To meet patient care needs, NHS employers often rely on flexible staffing models. 

Bank work is used to meet staffing requirements, often to fill sudden short-term changes in staff. But it should only be used on a temporary, short-term basis. It shouldn't be used to cover vacancies or leave, for example, or to reduce safe and effective substantive staffing levels.

Many employers push staff to take extra hours via the bank, often at lower rates. Some bank rates in England are even being cut to the lowest pay bands, undermining experience and responsibility.

If you work on the bank, you should always be paid at your normal rate. Don't accept any less.

Use this page to understand how to fight for change with your colleagues.

Bank work: what's the problem?

The problem for nursing staff

Bank contracts are zero-hours contracts made directly with an employer or NHS providers. This means they often fall outside of NHS terms and conditions, without its protections.

Zero-hour contracts mean no job security and no guaranteed hours. If bank work is your primary form of employment, you may not be able to access:

• statutory minimum sick leave
• parental leave
• other types of basic benefit

What's more, some employers in England are cutting bank rates – often to the lowest points of nursing pay – to reduce costs. This undermines your value and leaves you worse off.

The problem for patients

Bank work is not a long-term solution to staffing shortages. Workforce planning and a secure nursing workforce are the only ways to protect patients.

An over-reliance on short-term workforce arrangements  – like drawing from the bank  – can destabilise the nursing workforce and put patients at risk.

But with living costs continuing to rise, bank work provides important additional income for many nursing staff.

Are bank rates being cut where you work?

It's time to get connected. Use our step-by-step guide to unite with colleagues and call time on bank rate cuts. Just remember:

• Stay professional, organised and clear
• Stick to the plan: it won't work otherwise
• Keep your RCN rep or local officer informed of the action you're taking

• Start informal conversations
• Find out who is affected and who is concerned
• Set up a quick meeting or group chat
• Identify one or two people to coordinate
• Inform your local rep or contact us
• Record the personal impact that rate cuts are having on staff. This could be financially or in terms of wellbeing.

GOAL: Build awareness and support. You don't need everyone – just a core of group of affected colleagues willing to act.

• Keep a confidential note of the impact on patient safety. Remember, don't use patient-identifiable information
• Use your organisation's incident reporting processes, such as Datix, where appropriate
• Use our corridor care and safe staffing checklist to record patient safety issues if you or your colleagues have to provide care in inappropriate places

IMPORTANT: Real impacts on patient care are key to asserting your strength. It's vital that this is recorded for the plan to work.

• Draft a joint letter or email to respond to the relevant managers addressing the impact of bank rate cuts on staff and on the service. The relevant managers may include the ‘Bank Manager’, Chief People Officer, Chief Financial Officer and Chief Nurse. Escalation may progress to the Chief Executive and the Chair of the Board.
• Tell managers that you're willing to cover the staffing shortfall to maintain patient safety and the wellbeing of your colleagues for appropriate financial renumeration that recognises your skills and experience. 
• Make it clear that you're not refusing to work or disrupting care.

RESOURCE: Find information on additional hours rates on our NHS conditions of employment page.

Find information on raising concerns informally on our grievance page.

• Take notes and share updates with colleagues who are unable to attend
• Invite your local RCN rep if they're available. Be clear that this is a collective issue.
• Meet with your group privately to debrief and consider next steps.
  • Was there any movement from the managers/organisation?
  • What evidence have we gathered?
  • Is there anyone who has not joined this group that it would be beneficial to get involved? How can we do this?
  • Are staff being offered overtime?

REMEMBER: This is an informal stage, which means there is no legal right to be accompanied by an RCN rep. It is at the discretion of the organisation’s management. You can also ask RCN Reps to raise issues through your local partnership forum.

If there's no progress and your concerns remain unresolved, work with your local RCN Rep or our regional staff to submit a collective grievance. Be sure to include:

• what changed and when
• the steps you took
• the impact on care, staffing and morale
• requested access to overtime or reinstatement of appropriate bank rates

REMEMBER: A formal grievance requires a response from the employer and may trigger further escalation. Speak with RCN reps or us before submitting.

If, despite the grievance and other actions, the organisation fails to resolve the issues and there is no agreement between you and relevant managers, speak with our regional staff about potentially lodging a formal trade dispute. Then consider whether a ballot for further action may be appropriate.

NOTE: You need to build significant strength of feeling among members locally to reach this stage.

Say no to unpaid hours