Nearly 60 health visitors in Lincolnshire are being balloted by their union on taking strike action in a dispute over the transfer of their pay and conditions from the NHS to a local council.
The council has withheld annual pay rises for staff who were transferred from the NHS and are still on health service contracts, in a bid to encourage them to join its own payment system.
“It is unprecedented that the health visitors in Lincolnshire are being balloted for strike action”
As well as not giving affected staff pay rises, union officials also claimed the council was eroding the role of the health visitor by moving around some of its “key elements” at different seniority levels.
Unite claims that the 57 health visitors involved are “not getting paid the rate for the job and the erosion of their professional responsibilities which could adversely impact vulnerable families”.
The move, described as “unprecedented” by the union, follows the transfer of health visiting staff from the NHS to Lincolnshire County Council in October 2017, as part of a wider national policy.
The staff were able to remain on the health service’s Agenda for Change contract but have not received any annual pay rises since the transfer, unlike NHS staff elsewhere in the country.
Unite noted that health service staff in England last year accepted a three-year pay deal which, for the majority of staff, meant a 6.5% increase in pay over the three years.
Instead, the council wants those transferred to swap to its employment contract, which it argues has similar terms to Agenda for Change and would see them receive annual pay rises like its other staff.
Unite, which includes the Community Practitioners’ and Health Visitors’ Association, highlighted that the dispute only involved health visitors transferred from the NHS under Agenda for Change terms.
There are 111 full-time equivalent health visitor posts at the council. Those who not make up the 57 are either on grade 10 contacts or were employed by the county council since October 2017.
Unite said it calculates that its Lincolnshire health visitor members have lost more than £2,000 a year since they were transferred from the NHS to the county council in October 2017.
“What the council has done is create a two-tier health visitor service that is being dressed up”
The union also said it was “seriously concerned about the downgrading of the health visitors’ professional status”, which it said was resulting in fewer staff doing the specialist health visitor role. The strike ballot closes on Thursday 27 June.
Unite regional officer Steve Syson said: “It is unprecedented that the health visitors in Lincolnshire are being balloted for strike action on the council’s refusal to give them a pay rise since 2017, and also over concerns that their professional standards are being seriously eroded by a penny pinching employer.
“We want our members to have a pay rate that properly reflects the health visitor specialist role, in line with the county council’s grade 10, backdated to April last year. We also want no reduction in our members’ professional responsibilities and duties,” he said.
Unite professional officer for the East Midlands Jane Beach told Nursing Times the council had split the health visitor role into two levels, with level two only available to those on the council contract.
However, she said the level one had “specialist elements” removed, which limited their scope of practice and made it more in line with a staff nurse position.
“What the council has done is create a two-tier health visitor service that is being dressed up as a so-called ‘career progression scheme’,” said Ms Beach.
“The reality is that council bosses have removed key elements – leadership, planning, evaluating, managing complex safeguarding – from the level 1 health visitor role and moved these to level 2,” she said.
“By removing the specialist elements, the level 1 no longer constitutes a health visitor role,” she said. “This will leave a big gap in the service putting children and families at risk with fewer level 2 health visitors who themselves will be at risk of burnout.
“This is short sighted given the current crisis in general practice and, ultimately, will result in delays in support for children and families in Lincolnshire, many of them in vulnerable circumstances, which, we believe, will have a serious impact on their health and social welfare.”
However, Sally Savage, assistant director of children’s services at the local authority, said: “Lincolnshire County Council highly values the role of health visitors as part of our workforce.
“Health visitors transferred to the county council over a year ago on Agenda for Change terms and conditions,” she said. “They are able to choose to remain on those terms and conditions albeit that the inflationary increase does not apply for legal reasons.
“However, to enable health visitors to continue to receive inflationary increases in their salaries, all have been offered an opportunity to transfer to the county council terms and conditions, whilst retaining their NHS pension,” she said.
In a statement, Ms Savage also argued that the council pay scales “reflect Agenda for Change pay and are, in fact, slightly higher”.
“The job descriptions meet all the professional standards of specialist community public health nurses,” she said. “We feel that this offers a proportionate response to Unite’s concerns.”
In addition, she said the council had invited the union to submit a formal dispute, so it could sit “round the table” and “explore” resolutions, but to date this had not happened.
“We are working with the other unions who are supportive of our position,” Ms Savage stated.
She added: “We don’t agree with Unite’s assertion that the county council have reduced the professional responsibilities and duties of health visitors, who are a valued part of our workforce, using their professional skills on a day to day basis to support children and their families.”
Unite is campaigning for health visitors and other community nurses to be taken back from local councils into the NHS, claiming that the profession is currently facing a “crisis”.
The latest figures from NHS Digital reveal the lowest number of health visitors in England since September 2012.
There were 7,694 health visitors in England in January this year, a fall of 25% since their peak of more than 10,000 in October 2015 when the Health Visitor Implementation Plan came to an end.