The Vital Role of Nursing Agencies in the UK Healthcare System

nursing agency

Nursing agencies that provide temporary or ‘agency’ nurses to hospitals and other healthcare settings play an increasingly vital role in the UK’s National Health Service (NHS). With rising demand for nurses and ongoing staffing shortfalls within the NHS, agency nurses now make up a significant portion of the nursing workforce. This article explores the importance of agency nurses in supporting the UK’s healthcare system.

The Extent of Agency Nurse Use in the NHS

Over the last decade, spending on agency nurses in UK has steadily increased. In 2021/2022, NHS spending on agency nurses reached £1.99 billion, accounting for around 5% of the total temporary nursing workforce. High vacancy rates within the NHS nursing workforce are driving this growth. In 2022 there were a recorded 40,000 nurse vacancies across the UK. Agency nurses help fill these gaps, providing urgently needed nursing capacity.

Benefits Agency Nurses Provide

There are several key benefits provided by agency nurses:

  • Flexibility 

Agencies can rapidly deploy nurses on temporary contracts to wards and hospitals experiencing staff shortages or increased demand. This provides vital flexibility.

  • Specialist Skills 

Agencies offer access to nurses with specialist skills and experience, which individual hospitals may lack.

  • Continuity of Care

Agency nurses help maintain patient care standards during periods of NHS nurse staffing pressures.

  • Cost-Effectiveness

Paying an agency commission and temporary wages can in some cases cost less than high NHS nurse overtime rates.

Agency Nurses Keeping the NHS Afloat

Many NHS leaders have warned that without agency nurses in UK, some hospital services would struggle to operate safely. The Royal College of Nursing has indicated that agency nurses are ‘keeping the health service afloat’ during an unprecedented staffing crisis. 70% of NHS hospital ward managers reported in 2019 that without temporary nurses, their ward could not have run safely. Agency nurses are clearly vital for maintaining standards of care.

Concerns About Reliance on Agency Nurses

The increasing reliance on agency nurses in healthcare systems has raised significant concerns within the industry. 

Agency nurses in the UK fulfill a vital function by plugging staffing shortfalls and guaranteeing patient well-being. Yet there are several pivotal matters that necessitate attention to uphold healthcare services’ quality and stability.

Foremost among these concerns is the financial aspect. Hiring agency nurses is often more expensive than employing permanent staff. The fees associated with agency nursing can strain the budgets of healthcare organizations, diverting resources that could be better used for improving patient care, investing in medical equipment, or staff training. This financial strain can be particularly challenging for public healthcare systems with limited budgets.

Another concern is the potential impact on continuity of care. Agency nurses may not be familiar with the specific practices and protocols of a healthcare facility, leading to variations in patient care quality. Frequent turnover of agency staff can disrupt the continuity of care, making it harder for patients to build relationships with their healthcare providers, which is often essential for trust and effective treatment.

Furthermore, heavy reliance on agency nurses may indicate underlying issues in the recruitment and retention of permanent nursing staff. High turnover rates among permanent staff can lead to burnout and dissatisfaction, pushing healthcare organizations to turn to agency nurses as a quick fix. Addressing the root causes of nurse turnover, such as workloads, work-life balance, and professional development, is crucial for creating a more stable healthcare workforce.

Patient safety is another concern. No doubt agencies are highly experienced but the quality of care can vary which can affect the health of the patients. This variation can be because of differences in training and experience. It is imperative for patient safety that agency nurses adhere to identical competency and credentialing standards as permanent staff.

Agency Nurses – An Imperfect But Necessary Solution

While an over-dependence on agency nurses may not be ideal, the reality is that they have become an essential component in alleviating the substantial nurse staffing pressures faced by the NHS. Temporary nursing agencies provide the NHS with flexibility and continuity during times of change. Without the rapid deployment of agency nurses, standards of patient care would be severely compromised. While wider NHS reforms are needed, agency nurses play an indispensable role in upholding healthcare standards for the communities that the NHS serves.


Agency nurses enable the NHS to keep functioning in the face of major nursing workforce challenges. Although agency spending requires tighter control, agency nurses themselves provide a vital safety net that enables hospitals to maintain standards of care for patients. The role of agency nurses is likely to remain critical over the coming years as nurse vacancies persist. Managing the demand for temporary nurses will require NHS trusts and policymakers to focus on sustainable workforce planning. In the meantime, agency nurses will continue serving as the lifeblood for an overstretched but vital healthcare system.

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