Health Anchors in London and the London Living Wage

The rising cost of living is affecting millions of people across the UK. In recognition of the role the NHS can play in creating ‘good quality work’, NHS anchors in London are increasing their efforts to become London Living Wage employers. This blog outlines the work underway across London as part of Living Wage Week 2022.

Guest blog by Gabriela Griggs and Josephine Fletcher, part of the NHS London Anchor Programme Team, based within Health Education England.

Why is the London Living Wage important?

In 2021, Citizens UK and Trusts for London launched the ‘Making London a Living Wage City' campaign. Working with the Mayor of London, the campaign aims to lift tens of thousands out of in-work poverty by boosting the number of accredited Living Wage workplaces.

The London Living Wage (LLW) is currently set at £11.95 per hour (Living Wage Foundation 2022). This rate is calculated independently by the Resolution Foundation and overseen by the Living Wage Commission. The rate reflects London’s high cost of living, allowing London workers and their families to afford necessities and save for the future.

Accredited organisations voluntarily pay their employees the LLW, which is higher than the statutory minimum wage. Existing research on the employer benefits of the LLW includes reduced employee turnover, reduced absenteeism, and strengthened recruitment opportunities (Coulson and Bonner 2015). The new living wage rate for 2022-23 was announced in September, with a significant rise on previous years to reflect the current inflation rate.

While directly employed staff working for NHS Trusts and community health services in London are paid on NHS Agenda for Change pay scales, starting at £12.47 per hour in outer London (NHS Employers 2022), many thousands of outsourced staff are not. These include staff recognised as key workers over the pandemic, such as cleaners, porters, and caterers. The rising cost of living is widening the gap between how much they earn and what they can afford, from heating costs to food bills. Between June and September 2022, adults in London were more likely than in other regions across Great Britain to be behind on their rent, mortgage, and energy payments (Office for National Statistics 2022).

While there is a clear case for NHS employers to act, getting there takes work. NHS Trusts encounter several barriers, including funding where there are other commitments, getting buy-in from colleagues internally, collecting accurate workforce data from suppliers, implementing the pay uplift, and maintaining accredited status.

Overcoming these challenges, however, is possible and necessary. Health and care organisations - including NHS Trusts and primary care organisations – need to support their staff by doing all they can to lift them out of in-work poverty. Moreover, paying staff the LLW will have an immediate and long-lasting impact benefiting communities throughout London.

Action on the London Living Wage

The Mayor of London’s Good Work Standard was launched in 2019 to accredit UK businesses as good employers. This voluntary accreditation measures against a set of criteria, which include paying at least the London Living Wage as well as workplace wellbeing, skills, progression, and building a diverse and inclusive workforce.

Elsewhere, the Making London a Living Wage City campaign brings partners across the city to work strategically together, supporting each other to drive change through action plans across industrial sectors, including health and care.

The NHS in London has agreed on a target of 75% of Trusts to be accredited or on the journey to accreditation, with 100% of NHS organisations across the capital to commit in principle by the end of March 2023.

To date, 13 out of 35 NHS Trusts have been accredited as LLW employers alongside at least 28 primary care organisations. Many others are working towards becoming accredited. As of this year, all five Southeast London Integrated Care System trusts have achieved accreditation.

The NHS Agenda for Change pay scale does not apply to most staff employed in general practice. Understanding which roles are paid below the LLW threshold is limited and merits further research. For example, the pay scales for administrators and receptionists will vary significantly by practice and London borough. The newly established Primary Care Anchor Network is seeking to investigate this further, along with the unique opportunities and support needed to implement the LLW for staff working in primary care settings.

In addition, some ICSs are beginning to set out ambitions to become recognised as ‘living wage systems,’ fostering ‘living wage places’; two examples are the South London Listens and North Central London Integrated Care System. This approach is likely to increase the uptake of the LLW through proactive local leadership, the development of action plans, and close partnership working.

Case study: the South London and Maudsley experience

David Bradley, Chief Executive of South London and Maudsley NHS Foundation Trust, talked to us about their journey to making the Trust a Living Wage employer.

“I am proud that we pay all our staff the London Living Wage,” he said. “We have done so since February 2020, and it means that all our London-based employees, both those employed directly by contractors and by us, earn enough money to meet the capital's cost of living. This is more important than ever to ensure people receive fair pay and can benefit from good quality work.

“We became a London Living Wage employer one month before the Covid-19 pandemic exposed deep inequalities in our society – not just in access to healthcare and services but also through work and job security. As a founding member of South London Listens – a unique partnership programme to prevent a mental ill-health crisis - we heard first-hand how low wages and insecure work impacted the mental health of our communities.

"We all know that poverty fuels ill health. As NHS organisations, we need to do all we can to break this cycle and prevent people from becoming unwell."

Get involved!

Lizzie Smith, Regional Director for Health Education England (HEE) in London and NHS London Anchor programme SRO said, "The implementation of the London Living Wage is a key strand of the anchors' programme across the NHS in London. The financial constraints across the sector are significant, but the lowest paid in our workforce must not be further disadvantaged as a result. 

“If we are to tackle health and wider inequalities and create a sustainable health and care system for the capital, we must pay all who contribute a fair wage. We've set ourselves challenging targets to achieve; we're proud of our progress but have a lot more to do."

The Living Wage Foundation has a toolkit for NHS employers who want to implement the Living Wage in their contexts.

You can contact the authors at: josephine.fletcher@hee.nhs.uk and Gabriela.Griggs@hee.nhs.uk