Whose idea was that blasted bus 
Hi
I am surrounded by nursing staff of different grades and names at the moment.
There are ways of progressing through the grades and qualifications.
You can start at the bottom, a Health Care Assistant, do your NVQ training whilst working. It is a minimum wage job.
You do patient care, make the beds, take out canulas but not put them in.
Once you have some experience and a good record you can then train as a nurse assistant, more involved in actual nursing care, better pay.
Once you have qualified in that and shown you are capable you can then go on to be a nurse, dispensing medicine, doing injections, catheters etc.
You can then specialise and with the relevant experience and additional training
become a nurse practitioner and prescribe medication.
This level of nursing is well paid.
There are other routes, one who looked after me was a HCA, left school with no A Levels, did her NVQ then an A Level in her own time, 3 A Levels in 6 years and was accepted at university to train as a doctor and has just started. She is funding herself by doing some night shifts as an HCA.
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How encouraging Swims thanks for this .
I donāt think nurses are that badly paid when they are qualified .
Something like Ā£33- 35k pa
Itās not a bad wage and there is job satisfaction to factor in .
Selling insurance is an awful job .
Hi
Thatās the average salary, newly qualified is Ā£27,600.
Thatās for 3 x12 1/2 hour shifts, cluding nights and weekends.
The vast majority do treat it as a vocation, they need to dealing with dementia patients, who are difficult to manage and then they have their share of drunks and druggies who can be very nasty.
Everyone has to start somewhere .
Itās about an average graduate salary.
Drunks and druggies are best dealt with by the security men at hospitals .
Hi
I so agree about the drunks and druggies, unfortunately they still have to have medical treatment.
Nurses can be subject to a lot of abuse, a lot of which is racist and or sexist.
But not those nasty selfish people who refused the vaccinations Swimā¦
IR35 saw to a lot of that as agency doctors and nurses got hit by the stupid rules.
Pensions and stupid training rules (still EU rules) mean 55 year plus doctors cant be bothered with all that bollcks and take early retirement- that and to protect their pension payouts by working longer.
Truss is doing the right thing ā¦ give it time. Dropping 5% of their PAYE tax us a good move too - doctors and highly paid NHS staff just got a pay rise.
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IR35 just means that staff pay tax and NI as if they were employees. Regular agency staff. should be paying normal rates of tax and NI already. NHS staff had a pay rise before Truss. The tax cuts will simply bankrupt the NHS so the people we are discussing wonāt have jobs long term.
Itās a lot more than that Annie - it means you donāt get the same conditions as an employee in return. No redundancy pay, maternity pay, holiday pay, sick pay etc.
If you are affected by IR35 then you were not getting that anyway. Itās a lifestyle choice. Jam today or jam tomorrow. IR35 just brings people into line with regular agency rules & cuts out a tax loophole which meant that some were ripping off the economy. benefits should include holiday pay, sick pay, but not redundancy (which varies with employer & time served anyway). Not sure about maternity. I mean these are temporary contracts so the pay is higher to compensate. Some use workarounds such as a shell company. Itās all a bit of a joke. Some people paying tax for doing the same job others not. Besides which IR35 only came in 3-4 years ago. The problems with recruitment existed way before that (tory meddling).
You canāt put peopleās rates through a PAYE tax system and say its equivalent when under IR35 you still work through the agency and go without paid holidays, redundancy money, work provided, (instead of having to find it) a pension, redundancy pay, paternity or maternity pay. No VAT reclaim either - all paid after personal taxation.
IR35 just creates a second class worker.
Businesses and the government are paying 800 a day for IR35 workers where limited companies were paid 450 a day before the rule came in. If they donāt offer the higher rates nobody will do the work, they will go off payroll instead.
How is this sensible ?
You must be talking about a shell arrangement. Regular agencies do pay holiday, NIC etc. Redundancy isnāt a given in any job. Itās down to contract. I donāt see why a whole tranche of people who are effectively employees should be able to pay themselves convoluted arrangements to avoid taxation. Thatās what was happening with many contractors before the rules came in. Antipodeans in particular benefited by setting up limited companies whilst sitting alongside regular workers who paid tax or regular agency people who paid tax. It was a gravy train for them, but not the taxman.
I can see why it might upset people, but I donāt know many nurses and doctors were employed on such arrangements - it would appear strange if they were.
Not under IR35, its a specific ruling and tax determination, its not like working for an agency.
I know it is but that is their choice. Those who chose to go via that route could work for an agency instead.
Itās not really a choice, Annie. Many contractors got fined heavily when they were assessed for IR35 applicability when the rules changed, some even took their own lives.
There arenāt any agencies that would provide the same working terms and conditions for contractors as they would for staff. The closest are IR35 umbrella companies, who not only treat contractors as payrolled contractors (without any benefits such as holiday pay etc as I mentioned before) but also charge the contractors and take a cut of the rate so they can be paid for doing the payroll in the first place.
Just having limited companies for people who want to work as single person limited companies is far simpler and better all round. IR35 has been nothing but a disaster for everyone - especially companies needing short term resources with specific skill sets. If people (such as me) decide to run their own companies and take the risks associated with it, they should be free to avoid taxation like all other limited companies do. If they want to be payrolled, then the choice is to become a full time employee - thats the real choice, not a rule that makes you a second class worker with no rights or not.
I do not understand why doctors and nurses would be contracted on IR35 to start with. This usually applies to corporate type jobs, finance, management, consultancy work (as in management consultancy not medical consultants). Medical staff are employed from an NHS staff bank organisation where they are entitled to holiday pay and maternity leave.
I have a friend who works as an IT contractor (non NHS) and he was affected by IR35. He has found a way to work around it. Seems complex but I donāt understand how nurses and doctors are affected in the same way.
They worked as limited companies through agencies, the same as IT contractors so they could claim VAT, minimise tax through dividends instead of PAYE, claim back expenses pre-tax etc.
There are a few ways to work around IR35 but as its the agency that gets fined for getting it wrong (2017 changes I think), a lot of them are risk averse so put everyone under the rule. In many cases, you cannot provide services to large companies (including the NHS) if you are not a registered limited company (in my case as well).