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Update 4th October

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ACAS is facilitating collective conciliation between Trade Unions (GMB, Unite, RCN & Unison) and University Hospitals Plymouth NHS Trust (UHP).

UHP have invited Trade Unions to a joint ACAS / TU / Employer meeting on Wednesday 9th October. The purpose of this is to propose a solution to the Joint Trade Union dispute in regard to the HCSW pay dispute.

When we have details of any offer we will publish and circulate those details to GMB members.

*To enable GMB to communicate with you efficiently and ensure you receive all relevant information, please ensure that your personal, work, and contact details are up to date. Consider authorizing the use of text messages (SMS) and email in the membership options. You can change your contact options via your GMB website login page, or by contacting GMB Plymouth at 01752 660219, the Regional Office at 02920 491 260, or the Derriford Health Branch office at 01752 439274 (ext 39274).

How Industrial Action Ballots Are Regulated in the NHS and Health Care Services

Trade Union Act 2016

Ballot Thresholds: Turnout and Support

For industrial action to proceed, the Trade Union Act 2016 mandates that at least 50% of those eligible to vote must participate, and a majority of those who vote must support the action. For example, if 1,000 members are balloted, at least 500 must cast a vote, and at least 251 must vote ‘yes’ for any industrial action, including strikes or action short of a strike, to go ahead.

In “important public services” such as health care, an additional requirement applies: 40% of those eligible to vote must support the industrial action. This means that if 1,000 members are balloted, at least 500 must vote, and 400 (80%) of them must vote ‘yes’ for the action to take place.

The government has introduced regulations specifying which jobs in six key sectors (outlined below) are classified as “important public services” and therefore subject to the additional 40% threshold. The 40% threshold applies only if the majority of those eligible to vote are ordinarily involved in delivering an “important public service.”

Industrial Action Rules

The Trade Union Act also introduces stricter rules regarding industrial action ballots and notifications. In addition to meeting existing legal conditions for industrial action, unions must:

• Include extra information on voting papers, summarising the dispute and listing the types of action short of a strike.
• Provide 14 days’ notice of industrial action (previously 7 days). This can be reduced to 7 days if the employer agrees.
• Re-ballot members after 6 months if industrial action is to continue, or after 9 months with employer agreement.
• Report extra information about ballot results to members and employers.
• Report annually to the Certification Officer (CO) on any industrial action taken.

Important Public Services

The Trade Union Act identifies six sectors where services are classified as “important public services.” These sectors include:

1. Health
2. Education (for those aged 5 to 16)
3. Fire services
4. Transport
5. Nuclear decommissioning and the management of radioactive waste and spent fuel
6. Border security

Strike Action

TUC – Minimum Service Levels during Strikes

Understand the law!

The Trade Unions presented the following demands as part of the formal dispute with University Hospitals Plymouth NHS Trust (UHPT) in October 2023:

1. Regrading of HCSW (HCA Band 2) Staff:
   • Upgrade all patient-facing Health Care Support Workers (HCSW) in Band 2 – Band 3.
   • For those with more than two years of substantive service as an HCA in Band 2, upgrade them to the top of Band 3.

1. Consideration of Back-Pay:
   • Back-pay should be included as part of the overall package with the uplift. The NHS Job Evaluation Handbook states: “If the banding outcome changes as a result of re-evaluation, that change should be backdated to when the postholder and manager agreed the job has changed.”
   • Back-pay should reflect the length of time Band 3 duties have been performed. The NHS Job Evaluation Group issued guidance in August 2021 clarifying the distinctions between Band 2 and Band 3. However, as these distinctions existed prior to this date, back-pay should also apply to services carried out at Band 3 before August 2021, where applicable.
   • The Trade Unions demand back-pay from 2019 until the uplift date.

University Hospitals Plymouth NHS Trust (UHPT) employs over 900 Health Care Support Workers, Imaging Care Assistants, and Maternity Care Workers (all considered HCAs) at Derriford Hospital and Mount Gould Hospital. These staff members work on wards and in departments, providing essential frontline healthcare to patients.

The role of an HCA has evolved considerably over the years, often without recognition or fair pay. As a result, many HCAs feel undervalued. Currently, over 80% of UHPT’s HCAs are performing duties that warrant a higher pay grade (Band 3). More than 400 HCAs employed by UHPT should have been receiving Band 3 pay many years ago.

