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Terry Desombre: Senior Tutor in Health Care Management, School of Management Studies for the Service Sector, University of Surrey, Guildford, UK
Richard Benny: Lecturer in Law, School of Management Studies for the Service Sector, University of Surrey, Guildford, UK
Introduction
Before the National Health Service (NHS) reforms of 1990, nurses were assigned a title, for example sister/charge nurse, senior nursing officer and more recently senior nurse. What was common to all, nationally, was the title used to describe their posts. Their level of responsibility, however, may have been different, as was acknowledged by an incremental pay scale, with different points on the pay scale reflecting their level of responsibility.
In the early 1980s, as a result of theGriffiths Report, general management was introduced to the NHS. At this time the nursing hierarchy was rationalised and several tiers of management were removed, with heads of nursing beginning to take on more of a general management function.
With the introduction of the NHS and Community Care Act 1990, nurses were appointed to the board of directors by statute and as such assumed executive powers equivalent to other members of the board. At this time trusts were able to withdraw from nationally negotiated agreements (Whitley Council Agreements). These collective agreements, which were incorporated into individual employment contracts, had previously determined, for example, pay and working conditions of nurses. It was at this time (post- 1990) that the role, pay and terms and conditions of the head of nursing (executive nurse director) began to change significantly. Other roles were added to the nursing function that were considered to be related to the caring role of a nurse. The language used to describe that role changed both in complexity and meaning.
Legal aspects of the changes in job titles/job descriptions and job functions
From an employment law perspective, the developments described above raise two separate but related legal issues: these are, first, the law concerning job titles and second, the law regarding job functions and any changes in these functions adopted since the contract of employment was made.
Employment law relating to job titles
The law on job titles[1] is part of the law relating to particulars of terms of employment and is to be found in the Employment...