Money management

Careers in healthcare no longer mean careers exclusively in the NHS. National pay awards, continuity of employment and an enviable pension scheme can no longer be taken for granted.

Many staff, from front-line to senior management, are finding themselves in unfamiliar territory as they try to understand and protect their financial future.

Primary care provides the most visible example of this seismic shift in the career pattern of health service workers. Many staff in community services are facing the prospect of working for new provider organisations at some point in their careers. Social enterprises and limited companies are being formed as vehicles for services; private companies are tendering for NHS services; and voluntary sector organisations are increasing their share of care provision, all encouraged by government policies aimed at creating a competitive provider market.

Private nursing and care homes already employ large numbers of nurses and care assistants, and the proportion of workers providing NHS-commissioned services from outside the NHS is clearly set to increase.

Community nurses are one group that is increasingly concerned about the personal financial implications of these developments. Temporary TUPE arrangements that protect current terms and conditions for a limited period are helpful, but staff are aware that these will not last, and will not protect them when they move on to a new job.

Nurses directly employed by GPs have long recognised that their decision to work outside the NHS can affect their financial future. For many years they were unable to join the NHS Pension Scheme, and most have a gap in their contributions as a result. Now district nurses, health visitors and other community staff are becoming aware that changing employers can mean more than a change of logo on the badge and new corporate notepaper.

Recognising the need for practical help on financial matters tailored to nurses in this position, community nursing charity The Queen's Nursing Institute has produced a free CD-Rom, Money Management - QNI resource for community nurses.

The CD encourages nurses to tackle a review of their personal financial review as they would approach a new patient: first assessing the status quo, then planning and implementing changes and finally evaluating the impact of their actions.

Financial advice

Live links to reputable external bodies such as the NHS Pensions Agency (to calculate likely pension income) and the Citizen's Advice Bureau ensure that financial information is given by appropriately qualified people, and is constantly updated. Topics covered include working for GPs and non-NHS providers, becoming a nurse partner, coping with student debt, checking your National Insurance contributions, insuring against illness and taking early retirement.

The information is straightforward and objective, recognising that, while some people are worried about the future, others see opportunities in the changes, and are interested in exploring life outside of the NHS cocoon for the first time.

For HR managers, providing the CD offers an opportunity to highlight to staff the importance of being aware of their own situation, and of taking responsibility for it. By giving them a practical tool to do so, the organisation can help to support staff morale in the face of change, and encourage its entrepreneurs to take their first steps towards a very different future.

More than 1,000 copies of the CD have been sent out on request since it was launched in April, it is a big draw at conference exhibition stands, and some NHS organisations have made bulk orders for distribution to their staff. The CD was featured on BBC 2's Working Lunch programme, and it has been shortlisted for the Third Sector Excellence Awards.

Encouragingly, 80 per cent of users who returned an evaluation form said that they were planning to review their finances as a result of using the CD, and 95 per cent found it easy to use. As one of its aims is to give the users more confidence in dealing with their financial and employment issues, and to restore a sense of control over their situation, this is good news.