At the start of the pandemic NHS England, understood the need to ensure everyone carrying out duties in NHS premises had rights to follow public health advice to self-isolate on full pay. Without this right, workers are under huge financial pressure to come to work when they should be self-isolating, creating avoidable risks of infection for all staff and patients.


On 2.3.20 NHS England said this right should extend to all workers, including bank staff and workers employed by sub-contractors. However, a joint statement by Department of Health and Social Care, NHS England, Public Health England, NHS Employers and NHS Improvement substantially weakens this earlier pledge to just bank and subcontractors. In guidance issued on 27.3.20 they state: “Where an individual has no substantive employment with an NHS employing organisation, they will not be entitled to any pay from the NHS. Individual agencies should determine their own approach to pay for employees that have to self-isolate.”


The original pledge was not made because NHS management had suddenly become champions of workers’ rights. On the contrary, management issued this statement because they understood that it was essential for infection control purposes that there was no financial pressure forcing workers into NHS hospitals when they had signs of Coronavirus infection. They understood that the degrading of workers’ rights over many decades of outsourcing and real-terms pay cuts was one of the important ways in which the NHS was ill prepared  to deal with the pandemic.

It is not clear what happened between the 2nd and 27th March that meant agency workers were dropped from this basic protection. And if agency workers are not covered by the latest guidance then the infection control problems remain.


The government and NHS employers resent having to pay agency nurses wages but it is a problem of their own making.  Since 2010, nurses pay has fallen by around 15% in real terms. Nursing shortages due to poor workforce planning, Brexit, the scrapping of the student bursary and similar mean that there were 44000 fulltime nursing vacancies across the NHS when we entered this crisis. Many nurses, fed up with low pay and increased workload, have opted for agency work. They are now a large section of the NHS workforce. Some may be able to take the financial hit of a week or fortnight in selfisolation but some will not. If we are serious about slowing the spread of the virus then they need the same right to sick and selfisolation pay as substantive staff.

Moreover, agency work is not just confined to clinical staff. Many outsourced cleaning, security and transport services use agency to backfill staff vacancies. These are often very low paid and have very few rights.

As staffing shortages increase through the pandemic, the NHS will become ever more dependent on agency workers. They will be working alongside substantive staff through the crisis. As a basic infection control measure and to fulfil the employers’ health and safety duties, all workers including agency workers, need the right to selfisolate on full pay.

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