What’s going on with NHS agency rates and shifts?

Recently, agency nurses working in the NHS have seen a drop in hourly pay rates, and there are fewer shifts available at some NHS trusts.

Here, we’ll dig into why this is happening, and show what the future looks like for NHS agency staff (it’s brighter than you may think)…

The pandemic raised rates and shifts…

To understand why rates have dropped, we have to look at the recent past.

The NHS was under unprecedented pressure at the beginning of the Covid pandemic in 2020.

So the government created an emergency fund which enormously increased staffing budgets, making both agency rates and the number of shifts available temporarily much higher.

This meant we got used to work and pay that aren’t sustainable in ‘normal’ circumstances.

The budget dropped after the pandemic

Once the pandemic ended in 2022, the government took away the emergency budget and began to reassess NHS spending.

This means the NHS has been actively working to drop rates to the lowest reasonable levels for their framework agencies – like Florence – who work with the NHS on pre-approved terms.

The good news is we expect rates to further settle at around April this year.

Off-framework agencies (who work with the NHS ad hoc, under no pre-approved terms) might still offer higher rates for critical cover needs, though this will happen far less often as cost controls continue to tighten.

Shifts now have a shorter notice period

Adding to the squeeze: shifts now tend to be released with less notice, making them harder to find and secure.

On average, they’ve gone from being released seven days ahead of time to 48 hours – this is because of additional approval requirements post-Covid.

Block bookings are making a comeback

On the brighter side: at Florence, we’ve started to seeing greater shift visibility into the future  and block bookings released by many NHS trusts.

Our NHS team tells us:

“We are seeing more and more block bookings become available for many of our NHS partners, which is great news for agency nurses looking to be able to plan further into the future.” Ross Burton, Managing Director -NHS

International recruitment isn’t sustainable

There’s a large-scale push for international recruitment in permanent hires in the NHS – but sadly this approach continues to struggle to fill perm role vacancies, with 112,000 posts open.

Constant changes to the visa policies (like the recent decision not to provide visas to international workers’ dependents) are making international recruitment an unworkable long-term solution.

The government recognises this, saying:

“I want to be clear that international recruitment is not the long-term answer to our health and social care workforce needs”. Helen Whatley, Minister for Social Care. 

Clearly, this kind of recruitment isn’t going to be the way the NHS solves its staffing issues forever.

Staffing issues continue

Almost half of NHS staff in England (44%) have reported feeling unwell from work related stress.

Staff leaving due to burnout and high workloads will make it harder for the NHS to keep people in jobs, leading to further need for temporary staff to ensure patient safety.

So, are NHS agency nursing rates low?

Not in all cases if you look at the long-term view…

Firstly, as we’ve said – during Covid, due to the unprecedented demand and high emergency budgets, there was more availability of ‘off-framework’ rates – meaning some agencies could pay well above the norm.

Rates have now naturally dropped and less off-framework rates are available – but they do still exist in smaller numbers. They are also lower for some Trusts which are pushing hard for CAP rates.

However, agency rates are still, on average, 30% higher than perm positions in most cases.

So, as long as you find a partner who can book the shifts you want (hint: like with Florence!), you can still earn a great salary and keep the flexibility of being an agency nurse.

Has overall demand dropped for NHS agency nurses?

Not when you look at the numbers.

Yes, demand has dropped since Covid. Yes, it has also dropped in specific trusts, but there’s still a huge need for agency nurses in the NHS.

For example, at Florence we’ve seen 19,000 NHS nursing shifts available in the last 12 months.

There is a very real demand for your hard work.

Our mission is to continue to make it easy for the NHS to get these shifts filled fast by Florence nurses using our app, so patients get the care they deserve.

Will the government try to stop agency nursing for good?

No, we don’t think so. Agency nursing has been around for over 75 years.

When the shifts market or government policies change, it can be easy to forget that agency nursing has existed since the NHS was born in 1948.

The NHS is also one of the world’s largest employers and temporary staffing is a natural part of large-scale workforce management.

Because of this, it is highly unlikely (perhaps impossible) to stop using agency staff as a tool to ensure patient safety.

“There will always be the need for some flexibility within the system, whether that’s flexible shift working for staff and flexibility for hospital trusts to scale up the resource, depending on the pressures and demand.” Wes Streeting, Labour’s shadow Health Secretary. 

Agency nurses are a natural and positive part of the NHS workforce when placed into shifts as part of a sustainable and mutually respectful partnership.

What’s next for NHS agency nursing?

Our experienced team think the future is bright.

“I’ve worked within agencies supplying nurses to the NHS for over ten years, and for me, there is a predictable pattern of rates and demand being affected cyclically. Positively for nurses, from what I am seeing in the market, it looks to me like we are nearing the end of the current cycle.” Ross Burton, MD NHS, Florence. 

Strong rates are still available and a high demand for shifts in many trusts and hospitals. The challenge for agency nurses is finding an honest partner who will work with them to meet their shift needs.

So at Florence, we’re feeling positive for our nurses – not only do our team continually update our app with easy-to-book NHS shifts, pride ourselves on our honest communication, but we are also working tirelessly to secure rates that everyone can be happy with.

We’re bringing on new NHS trusts and hospitals every week with a huge demand for shifts, giving our nurses a huge amount of choice and flexible work.

Find out where we have a high demand for NHS nurses here.

Looking for a new and better way to book NHS agency shifts? Download the app today to give Florence a try. 

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