Recognition for healthcare assistants

It’s a foggy Tuesday in November. I’m ready to hunker down for the evening when my husband’s phone rings. It’s his GP. The results from his recent blood tests are worrying. He needs to get to hospital for more tests. Now. We scramble around to sort childcare and drive off into the fog.

An hour later we arrive at A&E. It’s small and cramped and we’re lucky to get seats. Eventually we hear my husband’s name and a healthcare assistant – let’s call her Maria - leads us down a busy corridor to a poky cubicle.

I apologise for getting in the way as I try to stash our coats and bags under a chair. Maria doesn’t seem too fazed by my faffing. What does annoy her is the tangle of cables on the floor by the ECG machine. She huffs at them and apologises to us for the delay as she painstakingly untangles them.

Then Maria gets quietly to work. She sticks stickers to my husband’s chest and uses the now orderly cables to hook him up to the ECG machine. She then disappears for a few minutes before returning to take his bloods. 

I sit back in my chair and think, thank goodness for Maria! And – is she actually being paid to do this?

Healthcare assistants going above and beyond – but not being paid for it

My wonderings about Maria’s pay aren’t entirely random. I’d recently spoken to Dan Smith from Unison about a campaign to get fair pay and terms for healthcare assistants in Greater Manchester (I’m in the Southwest).  

Dan explained that there are two national role profiles for healthcare assistants within the NHS. The job title can vary – someone like Maria could be called a clinical support worker, nursing assistant or nursing auxiliary.  These roles have two different bands: band two and band three.

“People in the band two role should only undertake personal care, like helping people with toileting or bathing,” said Dan. “The band three role allows people to do more clinical duties like patient observations and blood testing. It pays just under £2000 more a year.”

Through regular walkabouts and discussions with Unison members in the Manchester University NHS Foundation Trust, it become clear that the vast majority of healthcare assistants were employed as band two workers.

But – and it was a big but from Dan - “They were regularly and routinely undertaking clinical duties and not being paid for it.”                                                                                         

Building support in the workplace

Wendy Guest was determined to challenge this injustice. She’s the Unison branch secretary covering the Manchester University NHS Foundation Trust. “Wendy has been absolutely fundamental and pivotal this campaign,” said Dan. “She’s driven it for years and years.”  

I called Wendy to find out more. How did she get the campaign off the ground?

“When I first started this campaign in 2016, I knew it needed to be led by our members,” Wendy told me. “I believe that's the only way you get something over the line. It’s all well and good having an idea around what you believe, but unless you have the staff behind you, you won't achieve anything.”

Wendy and her team started organising. They encouraged healthcare assistants to fill in surveys and keep diaries about their duties. Ultimately, they wanted band two workers to be promoted to band three and receive back pay dating back to 1st April 2018.

A hard-fought campaign

The campaign, said Dan, was a ‘real long slog’. It faced lots of setbacks and frustration. Covid didn’t help matters because building support remotely can be challenging. Dan again: “It’s much easier to get someone to commit to taking action when you’re face to face in a group, rather than on the phone, one-to-one with a faceless individual.” 

Wendy describes how healthcare assistants got negative messages about the campaign. “Managers told them that it would never happen, that they’d never achieve anything. So we told them, ‘Yes you will! If you’re a collective together, you will achieve it.’”

Taking the campaign public

Even though around 350 workers at Manchester Foundation Trust had signed a collective grievance, the campaign wasn’t having enough impact within the workplace.

So in 2021 it went public. At an online event, healthcare assistants shared personal stories of working on the frontline during covid and undertaking duties above their pay grade.

A public petition garnered over 2000 signatures and councillors and MPs signed an open letter to trusts. The Manchester Evening News ran a story about the campaign. And not long after that, the trust came to the table to discuss a resolution.

Wendy firmly believes it was the healthcare assistants themselves that made the campaign a success. “It’s because of all the wonderful work they did by standing strong together, by doing everything that was asked of them – like the diaries – and the fact that they kept going and didn’t fall by the wayside.”

Money in the bank

Once Unison and the trust had worked out a framework agreement, it took the best part of a year to implement it. Now, healthcare assistants are finally seeing the difference in their bank accounts.

“The money has been hitting people’s pay cheques over the last few months, with some people getting five, six, seven or eight thousand pounds,” says Dan. “It’s amazing, particularly with the cost-of-living crisis biting now.”

How does Wendy feel now feel, knowing that healthcare assistants across Manchester are finally getting the reward and recognition they deserve?

“This group of workers has for too long been undervalued and taken advantage of,” said Wendy.  “They weren't recognised for how important they are within the NHS and they weren’t recognised for always going above and beyond. They never complained - they just carried on. So to see them getting extra money in their pockets for all the work they’ve done is just wonderful. I’m so proud of them.”

The ripple effect

The campaign’s success is now spreading. Unison is using the framework agreement as a benchmark for campaigning and negotiations elsewhere. For example, a mental health trust in Greater Manchester called Pennine Care has also agreed to convert its band two roles to band three and provide backpay from 1st April 2018.

Dan thinks the campaign could be transformative for the union and for workers. “Whereas duties have always been pushed down on healthcare assistants without reward, now things are moving in the opposite direction – the campaign has created an upward pressure on wages. It really shows the potential to win for other workers and sectors.”

For Wendy, the message is clear. “This is what you can achieve when the members actually engage. A branch is nothing without its members - the branch is the members.”  

As my husband and I leave A&E, we catch a glimpse of a harried-looking Maria. We thank her and I wish her luck for the rest of her shift. Her eyes smile at me over the top of her mask.  And I hope that if she’s not in a union already, she’s planning to join one soon.

You can read more about the campaign here