UNISON branches throughout the UK are enjoying big wins as a result of the union’s #PayFairForPatientCare campaign.
As the NHS struggles with staffing levels, members working in support medical roles – such as healthcare assistants (HCAs) – have been taking on increasing clinical responsibilities, but without the recognition and pay for it.
As a result, UNISON has been running campaigns calling for staff to be re-banded to higher grades and wages that better reflect the reality of the work they do.
In late July, across South Tees and North Tees and Hartlepool, over 1,200 HCAs achieved an incredible victory.
They were able to celebrate five years of backpay, with no clawback on previous enhancements, plus being re-banded to the top of band three.
And this came after a trust CEO told members on picket lines that she wouldn’t budge from the two years backpay they’d been offered.
A huge win
Regional organiser Dave Newey describes it as “a huge win [that was] achieved through 14 days of industrial action with over 400 HCAs on picket lines”, all of which was achieved through UNISON’s organising to win strategy.
In this case, the campaign involved two trusts – “South Tees, which is Middlesbrough and the surrounding area, all the way down to North Yorkshire … just over 1,000 HCAs in there, and then, North Tees, Stockton and up to Hartlepool, where you’ve got about 700 HCAs.”
The work began in May 2023 and needed to be run in both trusts at the same time because, although unusual, they operate in a ‘hybrid’ manner.
He continues: “The branch in north Tees had been doing some work on this for years, but it had tailed off, largely because of the COVID pandemic”, before landing in Dave’s lap last year to “be reinvigorated”.
He and his team started work to go through the five-stage organising to win process to get HCAs re-banded, with colleagues joining from the strategic organising unit and then from the region.
Healthcare assistants in Teeside hold a mass rally
The process begins with a planning stage, which involves mapping the workforce and mapping the hospitals, “making sure you’re in there and doing those huge ward walks … basically finding your information that you’re going to use throughout.”
Dave stresses that it’s also important to ensure that the issues are “profound enough to deal with”. In this case, that was that “HCAs had been working historically on band two years and been doing band three jobs”.
The second part of the process is “escalating the issue. Part of that is engaging with the trust to see what they’re going to do about it in the first instance, which is normally to say: ‘look, we’re either not going to deal or we’re going to deal with this in a way that definitely wouldn’t be acceptable to most of the workforce’.”
The escalation then requires “the crucial point of finding natural leaders or organics leaders in your hospitals across the workforce”.
Dave explains that this is a long piece of work that requires organisers to be going in and asking HCAs who those people are in their wards who they naturally turn to, who organise things anyway. Once identified, organisers have six-part conversations with leaders, “to make sure that they’re the right people, but also that they’re prepared to lead their wards through this campaign.”
He says that this is vital because the campaign has to be “rooted” in the members. The natural leaders might not be members at this point.
Identifying a grievance
The third stage means usually means identifying a grievance. “When that’s been identified, we start setting up an organising committee of those leaders and they would meet on a regular basis, start to have some mass meetings”.
That’s the time for a collective grievance, with a “significant percentage of the workforce entering into that grievance and then marching on the boss to present that collective grievance”.
North Tees went first on this in October 2023, in Hartlepool Hospital, while South Tees members presented their grievance in December last year.
If the issue isn’t resolved by this point then stage 4 involves further escalations – to create a crisis for the employer. If the grievance isn’t met with a response that’s acceptable to the members, then a consultative ballot will be opened on whether to move to strike action, “and then eventually, there’ll be an industrial action ballot”.
While all this is taking place, membership density is increasing, with Dave saying that, in this case, it was up to 75-80% of the workforce as members, which of course creates more of a problem for the employer.
In the case of the trusts in North and South Tees, that’s the path the dispute followed, with an industrial action ballot taking them to a first of those 14 days of strikes in March this year, culminating in July’s victory.
Healthcare assistants on a picket line
The July victory brought the campaign to the fifth stage: win, celebrate, review and sustain. In reviewing, Dave is clear that it was the organising to win approach that won the campaign across the two trusts.
“When I first went into North Tees, there was probably a 40% density. That’s much higher than in other places I know about, where’s there’s been 25-26%. That rose to – and is still at – about 80%.
“And the same is true in South Tees. When myself and colleagues first went in, they were at about a thirty-ish percent density and they’re now at around an 80% density” he says, noting that credit should be given to those stages and processes that they went through in the campaign.
Density is crucial to ballots. In North Tees, the industrial action ballot saw a turnout of 69% turnout and a 98% ‘yes’ vote, while in South Tees, it was a 76% turnout with 99% voting ‘yes’.
Dave says it’s important to stress that all the stages before are “structure tests”. He advises never moving to a ballot until you know that you’ve had HCAs engaging with every stage before, “so that you know, as much as you can, that it’ll be successful and achieve big percentages”.
He also emphasises that that a core message of running such a campaign is that it is “very intensive” and is a major team effort, with many colleagues involved together with branches.
But the rewards are huge. There is now a 70-strong organising committee across both trusts and “potentially 40 or 50 new reps” as a result of the activist development that comes with such a campaign. That could mean a “rep on every ward”, which strengthens the branches – and thereby strengthens the membership.
Dave’s experience just goes to demonstrate – organising to win is a win-win way to campaign.
Find out about UNISON’s Pay Fair for Patient Care campaign