Full details of nurses' contentious CBA deal with KNH management

When KNH Nurses went on strike in 2020. [Boniface Okendo, Standard]

A court battle pitting nurses against both Kenyatta National Hospital and the Salaries and Remuneration Commission (SRC) now deepens the standoff over implementation of a collective bargaining agreement (CBA) signed in favour of health workers.

Nurses want the court to order the hospital and the commission to recognise new terms in the CBA signed last year.

The Kenya National Union of Nurses (Knun) and KNH signed the CBA on December 20, 2023.

Employment terms

According to the CBA, nurses would be employed under contract, permanent and pensionable terms.

The KNH Chief Executive Officer, however, could second some of the hospital’s nurses to other health facilities within the country for a period not exceeding three years.

Under the agreement, the nurses would retain their rights at the facility including the remittance of pension, salary and allowances.

The secondment will, however, be regulated in the context of relevant pension legislation while the nurses will be eligible for promotion at the facilities. Any nurse selected for deployment outside Kenya would work in line with the hospital policies and government regulations.

Probation and letters of appointment are to be guided by KNH’s Human Resource Policies and Guidelines Manual, 2019, and other provisions of the law.

Under career progression, there are two grades for enrolled nurses and eight grades for nursing officers.

First category

In the first category, certificate holders will be designated as enrolled nurses under the KNH11 (K10) job group or senior enrolled nurses under KNH10 (K9).

In the second category, registered nurses with diploma, higher diploma and degree certificates will fall in eight grades.

Diploma holders will be employed under job groups KNH10/9/8 where they will earn a minimum of Sh52,927 and a maximum of Sh137,080.

Higher diploma holders will be employed under job groups KNH9/8/7 earning a minimum of Sh63,748 and a maximum of Sh160,267.

Nursing officer, senior nursing officer and principal nursing officer with degree certificates will be under job groups KNH/8/7/6 earning a minimum of Sh65,884 and a maximum of Sh160,267.

Diploma holders will be employed directly under the KNH10 group while higher diploma holders under KNH9 and degree holders under KNH8.

New grade

Incremental credit is to be awarded at the rate of one increment for each completed year of relevant experience of service provided maximum points in the scale are not exceeded.

In case one is promoted to another job group where they find themselves earning less than the minimum salary in the job group, then they will receive the minimum salary attached to the new grade effective immediately. In case they are promoted on the day preceding the effective date of their promotion one point immediately below the salary scale, then they will get the salary attached to the new grade effective date of promotion.

In the event a nurse is promoted to a new grade where they earn more than the maximum salary, then their earnings will be determined by different factors.

Accommodation allowance will be at the rates provided by the government and shall be paid for a continuous period of 28 days.

A foreigner employed as a nurse will be eligible for accommodation allowance at rates applicable to the grade for themselves, spouse and children for a period not exceeding 30 days but subject to KNH’s board approval.

Rented accommodation

At the end of the tour, a nurse may continue to draw salary for a period not exceeding 30 days when they must vacate the rented accommodation in advance of leaving the country.

Nurses are to get telephone allowance at rates determined by government guidelines. For deployment outside the country, the government is to make sure the sponsor takes care of all their transport and allowance in its guidelines and they are to earn hourly from the day they leave the country.

There will be reviews to ensure that Knun members are comfortable in the places deployed.

In case one is appointed to act in a higher capacity, the allowance shall be paid at the rate of 20 per cent of their substantive basic salary or as determined by the government.

If one ceases to act before 15 days, then they will not get paid but the days they were in acting capacity will count in the next deployment to get to 30 days to qualify for pay.

They will also qualify for all privileges and allowances attached to the post but not house allowance.

If they are away from work for less than 30 consecutive days due to an urgent annual or sick leave, the period shall not be regarded as a break in acting capacity and upon duty resumption they shall continue to act again.

In the event one is appointed to a duty where additional responsibilities are more than their own for more than 30 days, then they shall be eligible for special duty pay.

The pay will also be extended to nurses supposed to take over higher post duties but are disqualified due to lack of qualification or experience.

The special duty pay shall be paid at 15 per cent of the nurse’s basic salary and they shall hold the position for a period not exceeding six months. In the event the position is not filled, the CEO can extend the term for not more than six months.

Nurses will miss out on the pay if they are away from work for more than 30 days. They shall be eligible for subsistence and travel allowance payable to the office but they shall miss out on house allowance and other allowances assigned to it.

All nurses appointed by the CEO to perform extraneous duties will be given pay at the government rates and will qualify for meal allowance.

Extraneous duties

Nurses proceeding on leave will get an allowance once a year and it will be paid through the payroll at 30 per cent of their salary capped at a maximum of Sh50,000 as approved by the Salaries and Remuneration Commission (SRC).

Their leave period is for 30 days.

They will be given a commuter allowance in the event KNH does not provide transport and will be paid a Sh5,000 health risk allowance as per the SRC circular.

All permanent and contracted nurses shall be eligible for house allowances applicable to their grades and the health workers’ service allowance eligible to their cadres based on government circulars.

Uniform allowance

They will also get a uniform allowance capped at Sh15,000 for all job groups and a car loan and mortgages managed by KNH as advised by SRC.

Promotions will be effective from the approval date and based on performance. Nurses will be expected to work for 36 to 40 hours a week and any extra work should be compensated through grant of off-duty.

The facility will also be required to have a station for breastfeeding mothers and grant them break intervals and time off for meals to breastfeed.

KNH shall provide a safe working environment.

When a nurse retires, then the facility will meet their transport cost needs to the retirement destination.

The CEO’s vehicle with a 2,500cc capacity and below may be used for official duties with their permission and the users are to be reimbursed at a rate approved by the Automobile Association of Kenya. KNH shall offer training based on its needs to the nurses for at least five days a year and will assist them get scholarships for short courses of less than three months and long courses of more than three months. When trained by the facility, one shall be bound as follows: a year for six months to one-year training; two years for one to two-year training; and three years for two to three-year training.

Any training above three years will see one bound for a period not exceeding five years.

Female nurses will get 90 days of maternity leave with full pay exclusive of untaken leave days and in case one loses her pregnancy, she will be entitled to a 45-day leave.

Adoption leave

They will also be eligible for adoption leave of 60 days if the child is under five years, 45 days if the child is between five and 10 years and 20 days if the child is older than 10.

Male nurses will be eligible for paternity leave for a maximum of 14 days and in case they have more than one wife, they have to produce a certificate of marriage. For sick leave, nurses will be on full pay for three months and half pay for three months and after that no pay.

They will be also eligible for compassionate leave for 10 days, emergency leave, study leave, special leave for sportsmen and leave for special purposes.

They will also be eligible for 14-day disembarkation leave for a trip abroad lasting more than six and leave pending retirement. KNH shall provide in-patient and out-patient medical insurance schemes for the nurses, their spouses and up to four dependent children below 22 years and any treatment sought outside the country is based on the board’s approval.

Despite the mandatory retirement age being 60 years, nurses can opt for early retirement once they hit 50 and will be required to give a month’s notice.

Nurses with disabilities will retire at 65 years and mandatory retired nurses will continue to be under KNH’s medical scheme for five years.

Medical complication

In case a medical issue causes one to seek retirement, then it shall be under the CEO’s approval after examination by the medical board.

For resignation which is subject to acceptance, nurses will be required to give a month’s notice and before exit, they will be required to pay all monies/liabilities owed to the facility.

Redundancy shall be per the Employment Act and for termination of the contract, KNH management can do so under various causes.

When a nurse dies, KNH will transport their belongings to the place of burial and contribute towards funeral and coffin expenses.