Sunday 14 October 2018

As Small as a Nat’s Cough

When I opened my wage slip, after the much talked about and hyped NHS pay rise, I couldn’t see any increase. My pay had barely risen by a few pounds. I was not the only person to experience this, it wasn’t a payroll error, the vast majority of NHS staff were shocked by how little they received in their pay rise. Some people got as little as a 35p pay rise (1).

In June we (nurses) voted to accept a pay deal that we were told would give us a 3% pay rise (2), so why did we get such a small one, certainly not 3%?

Back in April I blogged about the pay deal (3), while it was still being offered to us, and I found it wanting. I actually found it a poor deal that took away far more than it gave (And to answer the question at the end of blog, in the end I didn’t vote for the deal because researching it showed me how bad it was), and that was when we were being told we would be getting a 3% basic pay rise. The reality turns out we only received a 1.5% pay rise in July (4), but how did this happen?

The advice the RCN issued to their members, they said nurses would receive a 3% basic pay rise for 2018-2019 (5). This briefing was were I took my information from, like many others did, but this information wasn’t correct. The actual deal stated that by the end of the next financial year (March 2019) all NHS staff will have received a 3% overall increase to their pay (6). This pay deal saw a restructuring of our Agenda for Change pay points, the yearly pay increases staff receive under the Agenda for Change deal (5), for most nurses their pay points will be cut from six to three, meaning people will reach the top pay for their pay bands quicker and then will only receive the yearly, negotiated pay deal (3). Most nurses will therefore be re-banded this year and will see their pay increase, but only when they reach their Incremental Date, the date they joined or re-joined the NHS. For most nurses their Incremental Date was not in July, mine wasn’t, and for many nurses they will not see a year’s worth of their new pay point when we hit April 2019. The government’s deal was that we would get a 1.5% basic pay rise this year and then our re-banding would see our pay increase by an average 1.5% and so by April 2019 our overall pay would have increased by 3% or so. This deal never contained the offer of a 3% basic pay rise (6). NHS Employers made this clear in a statement dated July this year (6). So why didn’t the RCN tell us this was the deal on the table when we voted on it?

In July, RCN general secretary Janet Davies wrote a letter to all RCN members (7), in it she said: “In good faith, we told all members they would receive a 3% uplift [??] this summer. I now find this is not the case for everyone. I can assure you I am demanding answers for you.” (7) The wording here is important. She wrote “a 3% uplift”, she didn’t say pay rise. Why didn’t she say “pay rise”? Did she already know that we wouldn’t be getting a 3% basic pay rise?

The RCN issued guidance to their reps (8), which was leaked in July, which stated: “The initial increase for most other staff will typically be 1.5% until they reach their normal incremental pay date.” (8) Clearly the RCN knew the vast majority won’t be receiving a 3% pay rise this July, and clearly the RCN was expecting large numbers of very unhappy members. This guidance document is very much a damage limiting exercise, fortunately it didn’t work.

NHS Employers statement contradicted Janet Davies’s letter (6). They issued a statement that stated: “The letter states that the RCN has in error told members in one of its documents that they would all receive “a 3 per cent uplift this summer.

The framework agreement, which is the document agreed by the NHS Staff Council that the RCN consulted its members on, does not make this claim.” (6) So, according to NHS Employers, the RCN knew that we wouldn’t be getting a 3% rise well before July, so Janet Davis shock and anger are at best misplaced, and at worst dishonest.

But all this still doesn’t explain why the RCN signed up to such a poor pay deal.

The RCN commissioned the Electoral Reform Services (ERS) (9) to conduct an independent review of how the RCN handled this. This was commissioned by the RCN as they were facing an Extraordinary General Meeting (EGM) were there was a call for a no confidence vote in the whole RCN leadership and calling for the RCN council to step down (10). I wonder how much they hoped this report would be another damage limitation exercise. If they did it failed.

The ERS published an interim report in early September (9), the full report is to come out later this autumn.

The ERS interim report (9) found that the RCN lacked communications leadership, and failed to successfully communicate the Government’s offer to its membership. This is shocking. An organisation the size of the RCN (It has 435,000 members (11)) should have a well-oiled communications machine. It represents nurses, midwives and healthcare assistants, it needs to be able to communicate complicated information to its members quickly and clearly, and yet it wasn’t able to communicate to its members that this pay offer contained a 1.5% pay rise and restructuring of our Agenda for Change pay points which would give most members an average rise in overall pay, by March 2019, of 3%? Why was that so difficult?

