February 2025, London, UK – An analysis of NHS workforce patterns has found that demand for “internal staff banks” increased significantly during 2024. The analysis looked at over 2 million NHS shifts being broadcast to digital staff banks across 2023 and 2024. The insights reveal a year-on-year rise in bank use to cover rota gaps, as well as a rise in the number of shifts successfully filled by internal banks. This analysis comes as ICS’ seek to reduce their overall spend on agency staff in line with new NHSE guidelines.
Vacancies drive up staff bank demand 10% year-on-year
An internal staff bank is a pool of healthcare professionals registered with a specific hospital who are approved to cover vacant shifts on a temporary or ad hoc basis, thereby helping prevent an over-reliance on third-party agencies.
Patchwork Health, whose technology underpins the internal staff banks at over 60 NHS organisations across the UK, analysed a sample size of over 2.5 million bank shifts advertised by a range of NHS organisations during 2023 and 2024 to build a picture of demand across the health service.
According to the analysis, total demand for bank staff increased by 10% during 2024, when compared to 2023 figures.
The leading reason behind bank shifts being advertised during 2024 was staff vacancy, with 2024 seeing a 4% year-on-year rise in vacancy-related bank shift requests. The second most common reason for requests was staff sickness.
Rising need for medics and A&E clinicians
The staff group experiencing the highest rise in demand was medics, with bank shift escalations for these clinicians increasing by 22% compared to 2023. This was largely driven by additional need for consultants.
Nursing demand also increased in 2024, rising by 11% year-on-year.
Across both 2023 and 2024, Emergency Medicine (A&E) was the leading department when it came to requesting shifts to be filled via the internal staff bank. During 2024, A&E departments across the NHS saw 20.4 million attendances between January and September – over 1.2 million more than over the same period in 2019 (pre-pandemic).
These figures point to the ongoing challenges faced by clinical teams and the crucial role that temporary staff are playing in ensuring wards are safely staffed.
Internal banks increasingly able to meet demand
Despite the 10% uplift in demand, the number of rota gaps that are being successfully filled by internal staff banks is also rising year-on-year. In 2024, the number of shifts filled by NHS sites using their own temporary staffing banks increased by 17%.
This reduces the number of shifts that need to be filled by third-party agencies, saving the NHS money and enabling organisations to fill rota gaps with pre-registered and approved staff. This comes in the wake of the introduction of a new cap on agency staff spend, which has been reduced to 3.2% of overall spending for 2024-25, down from 3.7%.
Dr Anas Nader, A&E clinician and CEO at Patchwork Health, comments:
“It’s no secret that clinical teams have been under more pressure than ever before in recent years. This has led to an increase in staff sickness, higher incidences of burnout, and compounded long-standing NHS retention challenges. The result is more rota gaps. However, it also means that more staff are seeking flexible work and turning to NHS internal staff banks in order to find it. So whilst this analysis shows that temporary staff are increasingly needed to keep wards safe, it also shows that there are clinicians available to plug these gaps and that the internal bank can successfully find them.”
