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Changes in Skills-Mix and Pay Determination among the Nursing Workforce in the UK

Author

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  • Damian Grimshaw

    (Lecturer in Employment Studies Manchester School of Management UMIST PO Box 88 MANCHESTER M60 1QD)

Abstract

The public sector workforce in the UK faces a number of challenges and pressures that are leading to an increasing fragmentation of employment. This paper reports evidence of one such pressure faced by nursing staff in the NHS-the recruitment of a new grade of unqualified nurse, the `health care assistant' (HCA), onto local terms and conditions of employment. Drawing on case-study evidence, including pay data from a sample of nursing personnel records from two Trusts, this paper addresses two central issues. First, the recruitment of growing numbers of HCAs may increase wage inequality among nurses as managers are able to adapt local pay scales to the widening wage inequality external to the organisation. Second, the greater managerial autonomy associated with hiring HCAs on local pay scales may increase opportunities for managers to reassess traditional demarcations between qualified and unqualified nursing staff and to seek cost reductions through reducing the proportion of qualified staff employed.

Suggested Citation

  • Damian Grimshaw, 1999. "Changes in Skills-Mix and Pay Determination among the Nursing Workforce in the UK," Work, Employment & Society, British Sociological Association, vol. 13(2), pages 295-328, June.
    • Handle: RePEc:sae:woemps:v:13:y:1999:i:2:p:295-328
    DOI: 10.1177/09500179922117953
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    References listed on IDEAS

    as
    1. Stephen Bach & David Winchester, 1994. "Opting Out of Pay Devolution? The Prospects for Local Pay Bargaining in UK Public Services," British Journal of Industrial Relations, London School of Economics, vol. 32(2), pages 263-282, June.
    2. Jill Rubery, 1997. "Wages and the Labour Market," British Journal of Industrial Relations, London School of Economics, vol. 35(3), pages 337-366, September.
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    Cited by:

    1. Chris Smith & Raffaella Valsecchi & Frank Mueller & Jonathan Gabe, 2008. "Knowledge and the discourse of labour process transformation: nurses and the case of NHS Direct for England," Work, Employment & Society, British Sociological Association, vol. 22(4), pages 581-599, December.
    2. Damian Grimshaw, 2000. "Public Sector Employment, Wage Inequality and the Gender Pay Ratio in the UK," International Review of Applied Economics, Taylor & Francis Journals, vol. 14(4), pages 427-448.
    3. Sharon C. Bolton, 2004. "A Simple Matter of Control? NHS Hospital Nurses and New Management," Journal of Management Studies, Wiley Blackwell, vol. 41(2), pages 317-333, March.
    4. Stephanie Tailby, 2005. "Agency and bank nursing in the UK National Health Service," Work, Employment & Society, British Sociological Association, vol. 19(2), pages 369-389, June.
    5. Ian Kessler & Paul Heron & Sue Dopson, 2013. "Indeterminacy and the Regulation of Task Allocation: The Shape of Support Roles in Healthcare," British Journal of Industrial Relations, London School of Economics, vol. 51(2), pages 310-332, June.
    6. Graeme Currie & Rachael Finn & Graham Martin, 2009. "Professional competition and modernizing the clinical workforce in the NHS," Work, Employment & Society, British Sociological Association, vol. 23(2), pages 267-284, June.
    7. Hannah Cooke, 2006. "Seagull management and the control of nursing work," Work, Employment & Society, British Sociological Association, vol. 20(2), pages 223-243, June.

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