But this wasn’t the only finding from this ERS report. They also found a lack of scrutiny of the offered deal by the RCN leadership. On the 2rd March Josie Irwin, the RCN’s lead negotiator with the Government, tried to go through the offer, line by line, with the RCN’s executive team, but there hadn’t been enough time allocated to that meeting for her to do so (9). This I find shocking, the RCN’s executive team didn’t have the intelligence to allocation the time needed to do this. They were in negotiations with the Government for the first decent pay rise NHS nurses would see in eight years, and they could not or would not be bothered to make it a top priority, with the time it needed. It was certainly a top priority to the vast majority of RCN members.

At that meeting RCN Wales director Tina Donnelly wanted to scrutinise elements of the offer but was stopped by then General Sectary Janet Davies, saying the deal was only for England and Tina Donnelly’s input was “not required” (9). It seems that Janet Davies actually stopped scrutiny of the offer, which again calls into question the letter she sent out to RCN members, and what she said in it.

The worst thing to come out of this report was a briefing from RCN lead negotiator Josie Irwin to the chair of council on 21 February, which stated: “If the unions (this means Unison and/or RCN for all practical purposes as the two biggest trade unions) are not able to go out to members with a positive recommendation to members the Treasury will… consider it too risky to proceed and the framework will be off the table.” (9)

This is just breath-taking in its spinelessness. The RCN were giving in to Government demands that they accept the deal now or they would remove it altogether. The RCN gave into the Government’s threats and bullying, and they didn’t even tell their members about the Government’s actions.

Of course the Government wanted the unions to quickly and quietly accept this deal, without any public embarrassments coming from the unions. The junior doctors’ one day strikes in 2016, over another deeply unfair pay deal, were toxic for the Government, and left they marred under negative headlines and public support for the doctors. The Government certainly didn’t want any more industrial action from the rest of the NHS. And the RCN played right into their hands and gave the Government all the good headlines they wanted, all the positive press over a 3% pay rise for nurses. And even more cynically, the Government gave us our smaller-than-a-nat’s-cough pay rise in July, when Parliament was off on its summer holiday. So Theresa May didn’t have to answer an awkward questions, in the House of Commons, about robbing nurses of any sort of a decent pay rise. Nice (!!).

Heads have rolled at RCN, over this appallingly poor behaviour, and rightly so. Janet Davies, RCN’s General Secretary, resigned in August (12). Did she jump or was she pushed? I am not sure but her behaviour was deeply unprofessional. Following a vote of no confidence in them, at the EGM on 28th September (13), and the RCN Council have all resigned (14). I would say the Council did the “decent thing” but it took an EGM to force them to do so, and before it they produced an email, to be distributed to RCN members, claiming, “This is a potentially dangerous time for the college with [a] small group of members putting at risk what has always been a proudly non-party political organisation, acting on behalf of and representing members whatever their opinions or background.” (15) This is a breath-taking claim, when the RCN gave in to Government pressure to accept a pay deal, which they hadn’t fully scrutinised, which has actually left nurses worse off.

What about Josie Irwin, the RCN lead negotiator, who negotiated us into this mess? According to the RCN website and her twitter feed, she is still in post.

What next for the RCN? Nominations for the RCN council elections has opened (16), so we need people willing to stand. But we need new and dynamic people, not the same old people who are standing as a nice career move or people who have been hanging around the RCN for years and want the status quo to continue. We need new blood to shake up the RCN. We need an RCN that will actually fight for its members.

What I am hoping for is that RCN will take on the Government over this deeply unfair pay deal. There is already a campaign to Ditch the Deal (17) and I would really hope that the RCN will join it. I want the RCN to put pressure on the government to rip up this deal and start again. Nursing, in the UK, is in crisis, last year 33,000 nurses left the NHS (18), and there are over 35,000 empty nursing posts in the NHS, which is a little over 10% of all nursing posts (19). One of the reasons nurses are leaving the NHS the poor pay, a report to the Commons Health Select Committee found (20). The RCN should have been using this as a negotiating point, that the government needs to do a lot more to reverse the lose of nurses or else patient care will suffer, and patients denied care because there are no enough nurses to provide it makes for very poor headlines, and this government does not like bad headlines. Last week, the Salaries Review Body recommended that senior judges in England and Wales should receive a 32% pay rise (21), and one of the reasons for this huge rise is the poor recruitment to senior judge posts. How will 1.5% pay rise encourage people to stay in nursing, let alone recruit new people into the profession?

