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Final decision looms on AfC changes after RCN backs plans

Major reductions to NHS workers terms and conditions have moved a step closer to being adopted after one of the largest health unions gave its backing to the plans.

The Royal College of Nursing has agreed to accept proposals from NHS Employers that would result in significant changes to the Agenda for Change pay framework.

With more than 410,000 members, the RCN is so far the biggest health union to rule on the plans.

A consultation by Unison, with more than 400,000 NHS members, is continuing until the end of the month after which its executive will choose whether or not to back the changes.

The Unite union has already come out against the plans and Nursing Times understands the GMB is also likely to reject them. Both unions are large but have comparatively few NHS members, compared to the RCN and Unison.

The GMB consultation does not finish until 4 February. But GMB national officer Rehana Azam told Nursing Times: “To date all responses received back are supporting the recommendation to reject.”

The Royal College of Midwives is also still consulting its membership. However, it appears to be heading the other way and has said it believes the proposals are the “most effective” way of protecting a national pay system.

If the unions with the larger NHS membership back the proposals it is likely they will go through at a meeting of the NHS Staff Council on 26 February, despite the opposition of Unite and the GMB.

Under the plans, nurses and other NHS staff on Agenda for Change will lose their right to automatic incremental pay rises and enhanced out of hours sick pay. Band 5 nurses will also lose their preceptorship pay rises during the first year of their employment.

In addition, employers will have the ability to remove senior staff on higher pay bands from Agenda for Change and instead pay them a standalone salary.

While news of the RCN’s support was greeted with dismay by some nurses commentating last week on, the union has defended its decision and said the majority of members who took part in its consultation exercise backed the proposals.

However, the college admitted that the response to the consultation had been limited, in spite of its efforts to encourage engagement with branch meetings and emails to members explaining the proposals.

Less than 1,000 RCN members responded individually, with 53% saying the controversial changes to terms and conditions should be accepted. In a separate part of the process 82% of RCN branches decided to accept the proposals.

RCN head of employment relations Josie Irwin suggested the poor level of response from individual members indicated they were “realistic” about the situation they faced.

She said: “I think members recognise it is important to demonstrate a level of flexibility in the current financial climate and a willingness to move to accept the proposals in return for a commitment to national bargaining.”

But she warned employers that members had been clear in their comments that moves to break away from the national deal completely would “make industrial action more likely”. “This is as far as people are prepared to go,” she said.

The decision to back the plans could stave off moves by some trusts to break away from the national deal.

A group of 19 trusts in the South West are still threatening to impose local changes. However, the group has told Nursing Times it will wait to see the outcome of the national negotiations before considering its plans further.

The RCN’s decision was welcomed by NHS Employers, which negotiates on behalf of NHS trusts.

NHS Employers director Dean Royles said: “These are very positive developments. We look forward to hearing the response from the other trades unions in the coming weeks.

“We want to continue working with the staff council unions to ensure Agenda for Change is fit for purpose and sustainable for the future.”

Readers' comments (14)

  • How viable will the Agenda for Change framework be if the South-West group of trusts decides to break away to local pay?
    Then how long will it be before other groups then break away too?
    Will this lead to better care of patients?

    Who know's, but I think it might lead to more chaos, less transparency and the feeling that we have an uncertain future ahead of us.
    Not only we have a postcode lottery of care, we'll also have a postcode lottery of terms & conditions depending on where you work.

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  • One of or more of the big staffing agencies will be scenting oppertunity !

    By targeting areas such as A&E, ITU, SCBU, CCU Etc very attrative renumeration packages could be offered to highly skilled and well educated staff. Packages such as those offered to long term "Management Consultants" so often retained by the NHS.

    The NHS management who know the cost of everything and the vaue of nothing would be faced with a choice --- pay up or close down !

    The appathy shown by the RCN's membership has little to do with "being realistic" and everything to do with a workforce that has been bullied and overworked to such an extent they are demoralised and burnt out.
    They are exhausted and have no strength left to oppose these draconian attacks on terms and conditions of service.

    Time, of course , will be the ultimate judge.

    Nursing and other health care professions will , increasingly, become unattractive career options for young people.

