Closing the health and wellbeing “gap” for frontline and essential workers

(Updated 7 July 2022)

Introduction

“The COVID pandemic has been trying and stressful for all of us.  But while many of the big City institutions have looked after their employees well, it is easy to forget that the City also has a legion of frontline workers, often not employed directly by the firms whose offices they clean, or to whom they provide security or courier services.  For them, COVID has probably been tougher than for the typical banker, fund manager, accountant or lawyer.

…I hope we can come up with some solid proposals to extend the great work we already do to look after our direct employees into our supply chains.  That includes also for those people who provide us with contracted-out services.  At the simplest level, for example, can they use our Employee Assistance Programmes? Can we use our purchasing power to give them discounted gym memberships or other benefits?  What else could we be doing?”

– Nigel Wilson, Chief Executive Officer at Legal & General Group’s opening address to the event focusing on “Closing the health and wellbeing “gap” for frontline and essential workers”, which took place on 22 November 2021.

When people think of a City worker, the image that typically springs to mind is that of someone dressed in a suit, who works at a desk and may be on a higher income.

While many City workers may fit this description, there is a large group of the workforce in routine, manual and service roles – our security staff, cleaners, construction workers, hospitality, and facilities management staff, for example – who are on lower incomes, may be on more insecure employment contracts (e.g. zero hours) and who, in many cases provide their essential services often behind the scenes and outside of normal office hours.

Without them, the City of London’s businesses would not be able to function.

Background

The COVID-19 pandemic has highlighted that all City firms and organisations rely upon an essential workforce that is often “unseen”.

The frontline and essential workforce comprises of people who were usually not able to work remotely due to the nature of their roles, and yet they provide essential functions without which few organisations can function.

In addition, because they are often not directly employed by the organisations on whose sites they work, they can find it difficult to access workplace health and wellbeing benefits offered to direct employees.

Compared with other groups within the workforce, essential and frontline workers are more likely to experience a health and wellbeing “gap” (also known as health inequalities).

Even before the COVID-19 pandemic, the frontline and essential workforce often experienced the poorest health and other inequalities within our society, and in many cases, COVID-19 has made this worse. Higher rates of severe COVID-19-related disease and death have been seen in individuals in public-facing and routine, manual, and service roles, and especially where they were also from Black, Asian, or ethnic minority backgrounds (1) (2).

Even pre-pandemic, this group of workers has often struggled to access support for their health and wellbeing at their place of work in the same way that their desk-based counterparts often can. People working night shift or “unsocial” working hours may also find it more problematic to access leisure or health/ support services. This is despite UK Health and Safety law making clear that businesses have responsibility for the health and safety of all individuals working on their sites, whether they are employees or not. All of these factors are contributing to increasing the inequalities – the health and wellbeing hap – faced by this group of workers, and this has impacts on businesses, too.

Wider strategic context

Prior to the pandemic, the City of London Corporation’s Public Health, Environmental Health, and Community Safety teams had been engaged in efforts to raise awareness of the health and wellbeing needs of City workers in routine, service and manual roles among City businesses. The pandemic has shown the need for this work to continue, and to do so in a collaborative way, and the City Corporation, City Mental Health Alliance, and the Lord Mayor’s Appeal have joined up, along with other key stakeholders, to explore how.

Beyond the City specifically, helping Londoners into “Good Work” is one of the nine “mission areas” outlined in the London Recovery Board’s plans for the capital’s post-pandemic recovery (3). A policy focus on “supporting those hit hardest by the pandemic, including BAME Londoners and other groups facing deep-rooted inequalities” is outlined as one of the Recovery Board’s longer-term ambitions.

In addition, the CBI’s “Seize the Moment” post-COVID recovery campaign (launched May 2021) explicitly includes reducing health inequalities within its key aims, and the important role employers have in this.

The UK Government has demonstrated that tackling health inequalities is a core priority, with the creation of the Office of Health Improvement and Disparities in October 2021, within the Department of Health and Social Care.

In April 2022 the UCL Insitute of Health Equity and Legal & General published a major report looking at the evidence of how businesses affect our health, and what they can do to help close the health and wellbeing “gap”.

Further background

According to the Business Register and Employment Survey (BRES) (4), there are roughly 8,000 workers in the City of London in security, facilities support and cleaning roles. Across London, it’s estimated that 21% of the total workforce is employed in caring, leisure, service, sales and customer service and elementary occupations, as well as taxi drivers and private hire vehicle drivers, and others.

What are we hoping to achieve?

We want to close the health and wellbeing gap for frontline and essential workers. Our ambition is to contribute to local and national efforts to reduce health inequalities and reduce sickness/ absenteeism in the workforce, specifically among those in routine, service and manual roles in the City of London.

