Leeds and York Community Health branch of UNISON (LYCH) represents staff of all grades, employed by among others, Leeds Community Health trust (LCH). A considerable number of these staff are employed at Band 3 as Neighbourhood Care Assistants (NCA), stemming from the amalgamation of traditional district nursing teams and community rehabilitation/intermediate care staff, into integrated neighbourhood teams. They all work without direct supervision in the community, delivering a range of interventions.
As time has passed, with increasing frequency, members of UNISON contacted the branch to say that as unregistered band 3 staff they were being asked to take on increasingly complex and technical tasks and greater levels of responsibility. This appears to have been due to the trust struggling to recruit band 5/6 nurses (an issue shared across the whole NHS), and the resultant increased workload experienced by all community teams. The situation, rather than improving has deteriorated and many have voiced their frustration that they were still being paid at band 3.
An increasing number of members felt that they should be paid at band 4 in recognition of the extra responsibilities and training they had taken on over the years, at the instigation of management. Furthermore, members felt that the introduction of the nursing associate at band 4 in England provided a comparator for the work they were undertaking at band 3.
As a branch, we tried to address this by supporting members with individual banding appeals, however, this was extremely time consuming, and showed a number of issues with Agenda for Change provision at a local level, which due to the onset of the pandemic, could not be addressed to the fullest degree.
The branch conducted a survey of members who were part of NCA band 3 workforce and our findings illustrated that:
- The staff employed as NCAs performed a wide range of tasks over and above their basic job descriptions.
- There was a serious lack of consistency across the thirteen neighbourhood teams across the city, with regard to what was expected of individuals and what training they had received.
- There was no central protocol of what jobs were appropriate for unregistered staff vs registered staff
- The job description for the NCA role bore no reflection to what was actually happening.
- The cumulative experience and acquired skills of NCAs was equal, if not greater in some instances than less experienced staff at a higher band.
We contacted management to provide this information in effort to achieve a positive outcome. However, unfortunately, it became necessary to raise it via the employers grievance policy to ensure that the issue could be addressed in full.
The initial phase was to appoint a project team, comprising a senior manager, two project staff, three UNISON reps, and two NCAs from the teams – we encouraged some committed UNISON members to get involved with this.
Management at the trust ran a number of focus groups comprised of non-registered and registered staff in order to compare and contrast what differences, if any, existed in the day-to-day practises between these groups. The results and findings from these exercises evidenced how much extra work was being done by NCA’s.
In addition, we discovered that a sizeable number of staff were/are happy in their current roles and preferred to focus on traditional rehabilitation and support. It is important to acknowledge and accept, that in any rebanding work, there will be staff who would prefer to work to the job description of their current band.
As anticipated, these findings had repercussions and senior nursing staff began insisting that certain duties were returned to registered nurses only. Commensurately, the workload of registered nurses increased. Again, this evidenced our claim that many support staff were completing the extra duties that have been delegated down without consideration to job descriptions and evaluation. The ‘traditional model’ in effect, is not sustainable and illusory and has only been allowed to continue due to the willingness of many support staff to go over and above to support their colleagues who themselves are picking up extra and ever more complex duties.
The next steps of our campaign are to collate all information gathered so far, and write one or more job descriptions which reflect more accurately the jobs as they now exist before taking them to a Job Evaluation Panel. We hope that this will show that there is a role for both Band 3 and Band 4 Neighbourhood Care Assistants in teams, and that there will be a way for our experienced non-registered staff to progress.
There is a long way to go, and as expected, the pandemic has significantly delayed progress as many contributors to the project have been required to work clinically throughout the last 12 months.
We have entered the toughest stage of the negotiations – agreeing what duties should go into a band 3 job description, and what is being done, and what needs to be done over and above that, by a potential band 4 NCA.
We are working with the UNISON national office team to raise issues with the Job Evaluation Group (JEG) around profiles reflecting the work of community staff and the challenges in proving equivalency of qualifications.
The project continues and we hope to achieve a proper career progression pathway for our non-registered staff, which will benefit the workforce and patient care.