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Nurses to 'demand' overhaul of Agenda for Change pay bands


Nurses are to campaign for a systematic re-banding of nursing jobs sitting within the NHS Agenda for Change (AfC) payscales, after raising concerns that they are increasingly working at a higher level than for which they are being paid.

During a debate at the Royal College of Nursing’s annual congress in Liverpool on Tuesday, there were reports of staff taking on additional duties due to pressures on services and staffing shortages.

“[NHS] trusts are getting a band 6 activity on a band 5 job description”

Ged Swinton

Nurses also spoke of “downbanding,” in which employers had reduced the number of higher paid roles and instead created posts at a lower salary, expecting nurses to continue working at the more senior level but for less pay.

They claimed employers often did not offer a way for staff to request their job description to be re-assessed, while noting that nursing roles had changed significantly since the AfC system was brought in over a decade ago in 2004.

As a result, they called for an overhaul of the AfC system across the UK to ensure nurses were paid salaries that reflected the level of skills and experience required in their roles.

“Job descriptions were matched to a staff nurse role 15 years ago. The staff nurse role has changed considerably since then and trusts are getting a band 6 activity on a band 5 job description,” said Ged Swinton, from the union’s Southampton and Isle of Wight.

“We need to go further and review job descriptions or all our members,” he added.

“Despite having the knowledge and skills to be in a more senior post, I am still in the same post as when I qualified nine years ago”

Amina Ahmed

“We all know we give more than we are paid for. We all know we work over and above our job descriptions for one reason only – patient care. That needs to be reflected in our salaries,” he said.

A paediatric nurse, who had been working at her acute trust for eight years, noted that she was still employed at a band 5 level, despite working at a more senior level.

“I support newly qualified nurses and I mentor student nurses. However, despite having the knowledge and skills to be in a more senior post, I am still in the same post as when I qualified nine years ago,” said Amina Ahmed.

She said she was “angry” and “frustrated” by the low pay in nursing, in combination with high rents where she lives in London, which was causing her and her family financial difficulty and threatened to force her into leaving the profession.

Another RCN member spoke of the “scandal” he believed was happening where thousands of band 2 healthcare assistants across the country were actually working at a band 3 level.

“I believe there is an argument for the newly qualified nurse to be appointed at band 6 after a period of preceptorship”

Julie Smith

One nurse suggested newly-qualified staff should be paid at a band 6 level following a period of preceptorship – instead of the usual band 5 – and indicated that band 8 salaries should be altered to compensate.

“I think there is clear evidence that we should look at the role of the nurse through a new lens,” said Julie Smith from the RCN’s Norfolk branch.

“I believe there is an argument for the newly-qualified nurse to be appointed at band 6 after a period of preceptorship, and that should include a complete overhaul of their qualification to enable them to be the nurses they need to be,” she said.

“That could be done by looking at the whole grade structure and where the gain could be made is between band 7 and band 8, because I think having four parts to band 8 is unnecessary and our band 7 [staff] frequently work at a band 8,” she added.

  • Agenda for Change – pay system implemented across the NHS in 2004 and designed to ensure equal pay for work of equal value
  • Job creep – where lower banded staff take on additional duties and responsibilities, often due to work pressures and staffing shortages, but their pay band is not increased accordingly
  • Downbanding – where managers reduce the number of higher banded staff and create lower banded roles to replace them. Nurses then often report still being expected to work at the higher level but not being recognised for it

Following the discussion, college members voted with overwhelming support to pass a motion submitted by the Greater Liverpool and Knowsley Branch for the RCN to “demand a systematic re-banding of nursing jobs throughout the NHS under Agenda for Change”.

Royal College of Nursing

Nurses to ‘demand’ overhaul of Agenda for Change pay bands

Mike Travis

Mike Travis, RCN lead steward at Alder Hey Children’s Hospital in Liverpool, who presented the resolution to delegates, said: “This is a big issue for NHS employers. The more they undermine AfC, the higher the risk of them falling foul of equal pay claims.

“Nurses have the contractual right to have their jobs regularly reviewed,” he said. “But the pressures on the NHS mean employers have ceased to review jobs routinely as they should.”

Commenting on the motion, Janet Davies, RCN chief executive and general secretary, said: “Nurses are clearly saying they don’t feel valued. We know downbanding is being used as a way of controlling costs – but it is short-sighted.

“Nurses are turning away from a profession they love because they are struggling to make ends meet and cope with ever increasing workloads,” she said. “At a time when there are severe nursing shortages, it is vital for nurses and for patients that we do not deter new people from entering the profession.”

She added: “Our general election manifesto calls for an end to the practice of downbanding registered nurses. It’s only fair that their pay reflects their experience and the care they provide.”

RCN Greater Liverpool & Knowsley Branch resolution:

That this meeting of Congress, in the light of pay restraint and downbanding, calls on RCN Council to demand a systematic re-banding of nursing jobs throughout the NHS under Agenda for Change.


Readers' comments (5)

  • So I assume you will ALSOfight for the thousands of HCAs stuck on band 2 and 3 doing band 5 jobs. Supporting newly qualified nurses. So many tasks they do that is beyond their role. Mopping up after RNs entrenched behind the nurses station or drug trolley. My last role saw RNs feeling superior leaving HCAs unsupported. A ward cannot function unless each member feels valued. For far too long now I have seen HCAs being dumped on rather than supported. My lead by example ignored. But then....90% of my RNs were imported!

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  • I would say as the afc scales are being challenged then it would include all bands. I've worked as both an hca and rgn... And I feel more underpaid as a rgn due to the responsibility I now have, the extension on my role, the fact I'm required to pay be on a register, required to revalidate and constantly train. The health care assistants I work with are made feel incredibly appreciated, but they are different roles.

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  • I'm glad your HCAs feel valued but 1000s are not. While RNs are constantly training and paying fees, HCAs are being forced to take responsibilities they are neither trained or paid for.
    The original AFC was a con and RCN sold our souls to get it. What next 'right arms and legs'? Since 1979 I have seen Nursing eroded and manipulated away from the bedside. I'm glad I'm at the end of my career. I certainly wouldn't choose it now and I steered my very eager daughter away to another career. I am not against the degree which led us down this road. I am against it being a pre reg requirement. Too many see Nursing as high tech being something special, we have abandoned the basics to unprepared HCAs. The responsibilities they have, exceed many non HCA experienced RNs perceptions

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  • Worked as HCA for 18 years and a top band 3, coming into my final year of nurse degree and upon qualification I will be £11.31 and before I was on £10.15. Minus student loan and lack of unsociable hours I could be on less, this isn't right surely and needs to be looked at!

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  • SML60 I'm with you Agenda for change is a total con job. You have a band 6 nurse and a band 7 nurse getting the same salary! despite the responsibilities being totally different. I also agree that when nurses work as a team you get more done and you will find that your HCAs are more willing to do favours for you ie run to pharmacy to collect TTAs etc, If you are willing to help them change a patient who has soiled themselves. Teamwork all the way!

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