Health workers’ grading fight

Health workers’ trade unions Unison and the Royal College of Nursing are conducting grading disputes on behalf of their Health Care Assistant (HCA) members. Settlements with cash-strapped healthcare trusts are proving difficult, leading to strikes in some cases.

This follows from a national agreement to reconsider the job profiles for these roles. To aim was to see if the HCA job descriptions had become obsolete, and to regrade the jobs accordingly.

Catch

The catch was that claims had to be pursued locally. But both unions and their HCA members didn’t always do so. In many trusts this wasn’t done for two years (and longer in a few cases).

Delayed claims resulted in settlements having to tackle back pay. The longer a settlement took to achieve, the greater the amount. Some settlements in the North West of England agreed more than three years back pay; this rapidly became the “going rate”.

Obstacle

The unions have achieved a degrees of success throughout the NHS, mostly though astute negotiation. The dire financial state of most NHS employers has been an obstacle to settlement; those agreements which have been secured were welcome.

St George’s and Epsom St Helier in South West London was one of the NHS trusts where Unison pursued regrading of HCA roles. Even though the employer has accepted the validity of the workers’ claim, it has not been possible to settle it through negotiation.

Impasse

This impasse is due to the trust’s desperate financial position. It decided to impose regrading unilaterally, refusing to concede the claimed three years back pay. In response Unison members are embarking on two days of strike action.

‘All eyes will be turned to a well-conducted dispute.’

This follows an overwhelmingly successful ballot of more than 600 Unison members. On a turnout of 78 per cent, over 99 per cent voted to strike.

This is the second such action which has proved necessary in London; all eyes will be turned to a well-conducted dispute. The strike will take place on 22 and 23 January. Further action will be undertaken should it be necessary.

• Grading is also an issue for phlebotomists. In Gloucester they are in a long fight to regrade their notoriously under-paid roles, which we have previously reported in Workers.

Regrettably their all-out strike continues; it began on 17 March 2025. That dispute is thankfully an outlier. Disputes elsewhere have, for the most part, not been drawn out in the same fashion.