According to the Royal College of Nursing, the number of students who were accepted onto nursing courses is nowhere near enough to meet the growing demand.
Many qualified nurses may consider leaving their full-time positions in favour of working as an agency nurse. Agency nurses work on a contract basis to provide crucial support to hospitals or other healthcare facilities when they are short-staffed or overstretched for whatever reason.
This page discusses the advantages of working as an agency nurse, opportunities overseas, rates of pay and how to find work as an agency nurse.
Advantages of working as an agency nurse
High demand for nurses
The number of nurses and health visitors in the UK has fallen year on year. In July 2018, numbers fell by 1.2% compared to the previous year.
Greater rates of pay
As an agency nurse you could receive higher rates of pay than if you were working as a permanent employee, this is partly to compensate for the fact that assignments can often be last minute or cancelled at short notice. Working on a shift by shift basis means that time for training is minimal so agency nursing is generally not suitable for newly qualified nurses. Agency nurses are expected to have sufficient experience in their area so they can provide the knowledge and support that only high-calibre nurses can in this fast-paced profession.
Agency nurses are paid on an hourly basis, which will depend on your agency, location, level of expertise, the day of the week and the time of day. The agency that you are using may specify the rates that they pay their nurses, but the hourly rates are based on those provided by Mayfair.
Advance your skill set
Working in a wide range of departments in a short space of time means that agency nurses are exposed to many different situations, which can help advance their nursing skills. Working in one location for a shift at a time also means that you don’t have time to get involved in office – or department – politics and you can simply concentrate on improving your patient care.
Flexible working hours
One of the main advantages of working as an agency nurse is that you can choose the hours that you want to work. Agency nurses will generally contact their agency, to find out what shifts are available in their area and accept the assignments that they would like to fulfil, which means you could avoid dreaded nightshifts if you so wish. This makes agency working a popular choice for parents and those with personal commitments as there is no obligation to work on particular days and they only need to accept the shifts that they are able to work. The flexibility of working as an agency nurse makes it an excellent opportunity for retired nurses who would like to refresh their skills or supplement their income. This way of working is shown to have beneficial effects on home life as well, indeed in SJD Accountancy’s latest Contractor Attitude Survey, 73% of those surveyed said that contracting has had a positive effect on their work/life balance.
For more information about the advantages of working as an agency nurse take a look at our benefits of contracting page.
Finding a nursing agency
Registering with several agencies could increase your opportunity for work. When choosing which agencies to sign up with, make sure you are clear on if there are any costs involved, how they will pay you, what deductions they will take from your income and the area that the shifts will be located.
Some recruitment agencies that place nurses in temporary positions throughout the UK are listed below:
- Hays – A global recruitment agency, who work across a variety of sectors from finance to education to healthcare. With both permanent and shift work positions available, they recruit for nursing roles within organisations including the NHS, NHS 111 and the Ministry of Defence.
- Thornbury Nursing Services – Working across the UK, Thornbury provide temporary nursing staff to NHS trusts, private hospitals, schools, prisons, GP surgeries and mental health centres amongst others.
- Ambition 24 Hours – A nursing agency, which operates throughout the UK and has positions for agency nurses across a variety of healthcare settings from accident and emergency to mental health.
Finding work as an agency nurse
There are alternatives to working through agencies if you would like to continue nursing, but on a temporary basis. Registering on the NHS Professionals (NHSP) website is a great place to start because once they have screened your application and you are an NHSP member, you will be able to accept temporary shifts at NHS trusts in your area.
Some individual NHS trusts will have their own bank staff, which they use when they need extra manpower. To apply to be a member of the temporary staffing bank for a specific NHS trust, you will usually just need to contact the trust in question. If you would like an alternative to working in a hospital, care at home agencies such as Prestige need temporary nursing staff to cover absent staff members, take a look at their website for more information or to apply.
Opportunities for nursing agencies overseas
Nursing is one of those positions that are in demand pretty much anywhere in the world and therefore there is a whole host of opportunities for nurses overseas – whether you are drawn to Middle Eastern countries like the United Arab Emirates, or further afield places like Australia and New Zealand.
Nurses are listed on the skilled occupation list (SOL) for Australia, New Zealand and Canada. These SOLs detail all the skills, which are seen to be in demand in that country and if you have expertise in one of these positions, you could be eligible for a skilled working visa. If you would like to work as an agency nurse in these countries you will of course first need to find an agency, some examples of agencies operating overseas are listed below:
- Nursing Australia – A nursing agency that places nursing staff in healthcare organisations across Australia. With offices in New South Wales, Victoria, Queensland, Western Australia and South Australia.
