REC backs review that aims to ensure temporary agency nurses are supported to raise concerns

Recruitment and Employment Confederation (REC) is urging agency nurses to get involved in an independent review to ensure nurses working on temporary assignments, so essential to patient care in NHS, can speak up without fear, and that their views are listened to, respected and acted upon more in the health service.

The National Guardian’s Office has now launched a review to identify barriers that prevent temporary staff from speaking up about patient care and safety, showcase good and innovative practices and make recommendations to strengthen the ability of temporary workers to raise concerns. This was prompted by Health Services Safety Investigations Body finding that, among other things, contingent workers were discriminated against because they were temps, and in some cases because of their ethnicity; and that some temporary workers felt unable to raise concerns about patient safety with the organisation in which they are working because they fear they will lose future opportunities to work in that organisation.

The REC is working with the independent National Guardian’s Office to involve as many agency nurses as possible in the study to boost patient safety in the NHS and raise the profile of the value of temp workers.

REC Deputy Chief Executive Kate Shoesmith said:

“The NHS must foster a workplace where every nurse, permanent or temporary, knows their voice is heard and valued. Contingent staff are essential, filling critical skills gaps and bridging the mismatch between demand and workforce capacity. It is crucial they feel safe and supported to raise concerns about patient safety without fearing it will jeopardise future opportunities. We need this to encourage the NHS to listen to agency nurses and fix how they are treated, not see them as an easy scapegoat. We strongly encourage agency nurses and agencies themselves to take this all-too rare an opportunity to have their say on how to make the NHS a better workplace.”

On the broader issue of agency workers in the NHS, Kate Shoesmith added:

“It’s disgraceful that agency staff are still excluded from the official NHS Staff Survey, which monitors vital issues such as patient safety. Patient safety should not suffer because the NHS does not respect temporary workers enough to give them a voice. Agency workers get to see different Trusts in operation and bring insights from that which are actually even more valuable because of this breadth of perspective. The NHS cannot deliver first-rate care while treating temporary workers as a secondary, overlooked workforce.”

The National Guardian review will focus on agency staff and bank only staff only.

Bethany Carter, Interim Director of Operations and Strategy at the National Guardian’s Office, said:
“Everyone working in the NHS should feel safe, supported and confident to speak up including those in temporary roles. This review gives temporary workers the chance not only to share the challenges they experience, but also to highlight examples of good practice already making a difference. Their voices are vital in helping us shape clear, practical recommendations for positive change.”

Notes to editors

1.     Agency nurses can share their thoughts via National Guardian’s online survey using this link. The survey is open until 11:59 PM on Friday, 31 October 2025. There is also the opportunity to participate in confidential focus groups in mid-October. If you wish to attend, please contact us via the lead for the project, Isabella Tetteh, on intelligenceandlearning@nationalguardianoffice.org.uk If you would like to speak to the review team but don’t feel comfortable doing so in a group setting, please get in touch via the lead for the project, Isabella Tetteh (intelligenceandlearning@nationalguardianoffice.org.uk). It will seek to arrange a one-to-on meeting with you.

The National Guardian review will involve:

a.     Desk-based research analysing publicly available data and intelligence.

b.     Engagement with temporary workers (nurses), Freedom to Speak Up guardians, healthcare system representatives (specifically NMC) and leading agency and bank staff providers.

It will base its evaluations and recommendations on good practices and relevant guidelines, including those set by itself and NHS England. Its review will engage stakeholders, including professional and systems regulators, to promote and embed learning.

2.     Completely separate from the National Guardians survey, is REC’s ongoing petition. Across the NHS, agencies and the staff they partner with step in every day to keep wards safe, services running, and patients cared for. A ban on flexible staffing would strip away choice, stretch exhausted permanent staff even further, and put patient safety at risk. Join thousands of others in saying no to unsafe cuts - sign the petition now and help REC reach 5,000 voices for safe, flexible care and ensure the government knows our concerns.

Sign the petition now