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NIESR: Staffing crisis pushes NHS staff into agency working, new report reveal

Following recent revelations in the national press about the cost of agency working to the NHS, new NIESR research looks at the reasons why public sector employers continue to use agency staff, and conversely why employees continue to choose to work via agencies.

The report, commissioned by the Office of Manpower Economics, offers the most comprehensive analysis of agency working in the UK public sector to date, focusing particularly on the NHS and public sector schools.

The research shows that:

  • Pay is not a primary source of motivation for leaving full-time employment. Rather, a move to agency working seems to stem from a desire to escape permanent public sector employment, amidst concerns about increased bureaucracy, target setting, insufficient resources, unmanageable workloads and a lack of work-life balance.
  • Our research would therefore suggest NHS and public sector school staff are ‘pushed’ into agency working through concerns of deteriorating job quality, rather than ‘pulled’ by opportunities of higher rates of pay.
  • From the perspective of public sector employers, our research indicates that agency usage will continue to persist in the current context of demand outstripping supply. Public sector employers recognise the concerns around monetary costs and the potential impact on the quality of services, but find themselves using agency staff as a last resort in response to underlining staffing issues.
  • More specifically, our research identifies that although the ‘agency rules’ – the flagship programme to reduce NHS reliance on agency staff – has succeeded in reducing overall agency spending, it has failed to address underlying issues around staffing and concerns of deteriorating job quality.

Report co-author, NIESR researcher Nathan Hudson-Sharp, said:

“Current rules around agency spending in the NHS seem to only address the symptoms of the problem. What they fail to do is tackle the underlining issue of demand continuing to outstrip supply. The future of agency working in the NHS would therefore seem to rest on implementing an approach that is much more comprehensive, and that would enable NHS employers to address underlining issues around staff shortages, training, workforce planning, recruitment and retention.”


The Report is entitled “Use of Agency Workers in the Public Sector” and is available here.

The OME provides the secretariat to the public sector pay review bodies and has an interest in the costs of agency working to the public sector, in particular education and health.

For further queries or to arrange an interview with the authors of the report, please contact the NIESR Press Office: Luca Pieri on 020 7654 1931 /  

NIESR aims to promote, through quantitative and qualitative research, a deeper understanding of the interaction of economic and social forces that affect people's lives, and the ways in which policies can improve them.

Further details of NIESR’s activities can be seen on or by contacting Switchboard Telephone Number: +44 (0) 207 222 7665


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