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  • Jenny Jones | 29-Jan-2013 5:33 am


    Whilst I agree with most of your post, I have to disagree on one point. Nurses have historically always been apathetic, although they hate to hear that. Apart from a couple of medium-sized industrial action episodes in the 80s and 90s, the majority of this profession have stood by and allowed much of this to happen. It isn't just about being buillied and over-worked. It is more about many simply not wanting to get involved and not taking responsibility. (1,000 indiviuals out of an RCN membership of 410,000 bothered to express an opinion.) None of us came into this profession to take industrial action. However, we do profess to be the patient's advocate. Yet we have barely raised a voice against the fact that patients are looked after in sub-standard hospitals by demoralised, poorly remunerated nurses, with dangerous staffing levels, factory-style patient processing that completely ignores the wellbeing of the patient, etc, etc.
    Nurses (with some exceptions) have consistently failed to take a stand against the conditions we tolerate for ourselves and our patients. Again there are always exceptions, but not nearly enough. Standing together, the sheer number of nurses would make us an unstoppable force. Unfortunately, I don't see the courage required within the workforce. I see a future of multiple Mid Staffs-type reports, where we will continue failing to learn lessons and act effectively.

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  • you will reep what you sow

    what about a nurse who works nights because of say child care, then goes off sick through no fault of thier own

    tip of the iceberg

    they will want more changes over the next few years and the RCN will just roll over as usual

    thank god im leaving this proffession, nursing is finished

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  • 5 yrs until I can retire early at 55, and then either be very part time or do something else entirely. Meanwhile I will continue to do the best job I can.

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  • Mags

    I am sure you are correct !

    Tell it how you wish it was and maybe one day ?

    I wont hold my breath !

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  • What have the unions been offered in return - no compulsory redundancy agreement?

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  • Anonymous | 29-Jan-2013 10:08 am

    you will reep what you sow

    what about a nurse who works nights because of say child care, then goes off sick through no fault of thier own

    How does that work? Last time I looked (as a parent and Nurse) kids are at home at night and generally out during the day. Anyone working night shifts and then acting as a primary carer during the day is not doing themselves or indeed anyone any favours and are more likely to become ill. Flexible working and term time contracts are relatively common in my Trust.

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  • I don't think redundancy will be on offer. They probably want people to walk out of their own volition due to deteriorating conditions, morale and pay. Isn't it much cheaper that way and saves on redundancy payments.

    Everyone left, will have to work xx times harder.
    Alternatively become a limited company, be your own boss, working on contracts for different agencies, trusts and organisations, and charge much more to deliver excellent care and advice, work the hours you want to work, deal with your own sick pay and become master of your own destiny. Don't forget to pay the proper tax and NI rates. You won't need to worry about AfC or unions, as you've got your own liability insurance and protection as a limited company :oP

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  • RCN members tend to be senior nurses mostly in manegerial positions.( in my experience) they will off course be inclined to support management. they will also be aware of the fact that nurses tend to not involve themselves in campaigns surveys etc until they have been backed into a corner. unfortunately for the nurses this works against all as the divide and rule strategy will be played bt NHS employers.
    the most effecttive campaigns are those carried out as all unions together rather than individual unions.
    once again divide and rule.

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  • Term time contracts and flexible working is going out of the window fast. Most employers are tightening the belt on these terms and conditions in the name of efficiency savings and service need. Once they get rid of some terms and conditions they pick on others. colleagues let us not allow NHS employers to start making changes, they will most definately continue eating up bit by bit and soon we will have terrible T&C if any.

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  • andy | 29-Jan-2013 6:18 pm

    they do this in France, Germany and other European countries, mainly working in the community and have group nursing practices as well. it would be a great way of improving failing community services in the UK as well as domiciliary MH services and care of the elderly and young children. I have never heard of this happening in the UK and wonder if it is against some law or whether it is only because of a problem of funding and obtaining loans.

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  • Apologies in advance for my ignorance, and being a manager......
    There are two things, one called Transforming Community Services (sorry for management speak) which was a programme to try and improve provision. The nurses in Surrey formed their own social enterprise and retained their NHS T&Cs, and seem to be doing very well.
    The other was Any Willing Provider (ditto apologies) which yes, some say opened the door to Branson, but it also allowed some primary care nurses to run a GP practice and buy in locum GP time and a pharmacist.
    Variations include something like consultant chambers but with specialist nurses who got tired of having their jobs threatened or posts down graded.
    There is an entrepreneurial group of nurses in the UK doing all these things and I'd be happy to post the links if anyone's interested.

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  • Dear Nobody
    Yes please post the links to the entrepreneurial nursing groups, I am very interested.

    I am in one of the 19 trusts who is considering local pay - time to leave the RCN I fear :(

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