Evidencing 8a Work

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Evidencing 8a Work

Postby Mikel Arteta » Wed Sep 07, 2016 2:06 pm

Hi everyone,

I started a Band 7 Clinical Psychologist Post in July, working for an IAPT Team, delivering Step 4 therapy (highly complex clients) and doing various other duties (I won't bore everyone with the ins and outs!). As we do not have any other CPs in the team and the nearest other CPs within the trust were geographically quite far away, I was allowed to seek supervision with a CP working within a different trust.

I had my first supervision session last week and before this I kept thinking 'I think I am performing 8a duties here' but part of me thought 'maybe I'm not, maybe this is what I am supposed to do as a band 7'. However, I had one band 7 post before this (one year in duration) and I did not have anywhere near the responsibility I have now.

Before I met with my supervisor I had line management supervision and asked if there was any possibility of a preceptorship, she said there wasn't.

Anyway, I go to meet my supervisor who is an 8c and lovely, I really enjoyed supervision. She starts off saying 'you're an 8a, right?' (she had a bit of an idea of my duties as our services sometimes link up and I had met her previously during meetings). I clarified this and told her I was a 7. I then proceeded to tell her my duties and she said 'you're definitely performing an 8a role'. She added that she was in a similar situation when she was in an 8b post, but thought she was performing an 8c role, but evidenced this and got upgraded to an 8c.

My supervisor first checked if I felt comfortable performing my duties, which I said I fully was and felt it was easily within my competencies. She then advised me to try to find an 8a CP IAPT job description and start to gather evidence to prove that I am indeed performing the role of an 8a. I have not found such a job description yet, but did find various articles via the internet e.g. 'New Ways of Working for Psychological Therapists', 'National Profiles for CPs, Counsellors, & Psychotherapists' etc.

I have never been in this position so I was after some advice, such as:

- Are there any other documentation which would be useful?
- Is is possible for this to happen (grade change), as it did for my supervisor?
- How would I go about the process (and not annoying my bosses too much, as I am getting on very well with them!)?

Any advice would be gratefully received :)

Thanks you :)
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Re: Evidencing 8a Work

Postby alexh » Wed Sep 07, 2016 4:36 pm

Very interesting, I've never been through it but will chip in tuppence nonetheless.

Was the job underbanded in the advert (ie does it match your current duties) or are you doing more than the JD?

Are you in a position to apply for 8a posts elsewhere as a means of pushing it, even if you would really prefer to stay. Often it's the lever that really makes things happen. As for annoying your bosses, it's not personal it's professional. You are giving them an opportunity to retain you and avoid the cost and disruption of replacing you, whether that's in the short or long term. Staff who can obtain better pay for the same work do not tend to stick around.

My first impression from our IAPT teaching when the CP roles were described was that they ask a lot of their band 7s! I wonder therefore if you should only look at IAPT 8a roles or also at other 8a CP posts for comparison. Maybe all IAPT CP posts are underbanded. Do you know of any 8as in your IAPT service?

Does the trust have a rebanding/ band review policy, or have you had a look at the ones published by some trusts online? That can be helpful for showing managers that there is genuine merit to your suggestion.
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Re: Evidencing 8a Work

Postby lakeland » Wed Sep 07, 2016 5:22 pm

I had a preceptorship post, and really found little difference between Band 7 and Band 8A KSFs. Off the top of my head, I think there was one extra domain, and one with a higher rating for the 8A. I think we've had some discussion on here before about how 7s and 8As (and probably 8As and 8Bs) have a lot of overlap. IMHO, a lot depends on the service, and how defined your role is as a 'psychologist' compared to being a 'clinician' (thinking about the differences between inpatient and community services in my experience). How much of the differences you've noticed in your role are to do with working in a different service?

Practically, it's likely to depend on what they want from the post. Do they want the slightly higher level stuff an 8A might do (and what actually is that?) or do they want someone to see patients and get them discharged asap? Do they have difficulty recruiting to the service? If so, they're more likely to keep you. Also, what alexh said about your job description.

I suppose what you have to consider is the ever-shrinking NHS budget, and how a service may simply not have enough money to reband a post. Our Trust changed the rules on preceptorship posts a little while ago, probably because they'd like to have more posts at a 7 than an 8A!

Keep us posted!
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Re: Evidencing 8a Work

Postby Loula » Wed Sep 07, 2016 8:56 pm

My preceptorship post is just about to be signed off, and I am using KSF criteria to evidence that I'm going from a band 7 to an 8a. There are only 3 areas of difference- I can't remember the exact details but it is basically covered by supervision of others, delivering training and increased complexity. I'm happy to email you the KSF stuff if you pm me your email address.

Other people on here have discussed applying for a rebanding. I would probably start with collecting evidence of your current role and job description matched to the KSF.
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Re: Evidencing 8a Work

Postby Mikel Arteta » Sun Sep 11, 2016 2:51 pm

Hi Alex,

Thanks for your reply. The job description as they sometimes are is quite generic. There's a possibility they would argue their way around it, but I believe I am doing more than what I was employed for. Pretty much everyone from admin. through to all other band 7's (who seem to think I am a higher band) come to me with everything as I often get referred to as a 'senior member of the team' even though all the high intensity therapists are the same band. Underneath the clinical service manager, I am the top clinical person! This idea of me being more senior than my banding suggests is strengthened when the boss sends e-mails out saying such as 'I will be away on Tue.-Wed., any urgent clinical advice, please see Damian' - with such e-mails going to the whole team consisting of about 60 people.

I am trying to get hold of 8a IAPT job descriptions, but haven't found any yet an there are no others in the trust.

I didn't know much about rebanding/ band review policies, so will try to see if there is one.

Thanks.

