Band 2 and band 3 healthcare support worker roles
Guidance to support employers when considering re-banding requests from band 2 and band 3 healthcare support staff and advice on how to consider these requests.
The NHS Job Evaluation Scheme has always recognised the clear and very distinct differences between band 2 and band 3 healthcare support worker roles in the delivery of personal care and clinical care.
Most jobs change over time but if changes in roles have not been captured and properly reflected in updated job descriptions that have gone through a job evaluation process, it is possible that they are not banded correctly.
Background to the current position
To support the implementation of Agenda for Change, the clinical support worker (CSW) band 2 and the clinical support worker higher level (CSWHL) band 3 matching profiles were first published in November 2004 in the nursing services and nursing community job profiles.
In 2013, they were republished within the nursing combined suite of profiles that was created by consolidating the nursing service and nursing community suites mentioned above. Consolidating profiles uses set conventions and protocols to ensure consistency of scoring with the source documents.
The original 2004 profiles were archived in July 2019. In July 2021 minor changes in wording were agreed by the NHS Staff Council to provide clarification on the important differences between the band 2 and band 3 profiles, not to change the essence of the profiles themselves.
Differences between the two profiles
The NHS Staff Council Job Evaluation Group (JEG) has always set out the clear differences between the two profiles. This has mainly been done by way of the job statements at the top of the profiles. The band 2 profile is concerned with personal care and the band 3 profile is concerned with a limited range of clinical tasks carried out under supervision.
This position has not changed and can be referenced back to the original CSW profiles in nursing services and community nursing first published in 2004 as shown in the table below.
Job statements
| 2004 (Archived July 2019) | 2013 | Amended 2021 | |
Band 2 | 1. Undertakes personal care duties for patients in a hospital or similar setting. 2. Reports patient’s condition to qualified staff / records patient information. |
2. Report patient’s condition to qualified staff. |
2. Supports clients with toileting, bathing, dressing and meals. 3. Record patient information. |
Band 3 | 1. Undertakes a range of delegated clinical care duties in hospital, community or other settings. 2. Record patient information.
| 1. Undertakes a range of delegated clinical care duties in hospital, community or other settings. 2. Record patient information.
|
2. Records patient observations and changes to patient clinical conditions. 3. Carries out limited clinical care duties. |
It is important to note that there have never been any changes made to factor levels in either of the profiles, just wording changes made to ensure the difference between the bands is made clear. An example of such wording change is illustrated below:
Factor 6 – Responsibility for patient/client care
| 2004 | 2013 | 2021 | |
Band 2 | Level 3 Undertakes personal care duties e.g. bathing, toileting. | Level 3 Undertakes personal care duties: bathing, toileting. | Level 3 |
Band 3 | Level 4 Undertakes a range of clinical care duties, record patient observations, collect specimens. | Level 4 Undertakes a limited range of delegated clinical care duties, record patient observations, collect specimens. | Level 4 Undertakes a limited range of delegated clinical care duties relevant to the services provided/work area and records patient observations: e.g. taking blood pressure, blood glucose monitoring, pregnancy testing, routine maternal and neonatal observations, observing patients for signs of agitation or distress, wound observations and simple wound dressings, removal of peripheral cannula urinalysis, removal of catheter. |
Why were the changes made?
The NHS Staff Council Job Evaluation Group made these amendments in response to feedback from employers and trade unions – as well as freedom of information requests – which had suggested that a lack of examples in the profiles were leading to some problems in local application. Some of this feedback came from trade unions that were already campaigning on this matter in a number of regions, supporting their members to get their jobs rebanded.
What should employers do if they get rebanding requests – from individuals or collectively?
Employers hold the responsibility for ensuring that their staff are paid appropriately for the roles they are required to and being asked to undertake. With staff deployment decisions and service operating models varying considerably from employer to employer there is not a simple one size fits all solution.
Employers should be regularly assessing whether or not changes have been made to roles and responsibilities and importantly ensuring that the information contained in accurate, up to date job descriptions goes through agreed job evaluation processes when any changes have occurred. They should work these issues through at local trust level in conjunction with staff side representatives and update job information accordingly.
The NHS Job Evaluation Handbook clearly states that if the banding outcome of a role has changed because of a re-evaluation, that this change should be backdated to the date the jobholder and manager agree that the job changed. Disputes about backdating should also be resolved through local procedures, see chapter 3, section 4.5.
Looking ahead
The current profiles for nursing and midwifery (bands 4 and above) are under review with any amendments likely to be published in 2024. It is likely that this will also lead to an increase in rebanding requests. Employers will want to prepare for this in advance by ensuring that job descriptions are up to date and that they have sufficient job evaluation capacity to handle an increase in activity.
Summary of key points
- The NHS Staff Council agreed minor wording amendments to the profiles for band 2 and band 3 healthcare support worker roles in August 2021.
- The profile levels and scores were not and have not been changed.
- Examples to illustrate the differences between the levels were expanded on to ensure the differentiation between the bands was made clear.
- Accurate and up to date job descriptions need to be agreed and then go through agreed job evaluation processes to see if banding changes are needed.
- Backdating is a matter for local determination.
- This is not just an issue for care support roles. Increase our job evaluation capacity in anticipation of future rebanding requests.
For further information, please see our webinar recording which includes additional resources to support employers.
