IDEAS home Printed from
   My bibliography  Save this article

Changes in Skills-Mix and Pay Determination among the Nursing Workforce in the UK


  • Damian Grimshaw

    (Lecturer in Employment Studies Manchester School of Management UMIST PO Box 88 MANCHESTER M60 1QD)


The public sector workforce in the UK faces a number of challenges and pressures that are leading to an increasing fragmentation of employment. This paper reports evidence of one such pressure faced by nursing staff in the NHS-the recruitment of a new grade of unqualified nurse, the `health care assistant' (HCA), onto local terms and conditions of employment. Drawing on case-study evidence, including pay data from a sample of nursing personnel records from two Trusts, this paper addresses two central issues. First, the recruitment of growing numbers of HCAs may increase wage inequality among nurses as managers are able to adapt local pay scales to the widening wage inequality external to the organisation. Second, the greater managerial autonomy associated with hiring HCAs on local pay scales may increase opportunities for managers to reassess traditional demarcations between qualified and unqualified nursing staff and to seek cost reductions through reducing the proportion of qualified staff employed.

Suggested Citation

  • Damian Grimshaw, 1999. "Changes in Skills-Mix and Pay Determination among the Nursing Workforce in the UK," Work, Employment & Society, British Sociological Association, vol. 13(2), pages 295-328, June.
  • Handle: RePEc:sae:woemps:v:13:y:1999:i:2:p:295-328

    Download full text from publisher

    File URL:
    Download Restriction: no


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Damian Grimshaw, 2000. "Public Sector Employment, Wage Inequality and the Gender Pay Ratio in the UK," International Review of Applied Economics, Taylor & Francis Journals, vol. 14(4), pages 427-448.
    2. Sharon C. Bolton, 2004. "A Simple Matter of Control? NHS Hospital Nurses and New Management," Journal of Management Studies, Wiley Blackwell, vol. 41(2), pages 317-333, March.

    More about this item


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:woemps:v:13:y:1999:i:2:p:295-328. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (SAGE Publications). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.