The National Guardian's Office has launched a review to identify barriers that prevent temporary staff from speaking up about patient care and safety, showcase good and innovative practices and make recommendations to strengthen the ability of temporary workers to raise concerns.

The review was prompted by Health Services Safety Investigations Body finding that, among other things, contingent workers were discriminated against because they were temps, and in some cases because of their ethnicity; and that some temporary workers felt unable to raise concerns about patient safety with the organisation in which they are working because they fear they will lose future opportunities to work in that organisation.

The Recruitment and Employment Confederation (REC) is working with the independent National Guardian's Office to involve as many agency nurses as possible in the study.

REC deputy chief executive, Kate Shoesmith, said: ‘We need this to encourage the NHS to listen to agency nurses and fix how they are treated, not see them as an easy scapegoat. We strongly encourage agency nurses and agencies themselves to take this all-too rare an opportunity to have their say on how to make the NHS a better workplace.'

Bethany Carter, interim director of operations and strategy at the National Guardian's Office, said: ‘Everyone working in the NHS should feel safe, supported and confident to speak up including those in temporary roles. This review gives temporary workers the chance not only to share the challenges they experience, but also to highlight examples of good practice already making a difference. Their voices are vital in helping us shape clear, practical recommendations for positive change.'

Temporary and agency nurses can get involved in the review by completing a questionnaire.

The review and its recommendations are expected to published by the end of February 2026.