NHS Job evaluation handbook 4
2.2 Pre October 2004, in line with industrial relations practice in the public sector in the immediate
post-war period, there was an over-arching joint negotiating body for the sector, the General
Whitley Council, and more than 20 individual joint committees and subcommittees for the
different occupational groups, each with responsibility for its own grading and pay structures,
and terms and conditions of employment.
2.3 There had been some developments, mainly from the early 1980s onwards, in response to
increasing tensions within the system, for example:
• Reviews of individual grading structures. The most well-known of these (largely because
of the high number of appeals generated) was the introduction of the Clinical Grading
Structure for nurses and midwives on 1 April 1988, which brought in the previous grades A
to I. There were other grading structure reviews in the late 1980s and early 1990s which
covered professions including estates officers, speech and language therapists and
hospital pharmacists. There was no attempt to undertake cross-Whitley Committee
reviews.
• The introduction of independent pay review bodies for doctors and dentists (1971), and
nursing staff, midwives, health visitors and professions allied to medicine (1984). These
took evidence from all relevant parties and recommended annual pay increases. They
replaced the traditional collective bargaining approach, which was considered to have
delivered unsatisfactory pay levels for some key public sector groups, but had no remit to
compare pay from one group to another (even among their remit groups). Staff groups
not covered by pay review bodies continued to use collective bargaining on pay increases,
but these increasingly mirrored the pay review body settlements.
• Changes to health service legislation from 1992. These changes allowed organisations to
develop their own terms and conditions and to apply these to new and promoted
employees, although existing employees could choose to retain their Whitley terms and
conditions. Most trust terms and conditions shadowed the relevant Whitley arrangements
in most areas, but a small number of trusts introduced totally new pay and grading
structures, and other terms and conditions. These were generally based on the various
commercial job evaluation systems available at the time e.g. Medequate, Hay.
2.4 By the mid-1990s this resulted in a mixture of pay and grading systems, with some significant
defects:
• Difficulty in accommodating developing jobs, such as healthcare assistants, operating
department practitioners (ODPs), and multi-disciplinary team members, who might be
carrying out similar roles, but whose salaries could vary significantly, depending on the
occupational background of the jobholders.
• Inability to respond quickly to technological developments and changes to work
organisation, even where everyone agreed they were desirable.