Nurses across the south west of England could face dismissal if they refuse to agree to locally set pay and conditions, under plans being considered by 20 trusts across the region.
The trusts are seeking to break away from nationally agreed pay scale Agenda for Change (AfC) and create a locally-negotiated deal linking pay to performance.
A discussion document issued by The South West Pay, Terms and Conditions Consortium, representing the 20 trusts, warns: 'Unless 'voluntary' agreement could be secured via either collective bargaining or majority acceptance following direct appeal to staff, it is likely that trusts would be obliged to dismiss and re-engage staff to secure such changes.'
The document adds that during negotiation with staff, trusts could present a 'sweet and sour' proposition' that combines 'harder measures' such as reducing sick and redundancy pay, with 'more attractive performance driven approaches.'
The RCN, which is part of a coalition of health unions in the south west opposing the move, says, if implemented, the move could lead to an exodus of nursing staff.
An RCN spokeswoman said: 'Foundation trusts cannot offer terms that are worse than those in AfC. To get around it they are talking about disengaging and re-engaging staff. One nurse said to me: 'if they try and disengage me I won't go back I'll just go and do agency work.'
Richard Vautrey, deputy chair of the BMA's GP's Committee, believes many nurses could move into general practice to gain more favourable rates. 'If NHS pay and terms are reduced, it will increase the desirability of working in general practice,' he said.
The boards of all 20 trusts involved in the pay discussions are set to vote on the plans by the end of the year.
A statement from the consortium concedes that dismissing and re-employing staff is an option that 'is neither desirable nor necessary' and the trusts hope to avoid this through reaching an agreement with staff.
However, such negotiations are already proving difficult, since the RCN and other unions, including Unite, do not recognise the consortium as an employer.
The trust spokesman said: 'We have been reaching out to them and have invited them to meetings but they have turned us down each time.'
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