Move up the ladder with a grading review

Most of us would hope to receive the right amount of pay and recognition for our work. But the boundaries between HCA job bands are often blurred to the extent that some take on responsibilities beyond their grade, without receiving the appropriate remuneration.

The problem dates back to the days of clinical grading, before Agenda for Change became the NHS pay system in 2004, explains Lesley Fisher, UNISON’s staff-side secretary for Haringey PCT and Barnet, Enfield and Haringey Mental Health Trust. Back then, she says there was little distinction between the job description and duties of a HCA on grades A and B other than the level of patient supervision they were expected to do.

‘Someone on a B grade might be asked to escort a patient for an X-ray. That might have been the only difference between their job and that of an A grade,’ she recalls.

These blurred boundaries have continued, Ms Fisher says. AfC, band 2 is fairly basic, requiring little or no experience or qualifications. Those on band 3 are expected to have responsibilities, to work independently if needed, and most have experience and qualifications. However, some band 2 HCAs can end up taking on tasks associated with band 3. To address this, Ms Fisher’s trust is developing a set of competencies that HCAs will need to meet before they can move from band 2 to 3. They will be specialty-specific and tied into a grading review.

HCAs who feel they might be in the wrong grade should approach their manager to ask for a review, Ms Fisher says. ‘They shouldn’t be worried that asking for a review will be a “black mark” against them. A good manager will want to develop their staff - indeed some even instigate grading reviews,’ she says.

If a review isn’t urgent, a good time to assess roles and responsibilities is in an annual appraisal. Every job should have a Knowledge and Skills Framework (KSF) outline, which describes what is required to carry out a role effectively, Ms Fisher says. The appraisal is a chance for manager and appraisee to discuss what the role requires, to establish whether they are ready to move up a level, and what competencies they need to progress their career.

To make the best case for a grading review, HCAs should look at their job description to to see if they are exceeding expectations. For example, it might be time for a review if you are on band 2 working on an acute ward doing basic tests such as taking blood pressure, and your work is generally unsupervised, as these duties come under band 3, Ms Fisher says.

If HCAs are unsure what the bands mean, they should ask their union for details. If they are doing tasks beyond their grade they should then speak to their manager.

HCAs are also advised to keep a record of any work they could use as evidence to show why they should move up a band. They may want to use UNISON’s professional portfolio. This ‘folder of evidence’ could include examples of knowledge gained, courses attended and samples of reflective learning.

Managers should explain to HCAs why they might not be ready to move up a grade, give them set targets to help them achieve their goals and a date for a further grading review.

HCAs who have concerns about their review should seek union support, Ms Fisher advises. And she stresses that they should be proactive about getting advice, because it is important that there is ‘a career structure for everyone - not just registered nurses’.

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