The NHS organisation, which is part of The NHS Alliance, urged the Government to pause the plans after its analysis found the proposals could create around £900m in recurring annual costs due to its impact on bank staff.

Sir Ciarán Devane, chief executive of the NHS Alliance, said: ‘While this initiative by the Government is for good reason, current proposals risk landing the NHS with another unfunded cost at a time when cuts have already had to be made to budgets. Patient care will be at genuine risk if fewer staff come forward to fill shifts and if more have to be diverted from other responsibilities to do the admin associated with these changes.'

NHS Employers has suggested ways to make the changes more workable, including:

• introducing the option for individual workers taking on shifts via the NHS bank to opt-out of the right to guaranteed-hours offers where they wish to retain the flexibility of existing arrangements
• removing from the scope any bank worker who already has a substantive contract with the NHS as they already benefit from contractual employment protections, in addition to administrative, clinical management and leadership roles
• exempting bank work needed as a result of emergency response requirements, seasonal pressures, staff sickness absence, annual leave and other short term workforce pressures
• and, removing the need for additional compensation payments for shifts cancelled in short notice period. 

UNISON head of health Helga Pile said: ‘Making employers pay workers for the stress of short-notice cancellation of shifts should encourage better planning in public services. Workers, including those in the NHS, will be able to give their best to patients. 

‘Ministers mustn't cave in to employer groups bent on preserving the power to cut hours or change rotas at the expense of staff wellbeing and service quality.'

A Government spokesperson said: ‘We are fully committed to ending exploitative zero hours contracts, so workers don't bear all the financial risk when hours, shifts and earnings are unpredictable.

‘We welcome the responses to our consultation and are working with NHS organisations to get the detail right to ensure this works in the real world, and our 10-Year Workforce Plan will further set out how we will ensure the NHS has the right people with the right skills to care for patients when they need it.'