Fair pay for health care support workers

Over time, the health care support worker role has grown. It needs redefining to ensure staff are valued and paid fairly for the work they do.

Here at the RCN, we believe many band 2 staff working in the NHS are delivering band 3 duties. We’re working with our local representatives and other trade unions to raise concerns and make sure health care support workers are paid fairly for the job they do.

Band 2 roles should be non-clinical and focus on personal care and support. They include:   

• Undertaking personal care duties
• Supporting with toileting, bathing and dressing
• Supporting with meals
• Recording fluid balance and nutrition

Band 3 roles also include delegated clinical care tasks, such as:

• Taking blood pressure 
• Monitoring blood glucose  
• Observing wounds 
• Dressing simple wounds 
• Removing catheters 
• Urine testing 
• Pregnancy testing  

For the full list of differences, visit the NHS guidance.

We’re taking action at employers that have made slow or no progress to reband their staff.

Together with staff representatives, we’re escalating our calls for action through employer staff side committees to make sure: 

• Employers assess current staff roles and band them correctly
• Agree processes and timelines to achieve this
• Agree backpay. We’re calling on employers to backpay staff to August 2021 when the profiles changed 

We encourage all our members to speak up about the realities of their jobs. If you’re a band 2 health care support worker and believe you’re working above your pay band, here’s how to speak up.

Speak to your local representative

Our local RCN representatives across England are already raising this issue through their staff side committees. In some areas, they have successfully secured re-banding for staff and significant back pay. Reach out to your local representative to make them aware of your concerns.

Take part in surveys

You may receive emails from us about taking part in a survey. We’re using surveys to gather evidence to use in our fight for fair pay for you and your colleagues. We want to hear from you, so please take part if we ask you.

Tell your line manager

We expect all NHS employers to have already completed or are in the process of undertaking a review of all band 2 job descriptions. If you are a band 2 health care support worker and are undertaking additional clinical and patient care duties, speak to your line manager about starting the process of reviewing your role through a job evaluation. 

Talk to your colleagues

It’s likely that other members of staff at your employer are experiencing similar issues. Reach out to colleagues and encourage them to join the RCN to ensure their voice is heard. We have shown during our recent industrial action that our voice is stronger together. Together we can secure fair pay for all nursing staff. Why not download and print our leaflet, which covers all the essential information? 

Your employer should be reviewing all affected job roles to make sure they're correctly banded. If you're carrying out band 3 duties in your role, you should be rebanded. You do not need a qualification to be considered for rebanding in this case.

Your employer is responsible for deciding how duties are divided among staff. They may decide that you shouldn’t be performing band 3 duties and should remain at band 2. But we would encourage you to ask your employer who will carry out these tasks if they’re removed from your role. Often, band 2 staff are given band 3 duties because there’s no one else to perform them.

The NHS changed their band 2 and 3 profiles in 2021. We expect all NHS employers to now carry out a review of their existing band 2 staff to make sure their role profiles are up to date and correctly reflect their roles and responsibilities.

If you’re rebanded from band 2 to band 3, your employer should backpay you to whichever date is earlier:

• the date when your role changed to include band 3 duties, as agreed with your manager
• 2021, when the profiles were amended 

Members should not be paid less than they were at a lower band. This conversation will form part of the agreement our staff side representatives reach with employers.

Our position is in line with NHS Terms and Conditions Handbook:

1.18 provides that on promotion the new starting salary (which includes enhancements) should produce on increase in earnings.