Grading Systems

There is no consistent approach to the grading of general practice staff posts. Despite the advent, from 2005 of the NHS Agenda for Change pay system some practices still use the old NHS Whitley Council grading system. The Whitley system though is probably around 10% lower than the Agenda system. And of course GPs are allowed to employ staff on a local grading system but this could deny staff the advantages that mainstream NHS employees enjoy.

In my view, the Whitley Council system was fairly easy to use, but the new Agenda for Change system is too complex and way too expensive! In fact, you could emphasise the unfairness of expecting GP practices to apply some of the Agenda’s recommended grades, though some practices can design and use their own system.

Grading Differentials

Here is my idea for grading staff posts. I would break down administrative staff into four groups;

• Higher clerical and supervisory – which would reflect the supervisory grade for HCAs and phlebotomists.
• Senior or general management – which would be used for nurse practitioners and practice nurses respectively.

In addition I would split the system into five grades to reflect the differences in practice sizes – taking into account the number of patients, doctors and staff. The grading of staff at lower levels would remain the same, but in larger practices senior staff would be graded higher with a sixth increment covering an overlap between the grades, AND I would keep proper records of grades and increments.

Practice sizes aside, I believe that the most senior staff grades should, on principle, be 25% higher than the next in line. There has to be a difference between grades to reflect seniority and increased managerial responsibility. Limiting pay rises for senior staff while hiking pay rises for lower grade staff effectively downgrades the senior post.

Local Grading System

Let’s assume that the highest salary paid to an employed practice manager, in a practice with over 15000 patients, is around £50000 per annum. Here’s how a grading system would look with that 25% differential and 5 or 6 increments per grade.

The first table shows a system starting at £50000 per annum and works downwards in five grades to the minimum payable as a National Minimum Wage. Don’t forget the NMW is £6.70 per hour whilst the National Living Wage is reckoned to be £7.20.

GP Practice Staff Grades

To break the grades into increments, then hourly rates:

Therefore, the value of an increment is as follows, with the largest values at the bottom end of the salary scale:

In conclusion, it’s a matter of paying a fair, reasonable rate. This article is only a guide but you may find it useful if your practice has no records of salary scales and increments. It could help you decide whether to award increments or not.

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