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Workforce: Will perma-flexi be the new bank and agency nursing?

Flexible employment contracts are on the rise elsewhere, but not much has changed in the NHS

Flexible employment contracts are on the rise elsewhere, but not much has changed in the NHS


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Bank and agency nurses are propping up the NHS. Last year, NHS Improvement reported that four out of five nursing vacancies were filled by a combination of agency or bank staff.

Despite their growing significance, the roles of agency and bank nurses have not changed much in recent years.

New technology might be helping at the margins – making shift allocation more efficient, for example – but what they do and how they are contracted has not.

Staff in the grey zone

Given the controversial new types of employment contract in other service sectors – such as zero-hours contracts and the ‘gig economy’ in service industries – this is surprising.

Developments in other countries also are piquing the interest of organisations looking to reduce staffing costs and increase flexible staffing. 

‘More flexibility for the employer often means that the employee is paying the price, in terms of reduced job security and benefits’

Forbes Magazine, the go-to read for captains of industry, recently lauded the use of ‘permalancers’. Its article The New Self-Employment Trend You'll Be Seeing Everywhere described permalancers as working in the ‘grey zone’ between freelancer and permanently contracted staff.

But just how new is this trend? I recall reading about ‘permalancer’ nurses in the United States more than 20 years ago, where lax employment law gives the employer the upper hand in deciding when employees should be paid to be at work.

In Australia, there are currently legal challenges to a proposed new flexible employment contract for social care workers, which has been labelled ‘perma-flexi’. Staff would get a 10% pay loading above that paid to permanent employees, in exchange for flexible rostering.

The trade unions are opposing this, calling it ‘a ruse to reduce pay’.

There’s a trade-off

Employment contract flexibility is a trade- off. More flexibility for the employer often means that the employee is paying the price, in terms of reduced job security and benefits, and less predictability of income.

The bank and agency model may not be particularly innovative, but any new alternatives are unlikely to do nurses any favours.


 

James Buchan is professor in the faculty of health and social sciences at Queen Margaret University, Edinburgh


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