Improvement and savings - temporary staffing

25 October 2016

Recent instruction from NHS Improvement Chief Executive Jim Mackey has focused the NHS’ attention on reducing temporary and agency staffing and consolidating services, many of which are traditionally back office. The NHS now faces a challenging time to bring about change, improve staff utilisation, increase retention and shift from a reliance on bank or agency.

So what are the issues that create 'high' temporary staffing in hospital?


While there are many different reasons for the use of temporary staffing, one of the most common ones is that there just is not the supply of permanent staff out there, ie it’s an issue of supply and demand, and often the demand exceeds the supply. The question then has to be asked: at a time when jobs in the UK have been at a premium, why are so many people choosing to work as a temporary employee through an agency rather than as an employee?


  • Hospitals are the training ground for health professionals, as there is only so much you can learn in the classroom or lecture theatre. This will always be the case as people retire and move on, and is the natural order of all organisations worldwide. However some hospitals seem to do more than their fair share of training as they train staff who then move on to get a job somewhere else or become locums or temps. 
  • Sometimes the wages are just better with the hospital next door? (especially if you live on the border of the London weighting zone).
  • For some the job as permanent employee is too hard or comes with too much pressure, which is one of the reasons why many nurses approaching retirement choose temporary work as a more flexible option. 

Funding (and timings)

  • Short term initiatives and uncertainty of length of funds for specific projects can mean organisations are risk averse to taking on permanent staffing.
  • Temporary staff brought in by the Trust to help deliver one off change or improvement initiatives.


Poor CQC ratings, KEOGH, waiting lists or you name it there is always an issue, now or just around the corner that extra resource will help solve (sadly this usually comes with a cost that can’t always be recovered). Then when things improve, costs and temp staffing are reduced until the next issue and so on.

Custom and practice for staff management 

  • More common than you think one of the answers is ‘that’s the way we always do it’ when it comes to planning staffing levels, rostering and balancing out holidays and rotas. 
  • Temporary staff have been around for so long that they are like permanent staff members anyway.

Demographics/age/brain drain

Simply put, some places are just more appealing to work than others.

The reality is that for each hospital, it will be a combination of these and other factors that drive high levels of temporary staffing.

So what can you do? Download our full report, where we highlight the four crucial areas to improve the situation.