NHS Bank Staff ‘at Least as Expensive’ as Using Agency Workers

Why It Matters

The findings show that simply shifting from agency to bank staff will not guarantee cost savings, forcing the NHS to rethink its temporary‑workforce strategy and budget allocations. Addressing the root causes of staff shortages is essential for sustainable financial and care outcomes.

Key Takeaways

• Nottingham Trust bank shifts cost ~$7,300, agency shifts ~$5,700
• Imperial College Trust bank shifts average ~$7,000, agency shifts ~$2,700
• Newcastle Trust bank shifts ~$1,730, agency shifts only ~$470
• NHS bank and agency spending rose 51% to $6.6bn (2018‑22)
• REC warns workforce shortages, not staffing model, drive high temporary costs

Pulse Analysis

The NHS has long promoted bank staff as a cheaper alternative to agency workers, especially after capping agency hourly rates in 2015. Recent government statements even claimed a $1.3 billion saving in 2024‑25 by favoring bank hires. However, the underlying assumption—that bank staffing is inherently less expensive—has been challenged by new data from freedom‑of‑information requests, which show that in some trusts, the most expensive bank shifts cost significantly more than comparable agency shifts.

Detailed analysis of trusts such as Nottingham University Hospitals, Imperial College Healthcare, and Newcastle upon Tyne Hospitals uncovers a stark cost disparity. In Nottingham, the five priciest bank shifts averaged about $7,300, outpacing agency equivalents by roughly $2,000. Imperial College’s figures are even more pronounced, with bank shifts near $7,000 versus $2,700 for agencies. Newcastle’s data, while lower in absolute terms, still shows bank shifts at $1,730 compared with just $470 for agency work. Across the system, total spending on bank and agency staff surged 51% to $6.6 billion between 2018‑19 and 2021‑22, underscoring the scale of temporary‑staff costs.

The REC’s interpretation is clear: workforce shortages, not the staffing model, are inflating costs. Policymakers must therefore shift focus from punitive caps or rhetoric about “rip‑off” agencies to long‑term solutions—expanding the flexible workforce pool, improving pay structures, and enhancing workforce planning. By addressing the root causes of staffing gaps, the NHS can achieve genuine savings while maintaining patient safety and staff morale, turning temporary staffing from a cost‑center into a strategic asset.