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Society of Radiographers and Agency Staff

It’s strange that the society of radiographers (SOR) has not shown any support towards its membership of agency workers over the current HMRC and NHS improvement plans.

Today I received April’s addition of my society of radiographers magazine, SOR, which is blatantly ignoring the elephant in the room with regards to changes forced on agency workers. I rushed through the pages expecting to see some support for its membership of agency staff. They could help and support agency radiographers in so many aspects of the current changes even by joining forces with the Nurses society. The Nurses society have overturned the current change to employed workers who top up their pay with additional agency shifts.

Employed radiographers and nurses share the same pay bands. If nurses are facing financial hardship radiographers and other allied health professionals will be too. This is probably why the bill for agency staff has escalated over the years.

Inequality

My theory is that equivalently educated non-clinical staff are better paid than clinical staff. However, clinical staff are caught in a cat and mouse scenario which involves them being seen to be doing a caring role for their own financial gain rather than the need to help others. This was evident in the Junior doctors pay campaign. The JDr’s blamed the shift changes that accompanied their pay cut rather than the pay decrease. Throughout the campaign, they constantly said, “it’s not about the pay” which in my opinion was wrong. It was about the pay and to people on the inside the words “its not about the pay” was a gut churning lie!

The Junior Drs had a chance, a public forum, to highlight the inequality in pay for clinical staff – instead they played politics and protected themselves leaving the rest of us high and dry with little money to live on.

The Proof

Here’s my example of clinical and non-clinical pay inequality. Look at band 5 and the “Possible roles at band 5”

Under band 5 we have several clinical occupations including adult nurse, diagnostic radiographer and midwife. We also have some none clinical occupations which are practice manager and ICT test analyst.

I got this information from the Health Education England website and took a screen shot of their opening statement. The above are pay bands from April 2017.

Nurses

Then I checked on NHS jobs that the pay bands were as stated on the health careers website.

These are current jobs and the searches were carried out on the 03/04/2017. Everything seems correct for Adult nurses. I’m not sure an adult nurse could become a band 7 (reference to the quote in picture above) without taking on considerable responsibility far out weighing the none banded roles of her equivalent senior none clinical employee.

 

MidWife

All correct for midwives, they are definitely paid band 5.

Radiographers

So far so good for radiographers the health careers website is, so far, correct just need to check the non-clinical jobs.

Non-Clinical band 5 roles

 

There is no band 5 pay scales mentioned in these comparable non-clinical roles. It’s my belief that job roles like this are the reason the NHS is in trouble financially. Clinical staff take pay cut after pay cut. When I first trained as a mammographer I trained at band 6 and qualified at band 7. As I’ve written in other blogs but now training mammographers are a band 5 and qualified at a band 6. This is a £10K pay cut. The job hasn’t changed nothing has been merged so what justifies the cuts? The NHS breast screening programme has not gotten any smaller in fact it has grown with the recent age extension. It’s not just my field that has had a wage shrinkage its clinical roles across all fields.

It’s shocking to think that after gaining a degree and possibly a post graduate certificate you are working on a par with an employee of Lidl. The responsibility we have and the work we do has far higher risks not only to the patient but ourselves too. Although most of us do this role because we are caring and compassionate – we are also intelligent individuals who could have applied ourselves to any degree course with much success and far greater prospects than what we are experiencing now.

Although we are grateful to the Nurses union for being the only union to throw its weight behind an already stretched workforce – isn’t it time that the unions combined to jointly campaign for professional clinical institutions to stop their membership living in society on the edge of poverty.

Steadily and surely, over the past 20 years, there has been a significant decline in trained mammographers leaving a shortage of mammographers in the UK.

Who are Mammographers?

Mammographers are trained radiographers who specialize in breast imaging. Because of the intimate nature of the positioning of breast tissue the speciality is exempt from the sex discrimination laws and consequently only female radiographers can apply for these positions.

Why Do we need them?

The high number of incidents of breast cancer in the UK lead to the introduction of the NHS Breast Screening service in the 1980’s. This service requires a high number of trained mammographers to work independently in the community often with no security and little facilities such as running water and toilets.
The NHS breast screening service requires two radiographers to screen a minimum of 40 women a day on mobile units which quickly run low and empty of running water. They do not have toilets and Mammographers are expected to use public facilities which can often be less than sanitary and some distance from the van.

