“It’s important that you’re paid fairly, it makes you feel valued,” says health care assistant David.
He’s one of around 400 health care assistants (HCAs) at King's College Hospital NHS Foundation Trust in London who have been uplifted from band 2 to 3 after being able to evidence they were carrying out tasks above band 2 level.
As well as a pay rise going forward, eligible HCAs are also getting back pay from August 2021. It’s a huge win for the RCN and its members, who instigated and led the action.
There was part of me that was tempted to give up, but I’m glad we kept going
David – who's worked in the NHS for 12 years – says he was so glad to be part of a union to help resolve his banding issue.
“There was part of me that was tempted to give up along the way,” David says. “But I’m glad we kept going. Working together got us the pay we deserve.
The RCN led the efforts to negotiate the band 3 uplift with the trust. It took months of hard work by our staff and members, who worked collaboratively with the trust and other health unions.
The spark
Following revisions to the band 2 and 3 national nursing job profiles for health care support workers, NHS employers across the UK should have undertaken a review and re-evaluation of band 2 roles. These changes clarified the differences between the two bands, following concerns that band 2 staff were expected to work above their pay band.
Towards the end of 2024, Pam, an HCA at the Princess Royal University Hospital (PRUH) – part of the King's College Trust – got in touch with the RCN about HCA banding.
She’s helped a lot of people by bringing this to our attention
Pam and her HCA colleagues were routinely undertaking delegated clinical care duties including recording patient observations which were outside the scope of a band 2 profile.
The trust was also requiring band 2 staff to have specific qualifications to apply for a band 3 role, including a level 3 qualification in a health-related subject, and maths and English skills equivalent to GCSE grades A to C or 4+.
This is when Duncan Mirams, an RCN organiser, got involved.
“We knew there was a solid case here, and we had to intervene,” Duncan says. “Initial ward walks revealed this issue was widely and deeply felt across the employer, with many members and non-union staff frustrated and wanting to see change. This showed us it was an issue we could organise around.”
Duncan visited the trust’s three main sites – King’s, PRUH and Orpington Hospital – recruiting members and speaking to staff about the banding issue. More than 50 members joined the RCN and a group was set up so they could share their stories and coordinate action. Each of the three sites was mapped to assess campaign strength and build key contacts.
Over the course of a year, the RCN held meetings with staff and surveyed affected members, and the trust held events with staff too, before negotiations took place between the RCN and hospital bosses.
Duncan praises Pam for being the spark that led to this positive result for everyone. “It wouldn’t have happened without Pam,” he says. “She’s helped a lot of people by bringing this case to our attention, and also by encouraging others to join the RCN and get involved."
‘Our voices should be heard’
Grace, an HCA working at the trust, heard about the joint action from the RCN, through emails and on our website.
She knew she had to be involved and felt that historically the problems faced by HCAs and band 2s had gone unnoticed.
“We contribute immensely to patient care. Our voices should be heard as well,” she says.
Grace is very happy at work now, saying she couldn’t have asked for a better outcome. She says all the members who joined the action should be proud of what they achieved together.
Speak out... your experience will help others
She adds that the support she received from Duncan and RCN Officer Sean Bickerstaffe was incredible, and has inspired her to explore becoming an RCN rep.
“I was able to fight my case with Sean’s help, but I want to be that person for others. There’s a lot more to be done to make sure HCAs are looked after,” Grace says.
“I would love to be the voice for my colleagues, particularly fellow HCAs.”
And if anyone is going through a similar situation, Grace has one simple piece of advice for you: “I would tell them to speak out,” she says.
“The more people who speak out, the more the issues are exposed, and we can deal with them.
“Remember: your experience will help others as well.”
Further information
- Read about our campaign for fair pay for health care support workers, including handy answers to some frequently asked questions.
- Interested in becoming an RCN rep? It's a rewarding role which can make a real difference to the working lives of your colleagues. Find out full details and how to register your interest.
- Check out our popular online learning tool First Steps. While originally developed for HCAs, it's a valuable resource for all nursing support staff working across health and care settings.
