Since before the inception of Agenda for Change, the standard working week for nursing staff within the NHS has been 37.5 hours. However, in both the NHS and independent sectors seven in ten nursing staff report working in excess of their contracted hours at least once a week.

Just over a third do so several times a week and 13.5% work additional hours on every shift. Patterns of work for nursing staff are driven by patient need, meaning services are often required to cover a 24-hour period, 365 days per year.

Increasingly, primary care services are required seven days a week and on an out-of-hours basis. Rota systems often result in variable hours in any given week, particularity where long days are part of the staffing model.

International evidence indicates that reducing the working week in health care while maintaining full pay, frequently results in improved staff wellbeing, better work-life balance, and reduced absence (Haroldsson G and Kellam J, 2021). Across Organisation for Economic Co-operation and Development (OECD) countries, the average working week is already closer to 37 hours, with a trend towards further reduction (OECD Data Explorer, no date).

In April this year, NHS staff in Scotland’s standard working week was changed to 36 hours with no loss of earnings.

References

Haroldsson G and Kellam J (2021) Going public: Iceland’s Journey to a shorter working week. Available at: autonomy.work/wp-content/uploads/2021/06/ICELAND_4DW.pdf (Accessed 7 April 2026).

OECD Data Explorer (no date) Average usual weekly hours worked on the main job. Available at: data-explorer.oecd.org (Accessed 7 April 2026).

Royal College of Nursing (2025) State of the Profession Report: RCN employment survey 2025. Available at: rcn.org.uk/Professional-Development/publications/rcn-employment-survey-2025-uk-pub-012-342 (Accessed 7 April 2026).

Scottish Government (2025) Reduction in the working week for Agenda for Change staff in NHS Scotland. Available at: publications.scot.nhs.uk/files/pcs2025-afc-08.pdf (Accessed 7 April 2026).