What I am I going to do? There have already been calls for us to strike over this, over the sheer contempt the Government has shown us (22). At he moment I am not sure. So firstly I am going to email my MP and call on her to support us (there’s a copy of the email below, feel free to copy and use it to email your MP), and then I am going to email my RCN rep, and the new council members and the new General Secretary, demanding that they Ditch the Deal and get us a decent pay rise. We all need to keep the heat on the RCN and on our MPs, they both rely on our support and we should make them work for it.

Theresa May, in her speech to the Tory party conference, claimed the end of austerity is in sight (23). This is not true for any of us in the NHS, and it’s her government keeping us in austerity.

Drew Payne

P.S. Find you MP’s name and contact details here

My Email

Dear _____

I am an NHS nurse and one of your constituents.

I am very concerned that again nurses have received a pay rise that sees us worse off in real terms.

This year classroom teachers received a 3% pay rise, the armed forces received a 2% pay rise (plus a one-off 0.9% payment), prison workers are receiving a 2% (plus a one-off payment of 0.75%) and junior doctors received a 2% pay rise.

Back in March we, nurses, were told we would be receiving a 3% pay rise but the reality was very different. In July we only received a 1.5% pay rise and a restructuring of Agenda for Change yearly pay increments, these were reduced from six to three, for most nurses, leaving most of us worse off in the long run.

Nursing is in crisis, last year 33,000 nurses left the NHS, and there are over 35,000 empty nursing posts in the NHS, which is a little over 10% of all nursing posts. One of the reasons nurses are leaving the NHS is over the poor pay.

We were sold this pay deal on false claims that we’d see a 3% pay rise, when the reality was much less. This less than inflation rise will see more nurses leaving the NHS, and we are the backbone of healthcare, without us so much patient would be impossible to deliver. 10% of nursing posts being unfilled is only increasing the workload of the other nurses in the NHS, and this pay deal will not encourage nurses to stay. If more nurses leave at the rate we have seen over the last five patient care will be irreparably damaged.

I am emailing you to ask for your help in supporting us nurses. Will you write to the Minister of Health, Matt Hancock, and ask him to relook at this pay deal that leaves most nurses worse off in real terms, and does nothing to encourage nurses to stay working in the NHS, were we are needed.


(My name)
(My address)

[Always include your address when emailing/writing to your MP, to prove are a constituent]

Public sector pay rise details (24)

Friday 17 August 2018

A Worrying Change and It’s Aftermath, An Update

 Back in December 2015 I posted a blog about Dr Hadiza Bawa-Garba (read it here), she had just been convicted of manslaughter, following the death of a boy under her care. It was claimed that she missed clinical signs that Jack Adcock, the boy, was deteriorating. He would die from a cardiac arrest, secondary to sepsis (1). 

Dr Bawa-Garba was prosecuted over his death, found guilty and received a suspended sentence of two years (2), this is at the very lightest end of the sentencing range for manslaughter, and shows that the judge did not believe there was any malice behind her actions. The jury deliberated for nearly 25 hours to reach their verdict and then it was a 10-2 split (3).

Initially an independent tribunal at the General Medical Council (GMC), the doctor’s regulatory body, recommended that she was suspended from practice for a year (4). The GMC itself though did not agree, they went to the High Court and obtained a ruling which struck off Dr Bawa-Garba for life (5). The GMC claimed that she had to be struck because she had been found guilty of manslaughter (5).

This week Dr Bawa-Garba won an appeal against the High Court ruling and she can again practice as a doctor (6). The Court of Appeal found that there was no malice in her actions and that she did not present any risk to the public (6).

But Dr Bawa-Garba wasn’t the only person prosecuted and sanctioned over Jack Adcock’s death. Isabel Amaro, the nurse looking Jack Adcock when he was admitted, was also found guilty of manslaughter (7), she too received a two year suspended sentence. Theresa Taylor, the unit’s Charge Nurse, was found not guilty (3).

The Nursing and Midwifery Council (NMC), the nursing equivalent of the GMC, also struck off Ms Amaro. They also struck her off for the same reason as the GMC went to the High Court to strike off Dr Bawa-Garba, Ms Amaro was found guilty of manslaughter (8), receiving the same sentence as Dr Bawa-Garba, which shows how much of a threat to public safety the judge saw her.

