The UK’s temporary healthcare workforce must prepare for two developments set to impact locums, contractors, and other flexible staff who engage with recruitment agencies and digital platforms.
The first is NHS England’s push to curb spending on agency staff and increase the use of internal “bank” staff, who are healthcare professionals directly employed by trusts for flexible shifts, and to fill more permanent roles.
Government crackdown on “rip-off temp agencies”
Department for Health and Social Care said in a statement, “NHS patients and staff are benefiting from an almost £1 billion boost for the frontline, as a government crackdown on rip-off temporary staffing agencies delivers unprecedented savings.”
The Health and Social Care Secretary Wes Streeting, announced strict agency spending limits last November and ordered trusts to reduce their spend on agency staff by 30% in the short term so more money could be reinvested in the frontline and the wider NHS workforce.
Latest figures show spending on agency staff has already fallen by almost £1 billion in 2024 to 2025, which is a huge reduction which he government claimed has helped funding go towards “improving the quality of care patients receive, helping to reduce waiting lists, and enhancing safety. This reduced reliance on agency staff has been shown to decrease clinical incidents.”
Agency placements set to fall
For locums and temporary workers who value the flexibility and often competitive rates of agency work, this directive could lead to shifts in demand. The emphasis on NHS internal banks suggests that trusts may prioritise filling vacancies from their own pools of staff, potentially reducing the overall number of agency placements.
The Recruitment & Employment Confederation (REC) has expressed concerns, according to reports, noting that an aggressive reduction in agency use might lead to staffing gaps, increased pressure on existing NHS staff. The REC is convinced staffing levels cannot be maintained through internal means alone. This environment could mean altered opportunities and terms for those providing temporary cover through external agencies.
What does the Health Minister have to say?
Health Minister Ashley Dalton said: “The taxpayer has been footing the bill for rip-off agencies for too long, while patients have languished on waiting lists and demoralised staff faced years of pay erosion. That’s why we are pledging to eliminate this squander, and through our Plan for Change we are making major progress and seeing a radical reduction in costs.
“We’re already backing our health workers with above-inflation pay rises and now nearly £1 billion is being reinvested back to the frontline, getting patients off waiting lists and putting money back into our workforce’s pocket.
“The NHS was forced to spend a staggering £3 billion on agency staff in 2023 to 2024, money that could have been used to tackle record waiting lists and improve patient care. Recruitment agencies have charged NHS trusts up to £2,000 for a single nursing shift, thanks to the 113,000 staffing vacancies across the service.”
Aya Healthcare acquires Locum’s Nest
At the same time, Aya Healthcare, one of the largest US staffing companies, has acquired UK-based Locum’s Nest. Locum’s Nest is known for its digital platform, which matches locum healthcare professionals and NHS trusts for available shifts, often without the involvement of traditional recruitment agencies.
Aya’s acquisition represents an entry into the UK market by a major US player, potentially bringing with it technological resources and operational scale. For users of Locum’s Nest, this development could lead to platform changes or broader access to shifts as Aya integrates its capabilities.
For traditional recruitment agencies, this acquisition introduces a significant competitor. A direct booking platform like Locum’s Nest, now with the backing of Aya, is positioned to gain market share by enabling NHS trusts to fill temporary roles more directly. This may reduce the reliance on conventional agencies for certain types of placements.
Implications for the flexible healthcare workforce
Considering these two trends together, the job market for locums, contractors, and temporary workers in UK healthcare appears to be evolving towards more direct engagement models and away from historical agency reliance.
Locums and contractors: what to expect
Expect potential changes in the volume and types of roles available through traditional agencies within the NHS. There may be an increased use of direct booking platforms, including the expanded Locum’s Nest, or joining NHS internal staff banks. Plus, more pressure to reduce costs within the NHS, combined with the efficiency of digital platforms, could influence pay rates and contract terms for temporary work.
Workers may also need to adapt by signing up to various booking channels and understanding shifts in engagement models.
Recruitment agencies: what to expect
- Agencies may need to refine their service offerings to demonstrate value beyond straightforward placement, perhaps by focusing on niche areas or comprehensive support services.
- Investment in digital capabilities will be increasingly important to compete in a market where direct digital platforms are gaining market share and preference from the NHS.
- Agencies heavily reliant on general NHS locum placements may face increased competition and pressure on margins.
Overall, the UK healthcare staffing market seems to be moving towards a more cost-cutting approach. This will require adaptation from both the flexible workforce and the agencies that serve it.