The second year of the 2018 pay deal for staff covered by the NHS Terms and Conditions of Service will continue to ensure that all directly employed NHS staff will be earning more than the Living Wage Foundation’s Real Living Wage rate in 2019/20. Anthony Hassall, chief accountable officer at NHS Salford Clinical Commissioning Group, one of only 15 NHS organistions in England to be accredited by the Living Wage Foundation, explains some of the issues that the Real Living Wage raises for NHS leaders considering signing up to this standard.
It’s fair to say that the real driver for Salford CCG’s interest in the Real Living Wage was our growing and developing relationship with Salford Council. Salford City Council is one of the 97 out of 418 local authorities across the UK accredited by the Living Wage Foundation. Closer partnership working over several years has meant that at NHS Salford CCG we are adopting more common standards with Salford City Council and continually looking at our role as an anchor organisation to consider anything we can do to make our communities healthier. Together we have acknowledged that nothing contributes more to the health and wellbeing of our population than stable work and fair pay.
The Living Wage Foundation Real Living Wage rates are announced at the beginning of November each year. The expectation is that employers should implement the rise as soon as possible. The 2018 NHS Terms and Conditions three year pay deal has so far delivered a rate of pay above the Real Living Wage rates for the financial years 2018/19 and 2019/20 for staff directly employed by NHS organisations, and we are hopeful it will continue to do so in future years.
We are well on the way to this standard for NHS directly employed staff in Salford, however we still have more work to do in relation to the pay rates within our whole supply chain. We are keen to deliver against the true intent of what the Real Living Wage means in Salford, and this means looking at the pay rates of those from whom we commission health, care and support services – a vast array of NHS, third sector and private sector organisations.
Living our values
Some of this is about living our values. If we recognise that proper work and fair pay is essential for healthy communities then we need to walk the talk. But the strongest argument is that this is just good employment practice. Paying a Real Living Wage has significant benefits in reducing staff turnover and in attracting good staff to work in Salford’s health and care system. That’s the best argument and the one that should resonate with NHS organisations across England.
Our work so far doesn’t mean that every member of staff in the health and care system in Salford is paid at Real Living Wage levels yet. We don’t have direct influence over things like pharmacy or dentistry for example. But we have begun to look methodically at our supply chain, starting with the organisations where we spend the most or have greatest direct influence.
Currently only one in ten GP practices in Salford are Real Living Wage Employers. From 2019 we are saying to GPs that to access additional funding they will need to meet the ‘Salford Standard’, a set of requirements we have for commissioning additional services from GPs, and from April 2019 demonstrating action towards paying the Real Living Wage will be one of those requirements.
Care homes in Salford are another area where this is not straightforward. We can have good conversations about moving staff to the Real Living Wage with locally-based care homes, but those run by national or regional providers are more difficult to influence.
We’re acutely aware of the pay differential between staff employed by NHS and Social Care organisations. We know that ADASS has estimated that bringing social care pay up to NHS levels would cost £3 billion - so this is a bigger issue than we can resolve locally. I’ve heard people say that they believe that it’s helpful for NHS organisations to maintain a pay differential to encourage good people into the NHS, that if you have a choice of being a cleaner in a hospital or working in domicillary care, the pay differential is useful. For me this organisational focus misses what we are trying to achieve in Salford. It’s not about individual organisations’ priorities, but about what our whole system can do together to improve the whole health of our community.
For me, this is about reducing health inequalities and about good employment practice. It’s about the gains that we see for our system from improved staff retention, reduced turnover, stability and a more skilled and motivated workforce. It is also about leading by example and using the power of being a large employer to address wealth, and therefore health, inequalities in our local communities. These arguments are as valid in Bath, Bedford and Birmingham as they are in Salford.
For more on UK wage rates, visit the Living Wage Foundation's webpage that compares the minimum wage, the national living wage and the Real Living Wage by clicking here.
Anthony Hassall is chief accountable officer at Salford CCG and a leader in the Greater Manchester Health and Care Partnership. He is also a board member at NHS Clinical Commissioners. You can follow him on Twitter @AntHassallNHS