NHS Trusts have admitted they did not specifically assess the impact on care of the government’s directive for them to massively cut their use of agency staff in the last quarter of 2025. There have been fewer staff dealing with patients at the busiest time of year while corridor care is still rampant.
A freedom of information request sent to NHS Trusts in London by the REC has uncovered that half of respondents had done no specific impact assessment of patient outcomes relating to the Department of Health’s directive to cut use of agency staff by ‘30% in the short term’. The number of Trusts not knowing the impact of these cuts could be even higher because responses from certain Trusts were unclear about whether an impact assessment was done or not. Given the relative scale of Trusts in London, this outcome is likely to be the case across much of England.
REC is urging DHSC to rethink what they term as their careless ‘Cut first, consider later’ approach to shedding thousands of agency staff from within its ranks. Instead, it says the Department should work in partnership with healthcare staffing firms on a safer and more sustainable NHS staffing workforce plan. During the winter, Bank staffing can get overwhelmed with demand for staff and by reducing the capacity of compliant, price-controlled on-framework agencies to support staffing needs, DHSC will leave Trusts with a choice between cancelling care or delivering it via exactly the sort of expensive off-framework provision the government rails against.
“The Department of Health’s misleading statements about temporary work costs hide the truth – while agency costs have been going down, temporary shift spending is rising as bureaucrats put ideology before the best outcomes for patients,” says REC Chief Executive Neil Carberry.
“Having run down the firms who did what government needed by delivering great care at controlled rates by pushing work to more expensive Bank shifts, the Department is therefore left with little or no compliant and effective safety valve for winter crises.
“It is time to look more practically and less ideologically at ways to fix the NHS’ long-standing recruitment and retention problems,’ Carberry continues: “As the government prepares to publish its Ten-Year NHS Workforce Plan, they should consult with agencies and the REC about how to make agency staffing work best for Trusts, patients and the exchequer.”
Carberry adds that the lack of proper impact assessments by so many NHS Trusts reflects the pace of change as policy making is rushed and agencies scapegoated. “How can the government ask NHS Trusts to cut 30% of agency staff use without making sure they assess the impact of this significant cut on patient care?” he asks. “Such assessments should be mandatory and publicly available so the Secretary of State can be held accountable for the consequences of this policy.
“On behalf of compliant, well-regulated, and care-focused agencies, the REC stands where it always has – ready to work with the NHS and the Department of Health on sustainable solutions. Scapegoating of agencies has run out of road and has solved no problems. The system did need and does need to change, and working with rather than against agencies to control spending, improve care and engage staff has a far bigger upside. We hope the government finally sees this in 2026.”
The REC represents healthcare staffing agencies which provide temporary workers to NHS Trusts. These agencies are experts in staffing in healthcare and have first-hand experience of the impact on NHS Trusts. This is the impact of the government’s decision to axe 30% of agency use without any idea about what it would mean in practice for service delivery.
Healthcare staffing agencies are reporting to the REC:
- Bank assignments routinely cost more than agency assignments.
- Banks take longer to fill placements – risking unsafe staffing levels for longer periods.
- Because Trusts are worried about using an agency to fill permanent vacancies hiring processes are taking much longer – all while corridor care has become the norm.
- You also cannot use an agency to do the turnaround jobs that many NHS Trusts need – for example we have heard about delays in hiring interims in finance / HR / projects.
- Because the NHS cannot use an agency to fill a nursing shift, they are having to find alternatives to keep patients safe. In one case that involved a security guard on a mental health ward.
“Quashing the ability of people to work flexibly through agencies will exacerbate the recruitment crisis in healthcare – immediately and in the long term,” said Carberry, “Treating staff with respect and listening to their choices matters.
“Sustainable NHS staffing requires deep expertise and a clear understanding of the service’s complex needs, not political grandstanding. The government keeps misleading the public about temporary staffing while relying on bullying tactics and favouritism.
“Trust leaders know agencies must be a controlled part of the mix,” Carberry concludes. “It is time for the government to face facts and listen to what Trusts are telling them.”