Definitions and Clarifications

Personal Care Activities:

• Personal care broadly refers to daily living activities, including toileting, bathing, dressing, feeding, and assisting patients with their appearance, such as brushing their hair.

Recording Patient Information:

• This involves documenting activities like fluid balance (intake and output), nutrition (eating meals), and making notes in a patient information system. It also includes recording clinical observations, test results, and patient care activities such as changing a wound dressing or taking blood pressure.

Patient Observations:

• HCAs work in various healthcare environments, including hospitals, community settings, mental health facilities, maternity services, and clinics. Therefore, patient observations vary depending on the setting. These may include:
  • Taking blood pressure, blood glucose levels, and pregnancy tests.
  • Performing routine maternal and neonatal observations.
  • Monitoring patients for signs of agitation or distress in mental health settings.

Clinical Care Duties and Clinical Observations:

• These duties include venepuncture, removing catheters and peripheral cannulas, wound observation and dressing, urinalysis, pregnancy testing, infant feeding support, one-to-one observations in mental health settings, and administering programmes of care, therapy, or treatment as determined by others.

The Trade Unions presented the following demands as part of the formal dispute with University Hospitals Plymouth NHS Trust (UHPT) in October 2023:

1. Upgrade of HCSW (HCA Band 2) Staff to Band 3:
   • Upgrade all patient-facing Health Care Support Workers (HCSW) in Band 2 – Band 3.
   • For those with more than two years of substantive service as an HCA in Band 2, upgrade them to the top of Band 3

1. Inclusion of Back-Pay:
   • Back-pay should be considered part of the overall package alongside the upgrade. The NHS Job Evaluation Handbook states: “If the banding outcome changes as a result of re-evaluation, that change should be backdated to when the postholder and manager agreed the job has changed.”
   • Back-pay should reflect the length of time Band 3 duties have been performed. While the NHS Job Evaluation Group issued guidance in August 2021 clarifying the distinctions between Band 2 and Band 3, these distinctions existed prior to this date. Therefore, back-pay should apply to any Band 3 duties carried out before August 2021, where applicable.
   • The Trade Unions demand back-pay from 2019 until the date of the upgrade.

University Hospitals Plymouth NHS Trust (UHPT) employs over 900 Health Care Support Workers, Imaging Care Assistants, and Maternity Care Workers (all classified as HCAs) at Derriford Hospital and Mount Gould Hospital. These staff members work on wards and in departments, providing essential frontline healthcare to patients.

The role of an HCA has evolved considerably over the years, often without recognition or fair pay, leaving many HCAs feeling undervalued. Over 80% of UHPT’s HCAs are currently performing duties that warrant a higher pay grade (Band 3). More than 400 HCAs employed by UHPT should have been receiving Band 3 pay many years ago.

HCA Band 2 would undertake personal care such as feeding, bathing, toileting, recording fluids balance and nutrition.

HCA Band 3 would undertake Monitoring of heart rate and blood pressure, bloods, wound observations during analysis.

Information Link 1

Information Link 2

There will be very few HCA’s employed by UHP who have not undertaken the Care Certificate or additional clinical observations/skills training over the past four years. This should be evidenced either digitally on ESR or as a paper copy in their personal file held by their department/ward manager.

• These are not just blood pressure, pulse and temperature but must include skills such as venepuncture, visual acuity, neurological observations, blood glucose monitoring, pregnancy testing, routine maternal and neonatal observations, observing patients for signs of agitation or distress, wound observations and simple wound dressings, removal of peripheral cannula, urinalysis, removal of catheter.

• Guidance was provided to UHPT by NHS Employers in August 2021 – 3 years ago! clarifying the review and the key differences between an HCA Band 2 and the HCA Band 3 job profiles. This guidance lists different initiatives and programmes of work that have impacted on the roles of the HCSW CSW-employer-guidance.pdf (nhsemployers.org)

• UHP have indicated that they are not currently prepared to uplift longer serving HCA Band 2 employees to the top of Band 3. There are over 400 HCA Band 2 employees who have been identified as having over 2 years service as an HCA. GMB feels that those members deserve to be uplifted to the top of Band 3.

• NHS Staff Council agreed some helpful guidance on the interaction between promotion and unsocial hours Pay on Promotion Scenarios & FAQs | NHS Employers Section 1.18.

If you have any questions please contact;

katherine.darcy@gmb.org.uk   or   raymond.stewart@gmbactivist.org.uk