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NHS nurses angry about agency ban

From 1 April, many nurses will only be able to take on extra work as overtime or through staff banks.
Annoyed nurse

Nurses have reacted with anger after learning they can no longer take on agency work if they are substantively employed by an NHS trust.

From 1 April, NHS Improvement is introducing a measure to stop most NHS trusts in England from employing someone through an agency if that person has a substantive contract with the NHS.

Many nurses aired their anger on social media this week and the RCN condemned the move, saying it was not consulted on the decision.

It is the latest in a series of measures, introduced since October 2015, to curb health service spending on agency staff.

In 2014-15, the NHS spent more than 3 billion on agency workers.

Work restrictions

The new rule means NHS nurses who want to work extra

Nurses have reacted with anger after learning they can no longer take on agency work if they are substantively employed by an NHS trust.


Many nurses are upset that agency working is no longer an option. Picture: iStock

From 1 April, NHS Improvement is introducing a measure to stop most NHS trusts in England from employing someone through an agency if that person has a substantive contract with the NHS.

Many nurses aired their anger on social media this week and the RCN condemned the move, saying it was not consulted on the decision. 

It is the latest in a series of measures, introduced since October 2015, to curb health service spending on agency staff. 

In 2014-15, the NHS spent more than £3 billion on agency workers.

Work restrictions

The new rule means NHS nurses who want to work extra hours must join their trust’s staff bank or work overtime. 

If they want to work extra hours at another trust that is not their main employer, they must join that trust’s bank, but this practice is not being encouraged by NHS Improvement. 

Only a small number of foundation trusts without any financial difficulties will be exempt from the rule, but they will still be encouraged to follow it. 

The RCN said nurse pay has been suppressed for many years, and that staff should be able to work in whatever way is best for them and their families. 

Unequal pay

Responding to the news on Nursing Standard’s Facebook page, one nurse said nurses would not need agency work if they were paid the same as other public sector workers.

She added: ‘No nurse ever said “oh I’d rather pick up extra shifts and spend less time with my family to earn less than other professions”.’

Another nurse said agency work in other hospitals allows staff to develop new skills and gain experience.

She said: ‘I do extra shifts in burns units, which I have learned so much from.’

‘Indentured labour’

RCN senior employment relations adviser Gerry O’Dwyer said: ‘They are turning some staff into indentured labour. 

‘It is saying “you can only work for us. You have to be on the bank and we will tell you exactly how much money you can earn”.’

NHS Improvement said its agency controls have saved the NHS £1 billion since 2015. 

Trusts were informed of the measure by NHS Improvement on 27 February, but the RCN said many of its members have only received letters from their employers this week explaining the change.

Unite national officer for health Colenzo Jarrett-Thorpe said he will write to NHS Improvement requesting a transition period to give staff time to join banks. 

Tax avoidance

NHS Improvement claims some trusts are trying to bypass agency controls by setting up staff banks and allowing workers, including permanent staff, to be paid through personal service companies (PSCs) and limited liability partnerships (LLPs). 

This will no longer be permitted under changes in April.

NHS Improvement chief executive Jim Mackey said: ‘We expect these new measures to take another big chunk out of excessive agency costs; there are far too many agency staff making the most out of the lower tax rates paid via personal service companies and limited liability partnerships.

‘This is a key part of the problem of so many staff choosing to work as agency staff instead of NHS staff.

‘These new rules will make sure most agency staff get paid and taxed in the same way as their NHS staff colleagues. This will make it fairer and more attractive for people to become permanent NHS staff, which is great news for hospitals and patients.’


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