Health unions are warning of a growing “two tier workforce” as social enterprises replace NHS terms and conditions with their own employment packages.

HSJ’s sister title Nursing Times surveyed 21 of 25 known social enterprises taking on community services. More than 9,000 registered community nurses and healthcare support workers were transferred to these organisations.

Transferred NHS staff keep their Agenda for Change terms and conditions under protection of employment laws and remain members of the NHS pension scheme. But new staff can be employed under different terms and conditions.

However, half the social enterprises told Nursing Times they would offer new staff “NHS equivalent” terms and conditions. Only one social enterprise can offer the NHS pension scheme to new staff after the Department of Health ruled this out for the others.

Unite professional officer for health David Munday warned the situation would  create a “two tier workforce”.

He said: “It is extremely destabilising, very poor for morale and actually very unfair.”

Unison policy officer Guy Collis said transfers of community services to social enterprises have been given by management rather than staff.

Sirona Health and Care in Bath and North East Somerset has taken on NHS and local authority staff as an integrated provider. Chief executive Janet Rowse admitted staff were not in favour of the move.