What are the issues?

Female radiographers who enter the NHS Breast screening service often have to give up other skills they have learnt as a radiographer and pass an intensive post graduate certificate in breast imaging. This can take over a year depending on when they were recruited and the time of the course starting. Because of the high volumes of women who need to be screened, every woman from 50 to 70 years of age registered with a GP, many Mammographers suffer work related injuries to their shoulders.
From this perspective is it any wonder that there is a shortage? On the agenda for change pay scale a qualified mammographer was banded a tier 7 which starts at £31,383 and over annual increments rises to £41,373. With the extra learning and leaving your current skills behind this might make mammography appealing to some radiographers. Radiographers where also enticed to join the profession as they would train at band 6 a tier lower. This helped attract experienced radiographers to the profession.
However, over the past 20 years the profession has been down graded and radiographers are now expected to train at band 5, the same banding as a newly qualified radiographer. Many female radiographers would have been promoted to band 6 in other more departmental specialities such as CT and MRI quite quickly so mammography training wouldn’t be something they would consider. Mammography is almost always located remotely from the main department and is very rarely integrated.
With over half the mammography workforce due to retire in the next five years the NHS is now panic stricken and will undoubtedly not give pay as a reason for the lack of recruitment to this part of the radiography profession. Bad working conditions and very little room for career progression is at the crux of this scenario. Offering a band 5 salary to an already qualified and experienced radiographer is disgusting. Salary is and will be the main reason for the shortage of mammographers how this is dealt with by the department of health will be interesting. Watch this space!

Whilst trawling through the hundreds of You Tube posts on the NHS I found a short video on the NHS’s need for agency staff from 2015. Alice Turner, the Principle Radiographer at the University North Staffordshire hospital, speaks out about radiology not keeping pace with demand and the important role agency staff play in rectifying this. With new Radiologists hard to recruit and the length of time it takes to train employed radiographers to film read a quick solution was to organise agency radiographer film readers. This helped share knowledge and experience amongst a group with a common goal and help this hospital ‘keep pace’ whilst radiologists focused on CT and MRI scan reports. If the agency staff now stop due to the agency pay cuts how will the NHS keep pace?

HMRC have brought out new legislation which comes into effect at the start of the new UK tax year on the 6^th April 2017. It will affect radiographers working as agency on the NHS who are paid through a limited company.

This means that the previous tax relief benefits of operating under a limited company are going to be a thing of the past and tax and national insurance will now have to paid under the PAYE effect, as though you were employed. This effectively will take 50% of your limited company earnings and you won’t receive any of the benefits of employed staff. It should also be highlighted that you will still take home considerably more than employed staff.

The current UK government have declared, in the budget, that we are moving towards a ‘more tax, less spend model’ and have their eyes on the third largest employer in the world, the NHS. So what does this mean to limited company Locums? Your agency is now responsible for you paying the correct tax and national insurance, if you are now deemed to be within IR35.

What is IR35?

IR35 is tax legislation, largely ignored by the government, until now which can enable an individual without a limited company to operate as a contractor and have their tax calculated either through their agency or pay an umbrella company to do this for them. Most agency staff take out the third party and form a limited company which means they have tax deducted from them under company tax legislation which is generally capped at 20% and pay themselves a salary which falls under the taxable allowance. By forming a limited company, they can afford to save part of their gross income for sick and holiday pay. If you are paid by the agency as PAYE or through an umbrella company, you have very little rainy day money and are probably better off being employed if you are the main income provider.

What to do now?

The government have now set up a tool on the government website which enables you to check if your contract falls within the IR35 legislation. This does give various different outcomes and has been reported to classify the similar contracts as both in and outside of IR35 and is a pretty useless tool (I wonder if IT contractors were asked to make this?). Most NHS trusts have put a complete blanket IR35 stamp on all contractors leaving no room for manoeuvre.

Other non-clinical fields, working in the public sector, have demanded a 15-20% increase in their contract rate, says Neil Lupin of Green Park recruitment agency. This is something that all agency radiographers in a contract with the NHS should be doing in order to obtain holiday and sick pay.

