Agency Nurse: Salary, Benefits and Challenges

by: Nurse Jaime

An agency nurse (or locum nurse) is someone who temporarily fills in a shift for a particular NHS Trust or private sector. Usually an agency nurse would end up working in different places depending on available shifts that his or her agency has. If you choose to go on this route of being self-employed, travelling to different hospitals will be a part of your life. You’ve hit a jackpot if you get shifts with block bookings in a hospital near where you live. Nevertheless, you have the option to choose the hospital that you want to work in depending on your circumstance and the hourly rate given. If you are willing to travel you could always get a high paying shift.

If you have finally decided that you are confident enough with your technical skills as a nurse and the courage to work in different hospitals, you must first register with a nursing agency. This is your point of contact on booking shifts. Each nursing agency will have connections with different NHS and private hospitals. You can register with more than one agency to increase the chance of looking for shifts. You must complete all the necessary documents and mandatory training to ensure that you are fit to practice before you can book any shifts. For every agency that you join in, it’s basically applying for a new job every time. 

Let me get straight to the point. The primary reason why some nurses opt to go into full time agency work is the SALARY. The hourly rate ranges from £22-£45 and it is way more than an hourly rate of a Band 5. However, this is a very high risk job. As you wouldn’t have any employee benefits being self-employed, you won’t get any sick pay, paid annual leave and pension contribution.

An agency nurse can earn in a week what a full time band 5 nurse earns in a month. There may be some shifts out there where the rates are terrible. Personally in my experience I did shifts wherein I was paid £22 an hour. If you do the math, I did 38 hours per week at that time, so I earned £836 a week and that is £3,344 a month. But as agency nursing offers flexibility, you can choose a workplace that will give you better rates. 

Let us look at a median rate in which I got £28 an hour, so that is £4,256 in a month working 152 hours. Personally, that is quite a good monthly wage for me. Higher paying rates may also be available at times. There was one particular hospital that I worked in who offered £34 an hour. For 150 hours in a month, I can get £5,168.

There would also be emergency, special and weekend/night rates. Emergency rates happen very rarely, this would be for covering shifts with very short notice and they are desperate to find someone. It is so rare that I have never encountered it personally in 5 years as an agency nurse. Special rates are for certain skills that demand more pay. For example, a Surgical First Assistant can get a lot more than a scrub nurse with rates ranging from £40- £55 an hour. There is also an enhanced pay for weekends, bank holidays and night shifts but the rate will still depend on your agency and the hospital that you will be working in. 

Being an agency worker also offers a great deal of flexibility of when and where you want to work. You decide what dates you want to work and you don’t have to worry about booking annual leave because you can take a time-off whenever you wish to. 

To be honest, since I decided to go on agency I have learned so much more in my craft. As a theatre nurse, I have seen different surgeries, techniques and practices that I would have never encountered if I stayed in one place.

So, what about your tax? As an agency worker you can get paid as a self employed and have your limited company, or through an umbrella company or PAYE (Pay as you Earn). As a director of your Limited Company, you need to hire an accountant to sort out your corporation tax and self-assessment which you will be paying every year. Most agency workers especially those who choose to book shifts in the NHS are being paid through an umbrella company or PAYE. With these, you will get your net salary and all the necessary deductions (NI tax, income tax etc) are already in place so you don’t have to worry about hiring an accountant for this route. So looking for a good umbrella company is vital to get a better salary and make the most of your hard-earned money. 

Agency nursing may be financially rewarding but it doesn't come with consequences. There may be times that no shifts are available. And that equates to NO WORK NO PAY. This also applies to when you get sick, get injured, or any circumstances where you’ll be unable to work, would also mean you wouldn’t get paid. You also have to think about getting a private pension or some sort of investment to prepare for your retirement if you’re thinking of doing this for the longer term. 

You will also be totally out of your comfort zone as you don’t have a set workplace. You will be working with different people in various hospital settings. As an agency, you’re expected to be competent at what you do and that means you must be able to adapt to their systems in a short period of time. Before working as an agency nurse, assess yourself if you are experienced enough to adjust to different settings and practices. At the end of the day, you are accountable to your own actions and you have to make sure that you're delivering care to patients safely. 

Being an agency nurse can offer a great deal of flexibility and better salary. There is no doubt about it. If you’re ready to spread your wings and fly solo, just make sure that you feel really confident with your craft and be mindful of the challenges that you may encounter. Always have a back up plan and savings as you wouldn’t get benefits that an employed nurse can get. Look after yourself, be confident but still practice within the limits of your competence. After all, no matter where we work as nurses, we always have to put patient’s safety first.