Draft plan for London & Eastern High Cost Area Supplement Campaign

Draft plan for London & Eastern High Cost Area Supplement Campaign

This plan was presented to the London & Eastern Health Combine and RISC in January and February. Guys and St Thomas Hospitals Branch proposed the motion for a HCAS campaign that was passed at the RISC.

Introduction

What is the High Cost Area Supplement?

The High Cost Area Supplement (HCAS), sometimes referred to as “London Weighting” is additional payment made to NHS workers who work in London and the surrounding areas. It was implemented as part of Agenda for Change, and was aimed to establish equity among the various forms of additional pay that were implemented across London hospitals.

HCAS is divided in to three areas:

Area	2025/26 pay rate
Inner London	20% subject to a minimum payment of £5,609 and a maximum of £8,466 per annum
Outer London	15% subject to a minimum payment of £4,714 and a maximum of £5,941 per annum.
Fringe	5% subject to a minimum payment of £1,303 and a maximum payment of £2,198 per annum.

The areas it covered are based on the boundaries of old Primary Care Trusts and Strategic Health Authorities, organisations which no longer exist and have been replaced by Integrated Care Boards (ICBs).

Problems with HCAS

Boundaries no longer reflect NHS organisation

HCAS was implemented in 2004, and has not been updated since. It has not been updated to reflect the fact that organisations which its areas applied, to no longer exist. A two decade of NHS cuts, privatisations, mergers and regional and national reorganisations have reshaped the NHS, and meant the boundaries do not reflect the current lay out of services and workplaces.

Barts Trust includes staff at The Royal London Hospital, and Newham Hospital. Royal London is in inner London, while Newham is in Outer London, creating pay inequalities within one NHS organisation.

Does not match rising cost of living

Nor has it not been updated to reflect the rising cost of living, which has risen hugely in London over the past two decades. While 20 years ago there may have been some difference in living costs to justify the different pay areas, now all of London is expensive to live in, and NHS workers either have to pay extortionate rents and struggle to pay their bills, or live on the outskirts of London, with long commutes to work on top of long shifts.

Regions around London have similar cost of living, but are not in HCAS

Surrounding towns and cities have also seen huge rises in the cost of living, and they are completely exempt from HCAS. The rising cost of living necessitates additional pay arrangements for those areas being created to compensate NHS workers for the rising costs there. NHS workers in these towns and cities in London & Eastern, and South Eastern regions have the highest cost of living in the country, but no compensation.

What are Unite’s demands?

Campaigning around the issue of HCAS can mobilise a large swathe of NHS workers, if we have demands which give them something to fight for. 

This necessitates demands to expand coverage of HCAS to surrounding regions, giving those outside its catchment area a reason to join the campaign, and demands to eliminate the inequality present in the current arrangements so workers across London’s boroughs will mobilise.

Draft demands

1. Renew HCAS - raise the HCAS rate, and expand its coverage
2. Redraw the boundaries - One rate for all the London Boroughs
3. Raise the rate, remove the cap - raise the London rate by 10%, remove the salary cap so workers receive all of the additional pay.
4. HCAS for Eastern and South Eastern regions - towns and cities surrounding London and in those regions to have their own HCAS rates

How shall we campaign?

The campaign should be organised through the LE combine, with all branches asked to send delegates to LE Combine meetings so that they are included in campaign planning and can report back on developments and local progress.

The Combines work can be reported back to the RISC, and oversight provided there.

1. Petition

Unite L&E should launch a petition asking NHS workers if they support the demands of the campaign, and if they are willing to take strike action to win these demands.

This can be an online and paper petition. The aim will be to secure 5000 signatures across Unite’s London & Eastern membership over the next two months, and present these signatures to the DOH in an action in March/April.

2. Leafleting

L&E to produce a model leaflet two-sided leaflet containing information about campaign, with space for branches to add their own specific local issues. Branches to be responsible for leafleting and petitioning their members.

3. Meetings

Branches to organise local meetings about the HCAS campaign in February, and L&E to hold a London wide meeting for reps and members in March, to prepare members for balloting on the issue as part of the national pay campaign.

4. Protests

L&E Reps to organise a protest march for HCAS renewal in March. Reps to book the day off, and take part in protest march from a hospital to DOH to deliver signatures and dispute letter. Propose we use St Thomas Hospital as starting point for march. Aim to mobilise 40-50 reps to protest, plus any members who can attend.

Rallies can be organised locally at NHS Trusts to build support for the campaign

Further protests can be held as the campaign develops; other targets could be:

• Meetings where Wes Streeting is attending
• Labour Party HQ
• NHS Trust offices

5. Ballot

L&E Region to formally open dispute with DOH in March, so that issue can be included on consultative ballots alongside national pay and cuts, and so we can proceed with ballot if other regions do not want to campaign.

Map of HCAS areas: