Spending on agency staff across the NHS in England has fallen by almost £1 billion in the last financial year, the government has confirmed, marking a significant step forward in Health Secretary Wes Streeting’s push to reduce reliance on costly temporary staffing.
According to figures released by the Department of Health and Social Care, NHS trusts spent nearly £1bn less on agency workers in 2024–25 compared with the previous year – a direct result of targeted efforts to curb what Streeting previously described as “unsustainable” levels of agency spending.
Speaking at the NHS Providers conference last November, Streeting highlighted that the NHS had been spending approximately £3bn annually on agency staff to cover vacancies due to long-term workforce shortages.
These roles were frequently filled at premium rates, driving up overall staffing costs.
As part of his wider NHS reform agenda, Streeting proposed new restrictions that would prohibit trusts from using agency staff in lower-band roles such as healthcare assistants and domestic support staff.
The proposals, although not yet implemented, also aim to prevent a common practice where permanent staff resign only to return via agencies, earning higher wages for the same job—ultimately costing the NHS considerably more.
In addition to agency use, NHS trusts have leaned heavily on “bank” staff—existing NHS employees who take on extra shifts, often through a trust-run staffing bank.
While bank work is generally cheaper than agency provision, it still represents a considerable expenditure, with UK-wide figures showing £5.8bn was spent on bank shifts last year, alongside £4.6bn on agency staffing.
To drive further change, Streeting and Sir James Mackey, Chief Executive of NHS England (soon to be phased out), issued a joint letter to NHS trusts and integrated care boards.
In it, they called for a 30% reduction in agency staffing and warned that further legislative action could follow if progress stalls by autumn 2025.
“If sufficient progress isn’t evident by the autumn, we will consider further legislative measures to end the overuse of agency staff,” the letter stated.
It also urged trust leaders to ensure pay rates for bank shifts remain attractive, yet do not exceed the rates paid by private agencies. A minimum 10% reduction in bank staff usage has also been mandated.
Elizabeth O’Mahony, NHS England’s Chief Financial Officer, praised the achievement, saying:
“The NHS is determined to ensure taxpayers’ money is used wisely. Reducing agency spend by nearly £1bn in a single year helps strengthen frontline services, brings down waiting lists, and supports fairness for our permanent staff.”
The move is seen as a key part of Labour’s plan to restore financial discipline within the NHS, while tackling long-standing recruitment and retention issues across the health service.
