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Practice nurses, Agenda for Change and the Contract

Lynn Young
Primary Healthcare Adviser for the RCN

Big announcements have been made since the last issue of NiP. The nursing and wider health media have been filled with details of the new pay system for nurses and other NHS-employed disciplines. Agenda for Change is a radical new pay system based upon job evaluation, pay bands, and a skills and knowledge framework. It is aimed at all healthcare workers, apart from the medical profession - which chose and won the case to remain outside and to negotiate its own specific terms and conditions of work.
Currently, Agenda for Change applies to NHS employees only, so GP-employed practice nurses may feel that it has nothing to do with them, and once again, as a group, may feel marginalised and discriminated against. This is not the case, and while ministers, managers and the GPC (the BMA negotiating committee for GPs) will not order GPs on how to pay their employees, the ­pressure is on GPs to become better employers.
The introduction of Agenda for Change comes at the same time as the proposed new GP Contract - which way the GPs will choose to vote is still not known.
The RCN knows some things about the new Contract, but not the finer details. We are led to believe that Agenda for Change is written into the proposals but is described as a "desirable" rather than a "must do". By the time you read this the result of the GP ballot will be known.
It is time for practice nurses to get informed, know the facts and be prepared to enter into the world of tough negotiations with their employers. The good GPs will see the benefits of Agenda for Change for all their employees, not simply the practice nurses, and implement the system with the rest of the NHS.
We have many lessons to learn, and we need to watch the early implementers with great care. Cheshire and Hereford PCTs will focus on the world of community and it will be interesting to learn how willingly their local general practices join up!
Nurse shortages are everywhere, as predicted over a decade ago when drastic reductions in nurse education were made. The shortage of skilled workers raises the stakes, and the power of the market is considerable.
The RCN advice to practice nurses may well be, "If your GP employer refuses to negotiate terms and conditions that relate to your skills, talents and responsibilities, it could be in your interest to look around to another setting, which offers more appropriate reward."
We have negotiated with the GPC and Confederation representatives and been quite clear about the message the RCN will give to its practice nurse members. Practice nurses and general practice need Agenda for Change, as well as Improving Working Lives (government policy for employment/human resource practice), and the RCN urges practice nurses to vote on Agenda for Change. If general practice is to recruit and retain high-quality practice nurses, it must invest in the improvements that, we hope, NHS-employed nurses will soon begin to feel.
The many good and enlightened GP employers will wish to get cracking on Improving Working Lives and Agenda for Change. They know that the National Service Frameworks and quality framework enshrined within the new GP Contract cannot be delivered unless practice nurses are properly supported and valued. Remember that the hospital consultants rejected their new contract, so assumptions cannot be made on the result of the GP vote. However, with or without a new GP Contract, it is time for practice nurses to arm themselves with information, knowledge and assertion skills.
If Agenda for Change does not come to you, I suspect there will be a practice nearby that is only too happy to take you in and reward you, according to your special talents and in the modern way!