Health Visitor. For professional managers more generalised profiles have been produced which we are examining whether they are suitable for application in health visiting. We can see real progress in School Nursing and District Nursing and hopefully the completed and agreed profiles will be published soon. A Community Nursery Nurses has not been profiled but we hope to remedy this in one of the Early Implementers.

For Community Psychiatric Nurses we expect revised profiles very soon which we hope will improve the original drafts.

Pharmacy, Psychology, Speech and Language Therapy

We have now reached an impasse with the work to date. It reflects what we consider to be a misapplication of the factor plan (pharmacy), or reveals fault-lines in some of the key factors (psychology) or has not properly related the work done to date to the Enderby Equal Value claim (speech and language therapy). In speech and language therapy there is a gap with a post that needs to be evaluated at Band 7.

The DOH accepts some of the points we are making and has proposed a meeting between ourselves, those producing the profiles and service heads.

Pathology

We believe that we are close to accepting profiles for cytology screeners, phlebotomists and medical laboratory assistants with a proviso that those undertaking higher levels of practice are separately evaluated.

For BMS staff we believe that the BMS 1 and 2 posts have been evaluated. We hope to amend and therefore complete a profile for a BMS 3. Generalised profiles have been produced for application for Professional Managers in Clinical and Technical Services. We are examining their suitability for application for Managers in Pathology.

We believe that a profile needs to be produced for a specialist BMS.

Clinical Science

We can now consult in this area. We assert one level (B21-24) of practice is missing which can be addressed in the Early Implementers hopefully at Guys and St. Thomas.

MTOs

We are seeking to develop a very broad range of profiles that cover a relatively broad career range possibly as much as from Bands 3 through to Band 8.

This process is going to separate those with clinical roles away from those with more technical roles. This process will be accelerated by state registration.

We have concerns that Agenda for Change will cut across many proposals for professional integration (e.g. audiology) and broader work on Healthcare Scientist careers. Guidelines on the suitability for application of particular profiles will be particularly needed in this area to ensure this does not happen.

Theatres

There are big differences in this area. We fear that existing profiles will cause an exit from the NHS and that is why we are certain that the DoH will accept amendments or more profiles generated to clearly reflect the enhanced roles members are taking on in this area.