The PDA and other NHS unions have been formally advised that NHS England will change its policy on the creation of subcos. These organisational structures have been used to reduce costs for NHS trusts by avoiding VAT, though this has been queried by the Treasury.
The VAT position aside, the greater concern to pharmacists and other NHS employees is when those organisations are also used to TUPE staff out of Agenda for Change employment contracts and access to the NHS pension. This is done by placing individuals on inferior pay, terms, and conditions.
On this basis, the NHS staff side has objected to this approach and would like individuals to maintain their current benefits even if they are transferred to a different employer. In recent times, this has been a factor of concern for ICB (Integrated Care Board) and NHS regional staff, where those organisations are currently being restructured with some functions potentially transferring to other organisations.
In line with the principle of a single NHS workforce, the government have listened carefully to those concerns. New national guidance will be introduced to confirm that new subsidiaries involving the transfer of NHS staff will now only be approved in a limited number of circumstances, and only where there is clear trade union support and protection of NHS terms and conditions, including pension access. The PDA welcomes this change of policy.
In addition to NHS employees being transferred OUTWARDS to a subco, there remain scenarios where pharmacists and their teams are still being transferred INWARDS to a newly created NHS subco. This is where an existing outpatient pharmacy contract may be subject to review, and a community pharmacy business may lose the contract to an in-house bid from the trust. In these circumstances, the PDA has called for those employees to be transferred onto Agenda for Change contracts and direct employment by the trust.
Due to the VAT aspect, trusts where this has occurred have instead created subcos, typically with the hospital chief pharmacist as a director, and kept pharmacists on different terms and conditions. The PDA will continue to push for these situations to result in staff joining the trust pharmacy department, which would not only be consistent with a single NHS workforce but would also offer more flexibility to pharmacists, who would join a larger team with more career opportunities.
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