- Geneva Agency New Zealand – This agency provides staffing solutions throughout New Zealand’s healthcare industry. They have offices in Auckland as well as regional offices across the country’s north and south islands to ensure that they can provide local support when it is needed.
- Solutions Staffing Canada – Specialists in placing temporary healthcare staff in organisations that are facing staffing shortages. Travel Nurse, which is a division of Solutions Staffing, place nurses in travel nursing positions across Canada.
You can find more about working overseas in our contracting abroad hub.
Do agency nurses need professional indemnity cover?
Due to the nature of the nursing profession, it is essential to have cover in place for if a negligence claim was to ever be made against you. If you are working for the NHS then you should be covered by the NHS Trust in question. However, this cover does not extend to nurses working for private hospitals and so it is always advisable to check if you need to take out your own cover or not. For more information about professional indemnity insurance take a look at our Insurance for Contractors page.
Do I need to charge VAT for my services?
As a general rule, healthcare professionals such as nurses are exempt from VAT if the following two conditions are met.
- The services that you are providing are within the profession which you are registered to practice.
- The primary purpose of your services is the protection, maintenance or restoration of the health of the person concerned.
Being VAT exempt means that you are not required to register for the flat rate VAT scheme, which will ease your administrative burden because you will have less paperwork to complete. Please note that this is a general rule and it is recommended that you seek advice from a professional who can provide advice based on your situation. Alternatively, you can visit our VAT guide for more information.
What is the best way to operate as an agency nurse?
Aside from simply working and getting paid via your nursing agency, the two most common ways to operate for agency nurses are working as a limited company director or working under an umbrella company. If you decide to operate under an umbrella company, you will be an employee of the umbrella company as they are the ones that pay your earnings to you once they have deducted your tax, your national insurance and their margin. The less appealing aspect of working under an umbrella company is that you will be subjected to full tax and national insurance in the same way that any other employee would be, which makes it a less tax-efficient way to operate.
Any accountant will tell you that working through a limited company is the most tax-efficient way to operate, as it allows greater opportunities for tax planning. However, limited company ownership is generally only recommended to those who are planning to work on a locum or contract basis for a substantial period of time (over three months) and who earn over £25,000 annually. Forming a limited company is probably more straightforward than you may first think and is usually completed the same day, within a few working hours. Limited company ownership does come with some administrative responsibilities such as keeping accurate company accounts and ensuring that the correct amount of tax, VAT and national insurance is paid. For more information take a look at our limited or umbrella, advantages and disadvantages of a limited company and company formation pages.
Limited or umbrella: what is the best way to operate as an agency nurse?
Aside from simply working and getting paid via your nursing agency, the two most common ways to operate for agency nurses are working as a limited company director or working under an umbrella company. If you decide to operate under an umbrella company, you will be an employee of the umbrella company as they are the ones that pay your earnings to you once they have deducted your tax, your national insurance and their margin.
Working through a limited company is usually the most tax efficient way to operate, as it allows greater opportunities for tax planning. However, limited company ownership is generally only recommended to those who are planning to work on a locum or contract basis for a substantial period of time (over three months).
Forming a limited company is straightforward and is usually completed the same day, within a few working hours. Limited company ownership does come with some administrative responsibilities such as keeping accurate company accounts and ensuring that the correct amount of tax, VAT and National Insurance is paid. For more information about the advantages and disadvantages of a limited company, have a look at our guide.
Do I need to appoint an accountant?
If you decide to work through your own limited company, it could be beneficial for you to hire an accountant to support you with all your taxation needs, guide you through the process of company formation and provide ongoing support on matters such as what costs you are able to claim as business expenses.
When choosing an accountant you may want to consider a firm that specialises in the contractor market and have experience dealing with the issues that contractors face – such as IR35.
SJD Accountancy is the UK’s largest contractor accountant and currently has over 15,000 clients. We provide an all-inclusive, fixed-fee accountancy package, which takes care of all your business and personal taxation needs. Our service also includes unlimited access to your own dedicated accountant, free face to face meetings and help to deal with HMRC. For more information about how SJD accountancy can help you please visit our service page or call us directly.