Doctors who work in London are campaigning for an increase to the allowance they receive for living and working in the capital that has not risen in more than 20 years despite the cost of everything having gone up considerably in this time.
London Weighting is an additional payment to a worker’s salary to address the added expense of working in London. This payment has not gone up for doctors since 2005, despite a significant increase in the cost of living in the last two decades – despite other sectors, including the civil service and other parts of the NHS, raising the payment accordingly. BMA London is now launching an online indicative ballot to assess doctors’ readiness to take further action if the allowance is not raised. The indicative ballot will open on Monday 19th October and run for six weeks, closing on Monday 30th November.
The current doctors’ London Weighting payment is a maximum of £2,162 a year for doctors working in inner London. For doctors working in outer London the payment is just £527, and for those working on the fringe of London it is a mere £149. The NHS already recognises that working in London carries additional costs. The pay system for all staff in the NHS, except doctors, dentists and senior managers, known as Agenda for Change, carries a maximum inner London weighting of £8,746, which has increased by 59% since 2005.
While doctors’ London Weighting has remained frozen, the costs of living and working in the capital have skyrocketed. Since 2005, house prices have increased by 112% and the cost of rent has gone up by 128%. ONS figures show average monthly rent in the capital reached £2,332 in August 2026, compared with £1,459 across England. Tube fares are up 82%, rail season tickets are up 100% and the congestion charge is up 87%. Council tax has gone up by 70%, while energy bills have gone up by 129%.
Doctors are demanding full parity between doctors and their NHS colleagues on London Weighting so that the payment properly reflects the additional cost of living and working in London. The campaign is for doctors working in London, across different branches and employment arrangements.
A doctor who is in their first year of working, who lives in North London and receives the outer London payment, said:
“Living and working in London is incredibly expensive and the cost of living is only becoming more unaffordable. I live with my family, which I’m lucky to be able to do, but I simply can’t afford to move out because rents are so high. I’m not the only one. Many doctors I work with are also living at home or having to go into their overdrafts just to afford the deposits needed to rent a flat. It’s not just housing either. The cost of food shopping, commuting to work and even socialising is astronomical, making it increasingly difficult to afford to live and work in the capital. Increasing the London Weighting would make a real difference, helping me save towards moving out while taking some of the financial pressure off the day-to-day cost of living and working in London.”
Dr Callum Parr, a resident doctor working in North West London and honorary secretary of BMA’s London regional council, said:
“Doctors and their NHS colleagues can work in the same hospital, travel on the same tube and face the same London rents, yet receive very different support towards those costs.
“The NHS already recognises that working in London costs more. What we are asking is why doctors’ payments have been left frozen since 2005 while those for our colleagues have increased.
“For doctors starting their careers, the cost of renting and travelling to work in London puts real pressure on their finances. An allowance that has stood still for more than two decades is increasingly disconnected from the costs it was designed to recognise.
“We are asking members whether they are prepared to take further action to secure a fair payment. Doctors deserve the same recognition of London’s additional costs as their NHS colleagues.”
