What's happening with NHS Agency staffing, and why it matters to you

When looking at large employers in the UK, the NHS is second to none.

It employs over 1.5million people in ambulance, community, mental health and hospital services, as well as commissioning roles and central bodies, like NHS England. However, although the NHS workforce has been growing, demand for services has been growing faster and the NHS has not been able to recruit and retain enough staff to keep up. According to The Kings Fund, the NHS has over 100,000 unfilled vacancies across doctors and nurses, as well as other NHS staff, including allied health professionals such as occupational therapists.

Tens of thousands of doctors, nurses, allied professionals, and support staff, work through agencies and Bank every year, filling essential gaps in rotas and ensuring patients continue to receive care when permanent staff are unavailable. While this can be costly to the NHS, without them, many wards, clinics and specialist services would struggle to operate.

Despite the obvious requirement for agency staff support, there is growing concern that some NHS Trusts are deciding to significantly reduce or eliminate the use of agency workers.

The Recruitment & Employment Confederation (REC) has issued a statement responding to these changes, raising questions about what this could mean for staffing, workforce flexibility and, more importantly, patient care.

What’s happening

Some NHS Trusts are shifting their policies to rely more heavily on their internal staff, reducing or removing agency workers from the mix. In some cases, incentives are being offered to encourage workers to switch from agency to bank.

In fact, the government is planning to ban NHS trusts from using agencies to hire temporary level workers in bands 2 and 3, such as healthcare assistants. 

While on the face of this the move could be seen as a more cost-effective way to resolve issues around the NHS’s agency spend and unfilled vacancies, it could also exacerbate the existing shortages as many healthcare professionals rely on agency work for a better work-life balance. If forced to give up agency work, some healthcare professionals, including doctors, may chose to leave the NHS altogether, retire, or work abroad.

Why this matters for healthcare workers and patients

Agency work has long been a core part of healthcare staffing. It offers:

• Skilled, experienced staff who help keep NHS services running.
• A way for Trusts to fill urgent gaps in staffing quickly.
• Flexibility for professionals balancing work with family, study or other commitments.

Thousands of flexible agency staff support the NHS every day by filling workforce gaps. While everyone hopes for fewer shortages, the reality is that the NHS is still far from having enough staff to meet patient needs.

These proposed changes go beyond agency staff; they touch on workforce flexibility, operational resilience and ultimately, patient care. Without clear plans to fill the gaps left by reduced agency use, the NHS risks creating challenges that affect everyone, from healthcare professionals to the patients who rely on timely and safe services.

What are the concerns? 

The REC has raised several points for discussion:

• Will this ban limit worker choice and flexibility?
• Could reduced use of agency staff impact patient safety if Bank teams can’t cover demand?
• Will incentives to move staff from agency to Bank lead to higher overall costs?
• Why has there been a lack of consultation with the agency sector on these staffing plans?

As these proposed changes unfold, the implications for both healthcare workers and patients are significant. Agency staff play a vital role in keeping NHS services running smoothly, and policy shifts that reduce flexibility could have wide-reaching consequences. For those working in healthcare or considering agency roles, staying informed and engaged with sector developments is more important than ever.

You can read the RECs statement here and access their Change.Gov petition on this topic.