There are three key ways we aim to do this:

• Raise awareness of the vital role that the frontline and essential workforce plays in the functioning of City and that by reducing health inequalities the City will function more effectively and cohesively promoting corporate social responsibility (CSR). The positive image of the City as location where the health and wellbeing needs of all workers are considered including, routine, service, and manual workers in the City, when they are at their place of work. The target audience for this element is City firms contracting in relevant services, as well as the direct employers of these workers themselves.
• Identify and share best practice of where businesses are working to promote the health of all of their workforce including the frontline and essential workers and reduce health inequalities among routine, service, and manual workers, to champion the approach, lead by example and to support a long-term and sustained culture change. It is hoped that this culture change supports wider efforts around workforce sustainability and a move away from a “race to the bottom”. See a case study below, from the Bank of England, as an example.
• Make sure that routine, service, and manual workers themselves are aware of free health and wellbeing services available, and that they are accessible including at times convenient to shift workers, through mapping existing services (such as those listed below), and signposting to them. This may also include any on-site services made available to workers by businesses, for example, extension of their Employee Assistance Programmes, or on-site gyms, to contractors.
  

As well as satisfying organisational responsibilities around Health, Safety, and Wellbeing, these ambitions align with other areas of organisational focus, such as Equality and Diversity, and Corporate Social Responsibility.

In addition to addressing and reducing health inequalities, this work has important considerations for businesses with regards to practices within their supply chains, and a recognition that a happy, healthy and respected workforce that is treated well is ultimately a more productive one.

What benefits are there to a supporting organisation?

In addition the benefits outlined above, this is a unique opportunity for an organisation to lead by example, directly contributing to the local, pan-London and national efforts to building back better and fairer post-pandemic, to demonstrate CSR in practice, and to set a precedent – all with the clear support of convening institutions such as Legal & General, PwC, the Lord Mayor’s Appeal, City Mental Health Alliance and City of London Corporation.

Stakeholders

A small working group has been established, comprising of representation from the City Corporation’s Public Health team, the City Mental Health Alliance, the Lord Mayor’s Appeal, Greater London Authority, Public Health England London, and large City employers including Legal and General, PwC, the Bank of England and Baker McKenzie.

Other large City firms have been engaged in preliminary discussions on this project.

In addition, engagement and partnership with the following groups of key stakeholders is essential to gaining insights and expertise, and driving the successes of a three-step process:

• Large City firms (HR/ Health & Safety/ Procurement/ Facilities Management/ Operations leads and senior leadership)
• Facilities Management companies
• Property Management companies
• City of London commercial landlords
  

Existing resources

A number of free resources and services are already available to support the health and wellbeing of the frontline and essential workforce, and businesses can signpost workers to them.

An important feature of this work is to signpost workers to this support, as well as identify other evidence-based, quality and free resources that can be included within this list.

• A list of actions businesses might like to consider in supporting their frontline and essential workforce can be accessed here.
• The City Wellbeing Centre
• City Advice
• Thrive LDN
• Good Thinking
• Doctors of the World’s “Six ways to improve your wellbeing” guidance (available in 27 languages)
• Dragon Café in the City

 

Case study: Bank of England

What does it mean to work hand in hand with our “Hidden Workforce”?

• Always use language consistently that equates our contractors at the same position as their equivalent Bank colleagues – the “One Bank” approach
• Bank procurement policy for minimum National Living Wage as a starting point for salary for out of London offices and LLW for within London
• Regular Bank/contractor management dialogue to understand and resolve issues.
• COVID response – decreasing hours of both Bank and Contractor team whilst maintaining salary
• Zero tolerance for Bank staff not treating any contractor with respect. Contractors are advised they can report any such behaviour
• Provide good facilities for our contractors such as office space, cloakroom facilities, ability to join our Gym at Bank staff rate
• Allow all our London Living Wage/ National Living Wage contractors to purchase food in the Bank at the Bank staff tariff

Some initiatives we have put into practice:

• Encourage contractors to participate alongside Bank staff in the Lord Mayor’s Show (this has been happening annually this we entered five years ago)
• Hold annual “Cleaner of the Year” award, where Bank staff vote with a Christmas breakfast provided for all staff
• Raising contractors’ profile on internal platform. Template supplied to all staff with key questions.
• Included in a Bank award as they made up part of a team that would normally only be carried out by Bank staff
• Recognition at senior level in the Bank via various platforms

Case study: Sir Robert McAlpine

Large construction firm Sir Robert McAlpine partnered with the City of London and Hackney Public Health team, local NHS and Clinical Commissioning Group, and OHID, to deliver COVID-19 vaccines to its workforce in 2022. Read the case study here.

 

References:

(1) “COVID-19 related deaths by occupation, England and Wales”- Office of National Statistics, January 2021

(2) “Initial assessment of London bus driver mortality from COVID-19”- UCL Institute of Health Equity, 2020

(3) “Helping Londoners into Good Work” – Mayor of London/ London Assembly

(4) “Business Register and Employment Survey” – ONS