Spending on agency nursing and care staff falls by £120m since 2023

Northern Ireland’s Health and Social Care (HSC) system has cut its spending on off-contract nurses, midwives and healthcare support workers by £120 million since May 2023, the Department of Health has confirmed.

The reduction follows the introduction of the Nursing/Midwifery and Healthcare Support Framework, a procurement reform designed to curb high-cost agency spending and strengthen the long-term stability of the workforce.

Health Minister Mike Nesbitt said the framework had now been fully implemented across all Trusts, marking a significant shift in efforts to bring agency expenditure under control.

He said:

“The Nursing/Midwifery and Healthcare Support Workers Framework has been successfully adopted by all Trusts and is working well. The new Framework is the first step in an extensive programme of work which has been undertaken in partnership with our trade unions to control and reduce the use of agency workers and build a substantive workforce.”

Mr Nesbitt added:

“This Framework, alongside work that we are progressing to end our reliance on agencies across all professions, is continuing to play a significant part in helping to build a sustainable workforce that delivers safe and effective care.”

A Shift Towards a Sustainable Workforce

Introduced on 15 May 2023, the new framework established a list of approved suppliers for agency nurses, midwives and support staff, with pre-agreed payment rates and contractual terms.

The move was intended to end the use of “off-contract” agencies — providers not covered by public procurement rules and typically associated with higher fees.

The Department said the work of reducing agency dependence is ongoing across all health professions, forming part of a wider plan to stabilise teams, support recruitment, and grow a permanent workforce.

Trusts continue to prioritise filling permanent vacancies but accept that some short-term agency use may remain necessary. Any continued agency deployment will be managed in a “safe, measured, and phased way”, officials said.

While the goal is to eliminate off-framework spending entirely, a small number of complex or high-risk patient cases still require specialised agency arrangements. These cases are monitored closely by both the Trusts and the Department of Health to ensure patient safety.

A Major Milestone in Workforce Reform

The £120m reduction marks one of the most significant financial impacts of the framework to date and is expected to ease pressure on already stretched health budgets.

Officials believe continued collaboration between the Department, Trusts and trade unions will be crucial as reforms progress towards a more stable and sustainable workforce model.