NHS bank rates are set at AfC rates with unsocial enhancements; agency rates are typically 30–60% higher. This shows the annual cost difference for the same hours.
Annual Cost
Bank cost (annual)£39,000
Agency cost (annual)£58,500
Agency premium+50%
Extra annual cost of agency vs bank
£19,500
≈ £375/week
Agencies add value through compliance, flexibility and filling hard-to-cover shifts — but the premium is significant. Many trusts cap agency usage and prioritise bank fill.