Nursing vacancies fall but agency spend stays stubbornly high
Substantive recruitment has improved across most regions, yet trusts are still paying premium rates to cover specialist rotas.
Substantive nursing vacancies have fallen for a fifth consecutive quarter, but the saving trusts expected has not materialised.
The gap sits in specialist areas. Critical care, theatres and neonatal rotas continue to rely on premium agency cover because the internal bank cannot supply the skill mix required at short notice.
Directors of nursing say the answer is rota design and retention rather than headline recruitment. Several trusts have started publishing internal fill rates by speciality to make the pressure points visible to boards.
The national picture masks wide regional variation, with coastal and rural trusts reporting the hardest positions.
Published 30 August 2026
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