Ministers forced to step in to end NHS shift row
New advice after Herald revealed contractors were paid five times more than nurses to vaccinate
NHS bosses have been told that all vaccinators should have “fair and equitable” access to shifts amid a row over pay and claims that dentists, optometrists and pharmacists were snapping up the £66-an-hour shifts.
A leaked memo from the Scottish Government to all health board chief executives, HR directors, and immunisation leads, dated March 3, states that “no group of staff should be given access to shifts in advance of other groups”.
It also states overtime should be offered to permanent NHS staff, NHS bank staff, and independent contractors “on a fair and equitable basis” with “limits placed on the ability of any individual to block book shifts”.
It comes amid an outcry over a two-tier pay system for vaccinators – which The Herald revealed on Wednesday, the same day as the leaked memo – which has seen nurses paid around £12 an hour while independent contractors – pharmacists, GPS, dentists and optometrists – receive £230 per 3.5-hour session, equivalent to £66 an hour. The situation is said to be creating tensions on the ground, with nurses who had returned from retirement to help out telling The Herald that it had left them feeling “hacked off” and demoralised.
Trade union Unison has also raised concerns with ministers that its members were not being offered shifts which were then being filled by independent contractors at five times the cost to taxpayers.
Now The Herald can also reveal that the pay anomaly has arisen out of misunderstanding of the term “independent contractor”.
One well-placed source said that when plans were being drawn up in 2020 to supply manpower to vaccinator hubs, the idea was that GP and dental partnerships, pharmacies and opticians – in effect independent businesses who contract their services to the NHS – would be reimbursed for providing a member of their team to do inoculations.
The £230 fee for a 3.5-hour session was agreed as compensation for overheads, such as bringing in locum cover.
It was never supposed to be a payment to an individual.
As responsibility for hiring
vaccinators was rolled out to health boards. Hwever, the message became confused and by January of this year “independent contractor” was being interpreted by some to mean individual healthcare professionals.
This has resulted not only in a pay gulf, but an incentive for locum pharmacists, dentists, GPS and optometrists to work as vaccinators rather than in other – less well-paid – community healthcare services.
The Herald has been made aware of cases of locum pharmacists who have pulled out of community pharmacy shifts until September to work as vaccinators instead.
One source said: “We’ve just gone through nine months of hell where we’ve had to keep the pharmacies open every day, we’re constantly on the verge of not having enough people because people are selfisolating, and the policy intention was that by doing it this way we could manage the number of staff that we give to the NHS to vaccinate.
“But instead we’ve got locums cancelling all their bookings because the board is paying them £66 an hour. It’s outrageous, and it’s destabilised our workforce.
“I would expect them to be coming to pharmacists and dentists and so on saying ‘we’re desperate, can you send people’ only when they’ve run out of nurses. But the nurses are all going bananas because they can’t get shifts.
“And the reason they can’t get shifts is because the locum pharmacists, locum opticians, locum dentists, have booked themselves up in perpetuity in the Klondike gold rush.” The March 3 memo, signed off by Stephen Lea-ross, deputy director of the Scottish Government’s health and social care workforce planning division, addresses the pharmacy problem by stating that only pharmacists “who are the owner of a pharmacy business” will qualify for the £230 rate – excluding locum pharmacists.
In the case of dentists and optometrists, however, Mr Lea-ross states that these locums can continue to be paid the £230 rate – but those who are permanent members of staff “within dental or optometry practices” will be limited to NHS Band 5 or Band 3 rates.
In relation to nurses, the memo also states that from now on permanent NHS employees who accept vaccinator shifts will be paid at their NHS banding so that they are not “disincentivised from accepting shifts ... which may incur a lower rate of pay than the staff member’s substantive rate”.
This means that some nurse vaccinators will be paid more than others.
Willie Duffy, regional organiser for health at Unison, said the Scottish Government is trying to fix issues “after the horse has bolted”.
He said: “Everybody thought we weren’t going to have enough people to do vaccinations, and they panicked. But we’re now in a position where we have more than enough staff. We’ve got thousands who’ve returned at the call of the Government, who at cost to themselves did the training to be vaccinators, and are now not being used.”
One pharmacist said: “It’s still a mess. It should be simple: fill the places with appropriate nurses on Band 5. If they need extra, borrow spare NHS staff on their existing band. If they still need extra then bring in existing primary care contractors and reimburse them as agreed. Since this is by far the most expensive solution it should only be used when absolutely necessary.”
A Scottish Government spokeswoman said: “We have become aware that, due to a misunderstanding of national guidelines, some individual pharmacists participating in the programme have been paid the incorrect rate. We are actively looking into this matter, and updated guidance will be issued shortly, reaffirming the existing position.
“All staff employed to work on the programme are paid in accordance with nationally set terms and conditions and are working to agreed job roles.”