Reading the NMC’s Fitness to Practice (FtP) findings on Ms Amaro was an unsettling experience, to say the least (8). Ms Amaro painted a disturbing picture of the unit on which Jack Adcock died. An under-staffed, under resourced, over worked unit, were Agency Nurses, such as Ms Amaro, were only “allowed” to raise concerns with the nurse-in-charge, and if the nurse-in-charge ignored her she wasn’t “allowed” to go over that person’s head. 

The NMC’s FtP hearing found that Ms Amaro’s actions were a one-off failure, that she wasn’t an unsafe nurse, that she had showed remorse for her actions and had sort training following the incident. They found that there was no malice in her actions and that she did not present any risk to the public (Exactly the same as the Court of Appeals said about Dr Bawa-Garba). The only reason they found to strike her off was that she had been convicted of manslaughter and that tarnished the public imagine of nursing, and therefore she was struck (8).

Following Dr Bawa-Garba’s Appeals Court victory the NMC has stated that it has no plans to review Ms Amaro’s striking off (9). “An independent panel took the decision to strike Ms Amaro from our register after hearing all of the evidence in the case and taking her conviction and suspended custodial sentence into account,” an NMC spokesperson said (9). After reading the FtP’s finding I take great exception to this statement, the evidence was so very thin. But this again this high-lights the very poor standards of the NMC’s FtP process. Dr Bawa-Garba’s original GMB tribunal panel, who recommended only a year’s suspension (4), had been made up of doctors; Ms Amaro’s FtP panel was made-up of one nurse (An Assistant Director of Nursing) and two lay people. Not exactly a panel of her peers.

Dr Bawa-Garba had the support from the medical profession (10), more than 8,000 doctors had signed an online letter condemning her treatment (11), her legal action was crowdfunded by other doctors (12) and the BMA annual conference passed a vote of no confidence in GMC over its treatment of Dr Bawa-Garba (13). The nursing profession has remained silent over Isabel Amaro’s treatment. We should be hanging heads in shame. The NMC’s treatment of Ms Amaro has been disgusting and yet again nurses seem to be reacting with the attitude “Thank God it wasn’t me”, but it could easily be anyone of us. All of us in the NHS are working in unsafe environments, over-worked, under staffed and under resourced, all of us could make a mistake in the same situation that Ms Amaro was in.

Dr Bawa-Garba and Isabel Amaro both had unblemished clinical records, both women were working in an impossibly stressful situation, both of them were involved in a situation that lead to a patient’s death (Though they weren’t the only ones responsible and neither of them acted maliciously), both of them were used as scapegoats for a disgustingly poor clinical environment, yet only one of them had the support of her peers, the doctor. As nurses we should be completely ashamed of ourselves for lettings this happen.

Where is the campaign to get Isabel Amaro restored to the NMC register?

As for Leicester Royal Infirmary, the hospital that allowed its clinical working environment to become so unsafe that a child died, well the police did not pursue charges against the hospital, saying there was no evidence (14).

Drew Payne

An Update (27/08/2018), I’m Proved Wrong and I’m So Happy About It

The thrust, at the end of my blog, was that no one was fighting for Isabel Amaro. Dr Bawa-Garba was only re-instated onto the GMC register because of the support, fundraising and campaigning of other doctors. When I wrote my blog I couldn’t find anyone doing that for Isabel Amaro.

At the end of last I received an email, from Change-Dot-Org, advising of a petition calling for Ms Amaro's reinstatement (15), being run by the group #IamNurseAmaro. It is also being supported by NMCWatch (16), an organisation highlighting the failings of the NMC, and they certainly have a lot to highlight. #IamNurseAmaro have their own Facebook page here. Keeley House Baker has also written an in-depth blog about Ms Amaro (17).

I have signed the petition, please sign it too because the more people who do sign it the less the NMC can ignore it. But also sign-up to #IamNurseAmaro Facebook page. Getting Ms Amaro back onto the NMC Register will take more than just signing a petition, we need to make a lot of noise and repeatedly highlight the injustice of her treatment.

The Facebook page does make uncomfortable reading because they talk about the high toll all this has taken on Ms Amaro and her health. 

It could so easily be any other nurse, it could be me.

Sign the petition here.
Join the Facebook page here.

Drew Payne