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Inflexibility and stress pushing nurses and teachers towards agency work, new report shows

Disillusionment with permanent employment in the public sector is the main driver pushing health and teaching professionals into agency work, says new research by the National Institute of Economic and Social Research (NIESR) in partnership with the Recruitment & Employment Confederations (REC).

The investigation into the Use of Agency Workers in the Public Sector commissioned by the government’s Office for Manpower Economics found:

  • Agency staff are likely to be highly experienced, with many years’ experience working in the public sector.
  • Agency nurses and supply teachers cited better work-life balance, the ability to pick and choose when they worked and escaping stress, bureaucracy and office politics as factors in their decision to walk away from permanent public sector employment.
  • Both groups reported that the flexibility that temporary work allowed them was a much bigger incentive that pay.

In the report, NHS trust managers acknowledge that agency staff skills are on a par with substantive NHS staff, explaining that their concerns are with continuity rather than skill level. NHS leaders admitted they need to fundamentally redesign the traditional ideas about work patterns in hospitals to accommodate staff desire for more part-time opportunities and flexibility.

Interviews also highlighted that internal NHS banks suffer from a poor reputation in relation to their payment procedures and shift allocations.

Headteachers acknowledged the speed and ease of recruiting supply teachers via agencies and the knowledge and access to candidates agencies have that schools don’t. However, in comparison to employers in the NHS, school leaders have less understanding about agencies’ fee structures, the vetting of candidates that agencies undertake or the justification for transfer or ‘finders fees’.

REC chief executive, Kevin Green, said, “When we speak to agency nurses and supply teachers they say they’ve made a positive choice to work this way because they want the freedom and flexibility to work where and when they choose.

“Being a nurse or a teacher is a hugely demanding job which comes with all sorts of pressures so it’s no surprise that some experienced professionals want to achieve a better work/life balance. For too long employers in the public sector have ignored this desire for flexibility when they should instead use it to develop ways to retain their talent and attract more people into these jobs to alleviate skills shortages.”


Report co-author, NIESR researcher, Nathan Hudson-Sharp, commented, “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.”

Agency workers in the NHS account for 0.8% of the total NHS employment in 2015. In public sector education approximately 1.3% of the jobs are filled by agency workers.

Both headteachers and trust managers all remain sceptical that agency staff use will decrease in the near future, citing ongoing recruitment and retention difficulties.

Recruitment agencies interviewed for the research said that the future volume of agency workers in the NHS and schools is dependent on the government’s ability to attract more candidates into the workforce and retain them once they start work.

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