How you want to be paid

From the 6^th of April if you are a Locum radiographer working for the NHS through a limited company and are within the IR35 or have been told you are, by the trust you’re currently working for, you will have to seek a different method of payment. Your responsibility for self-assessment is no longer.

This isn’t entirely true you can still operate a limited company and be paid a net salary, after tax and national insurance into your business account and still complete a self-assessment. This way if you do any private work you can be paid gross.

You can choose an umbrella company and pay them a weekly fee for deducting tax and national insurance. It is illegal for your agency to stop you from using any IR35 compliant umbrella company. Agencies may have their preferred list but you can choose your own.

Your agency can pay you under their own PAYE scheme.

What benefits can I claim

In 2016 new legislation was brought in affecting what you can claim working under an intermediary. An employment intermediary is (ESM5510 www.gov.uk)

• An agency
• A recruitment or employment business
• An umbrella company
• An MSC
• A PSC

You can no longer claim for ‘ordinary commuting’ so you are expected to pay for

• Travel in the performance of your duties
• Travel to or from a place the necessarily attend in the performance of their duties (excluding ordinary community)
• Travel between a worker’s home and a temporary’ workplace

You can no longer claim for meals or food consumed as part of your working day even if you have a receipt.

You can claim for the cost of protective clothing or clothing required for the performance of your role.

You are able to claim for subscriptions to professional bodies or societies.

The big Tax Break

Umbrella companies do give people an opportunity to gain massive savings through pension contributions which would enable you possible to take early retirement. After ploughing through the mine fields of umbrella companies, you will probably want to take opportunity of the pension tax break!

I called 5 umbrella companies each of them without fail and before quoting asked me which agency I was with and who was my contact at this agency. When I questioned them why that was relevant most of them backtracked and said it wasn’t it’s just information they took as part of their sales quotation. I know what your all thinking! One umbrella company advised me it was because the agency contribute to the fee and that if I was with RIG I would get a bigger reduction in my fee than my current agency!

So this is what I found when I made a few enquiries, I chose a random rate as an example: –

Correct as of March 2017

The Break Down

Working still with £32 an hour you will pay roughly –

Gross pay      £1200

Tax £218

Employees NI contribution £85

Employers NI contribution £125

Umbrella company fee £24

Total         £452

Net pay £748

You can reduce all three of these elements by significantly adding to your pension through an umbrella company. You can contribute up to 48% of your salary, although by ringing around a pension was never offered to me and caused a slight headache when I asked about one. Some umbrella companies would only allow you to use their own affiliated company otherwise I was told I would have to seek a tax rebate at the end of the tax year which slightly defeats the purpose and the main perk of an umbrella company. Some of the advisers also seemed to think that a 1% contribution was set in stone which I found frustrating. I was told by one umbrella company that £24 a week fee was the maximum fee but, as you can see, one company charged me £25. They all told me that the fee was not negotiable but from working previously as an agency radiographer some years ago, under an umbrella company, I regularly would negotiate the fee.

IR35 is tax legislation largely ignored by the government, until now. It can enable an individual, without a limited company, to operate as a contractor and have their tax calculated either through their agency or pay an umbrella company to do this for them. Most agency staff take out the third party and form a limited company. This means they have tax deducted from them under company tax legislation which is generally capped at 20%. Then they pay themselves a salary which falls under the taxable allowance. By forming a limited company, they can afford to save part of their gross income for sick and holiday pay. Being paid by an agency through PAYE or an umbrella company gives you very little rainy day money. Therefore you are probably better off being employed if you are the main income provider.

How to check if your in or out of IR35

The government have now set up a tool on the government website which enables you to check if your contract falls within the IR35 legislation. This does give various different outcomes. It has been reported to classify the similar contracts as both in and outside of IR35 and is a pretty useless tool (I wonder if IT contractors were asked to make this?). Most NHS trusts have put a complete blanket IR35 stamp on all contractors leaving no room for manoeuvre.

Other non-clinical fields, working in the public sector, have demanded a 15-20% increase in their contract rate, says Neil Lupin of Green Park recruitment agency. This is something that all agency radiographers in a contract with the NHS should be doing in order to obtain holiday and sick pay.