Future NHS staffing requirements : third report / Health Committee.

  • Great Britain. Parliament. House of Commons. Health Committee.
Date:
1999
Catalogue details

Licence: Open Government Licence

Credit: Future NHS staffing requirements : third report / Health Committee. Source: Wellcome Collection.

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    Grading Structures for Nursing and Midwifery 117. When the current grading and pay structures were introduced, nurses and support workers were graded A —I. There were descriptions for each of the grades, but they were sufficiently broad to allow for a wide variety of opinions regarding which nurse should be on which grade. Consequently, nurses and midwives undertaking comparable roles, but working in different hospitals could (and continue to) receive different grades for their jobs. There was often significant disharmony caused by the grades individual staff actually received, with appeals against designated grades still being heard 10 years later. 118. The grading system has never been very popular. It tried to differentiate between the roles and responsibilities of nurses and midwives within the NHS and to reward accordingly. It took into account such things as: individuals’ staff management responsibilities, their capacity to act as a team leader, supervise learners, manage a budget, and give care under supervision. As a rule, a newly-qualified registered nurse was put onto a “D” grade and the most senior clinical manager would be put on a “H” or “I” grade. Some employers would not give “I” grades, in which case ““H” became the most senior grade in that hospital or community. _ 119. Mrs Heather Ballard, Professional Officer, CDNA articulated the anomalies in the current system: “What we have not got at the moment in the community is any consistency in terms of grade and skill mix...around the country, there are huge variations which do not seem to bear any resemblance to local needs; you might have one trust where they have a grading structure which consists of B grade auxiliary nurses, D grade staff nurses and G grade district nurses, and, next door, they may well have B grades, Cs, Ds, Es, Fs, Gs, and Hs, and there does not seem to be any rhyme or reason to that.”!*° She later added: “There are positive developments in terms of grading and potential for increased earnings with the discretionary incremental points that have just come in and the potential for the nurse consultant, but there is a certain amount of cynicism because of the misuse of the current grading system that we already have.’’'*° 120. Although Mrs Ballard was enthusiastic about discretionary awards, this view was not shared by all of our witnesses. In written evidence MSF stated: “The recommendation of the Pay Review Body in 1998 of a system of discretionary increments added to the top grade of the higher nursing and PAMs grades does not address the problems associated with career progress. This scheme is divisive, discriminatory and does not help those staff on the lower grades where morale is also low. It is hard to find anyone in favour of the scheme.” 121. Miss Louise Silverton of the RCM said: “Grading, from the point of view of midwives, is a subject where, if you mention it to them, they just groan. The grading structure and the definitions never were appropriate for midwives right back at the beginning. We have been working with something that did not fit and did not work. It has been applied in a way which was cash limited rather than relating to the job that anybody did.”'* She added: “We have an issue of individual trusts deciding they can buck the system so they will pay '45 O118. OG 171. hl) p70, para 5. POTTS,