The Employment Rights Act 2025 received royal assent in December and is now working its way through a staged implementation that runs into 2027. Among its central provisions is a new duty on employers to offer guaranteed hours to workers who regularly clock up shifts on a zero-hours or low-hours basis, calculated over a reference period the government currently favours setting at twelve weeks. Ministers have framed this, along with new rights to reasonable shift notice and compensation for late cancellations, as ending what they call one-sided flexibility. For the hospitality and retail sectors that dominate public discussion of zero-hours work, that framing is broadly uncontroversial. For the NHS, whose staff banks depend on the same contractual mechanism, it is proving more complicated.

An impact assessment published this month put the direct cost to employers across the economy at between £350m and £2.9bn a year, with an indicative central estimate of £1.1bn. Roughly £1.2bn of the upper-end figure relates specifically to compensation for cancelled or curtailed shifts. Business groups have queued up to call the numbers an underestimate, but the government's own admission that the reforms will increase administrative costs and reduce employer flexibility is itself notable, since it concedes the trade-off health service leaders have been warning about since the legislation was first drafted.

NHS banks are not the gig economy arrangement the reforms were designed to curb. A large proportion of bank workers already hold substantive NHS contracts and use bank shifts to pick up additional, voluntary hours around their permanent role. Dean Royles, interim chief executive at NHS Employers, has urged chief people officers to audit current bank use, map which staff are working regular patterns, and review rostering processes ahead of the changes, warning that the duty to offer guaranteed hours could otherwise sweep up exactly these workers by accident. Legal advisers working with trusts have made a similar point: without a clear carve-out, staff who already have a substantive contract and simply pick up predictable bank shifts on top of it risk becoming eligible for a second, overlapping guaranteed-hours offer, adding administrative complexity without addressing any genuine exploitation.

The agency question compounds this. The Recruitment and Employment Confederation has specifically cited healthcare in its objections to how the guaranteed-hours duty might apply to agency staff, pointing out that a trust can ask an agency to supply nurses at short notice to cover sickness or an unexpected surge in demand, then cancel those shifts when circumstances change. Under the proposed rules, the agency could become liable for cancellation payments arising from a decision it had no part in making, before it has any mechanism to recover the cost from the trust that cancelled. A government consultation on how the guaranteed-hours measures should apply to agency workers closed in late 2024, with the outcome published the following March, but the practical detail of who bears the liability in a healthcare setting remains unresolved.

None of this undermines the underlying purpose of the legislation, which targets a real problem in sectors where zero-hours contracts genuinely do function as one-sided flexibility. But it does illustrate a familiar pattern in how NHS-adjacent employment law gets made: a policy calibrated for the retail till or the delivery rider gets applied, largely unmodified, to a workforce with its own contractual architecture and its own safe-staffing imperatives. With trusts already absorbing efficiency targets ahead of October's Budget, an unbudgeted and still not fully specified compliance cost is not the kind of flexibility the service was hoping for.