Hi Lakeland,

There is a significant different from my year long first 7 post in CAMHS. Here I often knocked on the doors of the 8b asking advice and they would often 'sort out' difficult issues occurring. I didn't do this with the 8as as their roles were no different, but the clinical lead was looking to change this as this was being noticed by a lot of people.

My supervisor describes a 7 being a 'jobbing psychologist'. I think what she means by this is that you have certain duties e.g. assessment, interventions, research, etc. and you deliver this for the service.

Basically here, I deliver therapy for the most complex clients in the service, who are incredibly complex; the most difficult work I have carried out. I feel equipped for this and I am using every ounce of skill I have developed! This Step 4 therapy part of the service is new, so I have had to shape this by myself, in terms of who is accepted on to the waiting list, the referral process, the actual therapy process (e.g. pathway, length, etc.) an have delivered training to the whole team all about this. On top of this, I make decisions on the ambiguous referrals coming in to service, whether they are accepted or not. I have build relationships up with secondary care services with in particular regard to who is appropriate for them and vice versa an any discussions they have come to me. Any practitioner who has a really risk case and want to know what to do on the spot - comes to me. If there is deliberation on whether someone should be expedited up a list - I make the decision. Basically, I am doing a lot of internal an external consultancy way above what I did in CAMHS. I have complete control over the Step 4 therapy arm of the service and can make any decision I want. As discussed with my supervisor, I feel comfortable and competent doing this n my boss frequently tells me I am doing a really good job. The boss is really nice. She obviously does some of the above I talked about, but also does a lot of managerial duties; recruitment, budgets, etc., which I don't do. The boss will also often come to me when she is not sure and ask me to take a look at something and then I end up dealing with it. Also if a client rings up distressed or angry, it's always sent my way.

There is a duty system, but it feels like I am on daily duty :D I have also helped put into place having MDT meetings. And if I make comments that say for example, handling of risk is not done well enough (some practitioners are way too anxious about it), the boss will talk about her and I compiling policies together. I did a great job in CAMHS, but was just another practitioner, here I am almost number two!

But yes, Lakeland, you're right in that budgets are shrinking and lots of people are getting down banded, let alone up!

Thanks.

Loula,

That would be really useful, I'll PM you.

Thanks.

Thank you for everyone's advice, it is nice to have colleagues support :)
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you were only waiting for this moment to arise
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Re: Evidencing 8a Work

Postby BlueCat » Wed Sep 21, 2016 10:33 am

It can be a really tricky one. I had a similar situation, albeit many years ago, where I was definitely doing the role of an 8a in my band 7 post. I was leading on various initiatives, acting as a sounding board for other professionals, supervising trainees, contributing to ongoing research etc. My supervisors acknowledged that I was undertaking the role of an 8a, but there was no question of rebanding.

They were really nice about it, it wasn't at all conflictual, but it boiled down to:

Yes you are doing the role of an 8a, and you seem to be enjoying at and developing lots of good transferrable skills. However, we do not require you to do this. The way the service has been set up and the job role created does not require any of this of you. There isn't any funding for anything else. We'd really like to help you continue to develop within this role, and that means performing those sorts of duties. However, we want to be really clear that you are doing this as development, and we are acknowledging it is above and beyond the requirements of the role.

In your particular circumstance, Mikel, I wonder if there's a sense of the band 7 CBT practitioners as highly skilled practitioners within the core CBT model, and their banding reflects that. They will have had a lot more true-to-model training and supervision than you (unless training has changed significantly over the years) but much less breadth or skill to deal with complexity. And I wonder whether there's a sense of your role, the clinical psychologist, as maybe bringing more skill in complexity and formulation, being able to use a more integrative but still based-in-CBT approach, and the banding reflects that?

I think it is also important to hold on to the fact that a band 7 is not a low band, even if it is the entry band for our profession. It is the banding of team managers, senior nurses - for many people it is the pinnacle of their career. I have found that there are clear service differences. Some services simply don't appoint more highly banded people. Sometimes the service model is set up, and the funding is fixed, and that's that. It may also be that the requests being made to you aren't part of how the job role was envisaged when it was set up, but something that is being requested of you (rather than required of the role). This might seem all a bit semantic, but it was one of the guiding principles of A4C - the job role requirements are what is banded, not the person doing them. It may be that your new supervisor is referring back to the beginning of the implementation of A4C (which wasn't really all that long ago in some places) when there was quite often a bit of a reshuffle following bandings (in some places it wasn't fully rolled out until 2008-2009).

I'm not saying don't bother, or suck it up. I guess I'm trying to highlight that it isn't so much what you're DOING, it is more what the role REQUIRES and how the service has been set up that will be the deciding factor. After all, there's always that lovely little "and other duties as requested by management" at the end of every job description that can cover anything at all.

Good luck.
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Re: Evidencing 8a Work

Postby maven » Wed Sep 21, 2016 12:24 pm

Unless you have supervision or line management of other qualified staff, I think you will struggle to justify uplifting a post that is banded the same as many parallel posts across the UK. But there is no harm in trying.
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Re: Evidencing 8a Work

Postby baa » Sun Sep 25, 2016 8:21 pm

maven wrote:Unless you have supervision or line management of other qualified staff, I think you will struggle to justify uplifting a post that is banded the same as many parallel posts across the UK. But there is no harm in trying.


Definitely no harm in trying, but bear in mind that band 7 therapists in iapt supervise other band 7 qualified therapists, and triage referrals, and some line managers in some trusts are also band 7s. Also, if you (one) generally have more experience than others, then you end up being the go to for informal consultancy or risk issues.

Additionally, in my team, if you have an extra skill for some reason (therapy training in another modality) then you do tend to get more control over pathways /lists etc.
At least I'm not as mad as that one!
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