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NHS or independent sector – which is best for you?

NHS vs Independent nurse

The majority of new-qualified nurses and midwives go on to work in the NHS, but thanks to the changing employment landscape there are now more opportunities than ever to work in the private healthcare sector. If you’re considering which is right for you, our handy guide may help.

The numbers

The NHS Confederation reported that the organisation employed 377,191 qualified nursing staff in 2014* – unsurprisingly making it by far the biggest employer in the sector. Around 175,000 of these nurses are working in hospitals, with most of the remainder working in the community.

By contrast the independent sector employs more than 100,000 nurses – but this number is increasing as more tendering of work to private providers takes place within the NHS system.

Choose your field first

Before we look at the pros and cons of NHS vs independent sectors, it might be that you’re steered one way or the other by your chosen field of nursing.

For example, if you crave the challenge and excitement of working as an accident and emergency nurse, then you’ll be looking for a job with the NHS. Whereas if you are drawn to a career as a care home nurse, you’ll definitely need to consider the independent sector.

Student nurses choose whether to study nursing related to adults, children, mental health patients or people with learning disabilities while still in training – and this choice can influence whether you’re more likely to go into the public or private sector.

Anyone specialising in paediatric nursing will find the majority of roles are still in the NHS, whereas those studying mental health or learning disabilities nursing will likely have a choice of acute or longer-term care roles in the NHS – or long-term care jobs in the independent sector.

In contrast, studying adult nursing will give you a much wider choice of independent sector roles.

Cast aside those clichés

There may be a perception that most nursing in the independent sector involves working in expensive private hospitals with plush carpets and gourmet food – and similarly that public sector nurses are all bravely battling away in underfunded NHS hospitals.

In reality the independent sector is comprised of a wide range of working environments – from care homes and hospices to oil rigs – and of course some fancy hospitals.

At a basic level, the sector can be divided into for-profit care providers (such as private hospitals and insurers) and not-for-profit ones (such as charities, hospices etc.).

The public sector isn’t just the NHS either. It covers the thousands of nurses who work in the three armed forces, school nurses – and many of those working in prisons and young offender institutes.

Nurses are also playing an increasingly significant role in primary care provision in the NHS with the advent of the nursing practitioner – assessing patients and carrying out certain procedures in GP surgeries.

Pay rates

The received wisdom is that the NHS will offer you a better pension and job security than the private sector. However, with radical changes happening in the NHS and the wider economy, the pension situation for public sector nurses now looks less copper-bottomed than it has in the past.

Most private healthcare companies pay similar rates to the NHS – but these are not governed by the Agenda for Change as they are in the NHS, and may fall short. On the other hand, you may be able to negotiate a higher salary than the one advertised. Working for the private sector may allow you to work closer to home and offer more flexible working arrangements.

Career development

Career development is one area where the NHS shines. As the UK’s biggest employer it offers a myriad of opportunities to move upwards or sideways – and there’s a firm career ladder in place with incremental pay rises and a focus on mentoring and continuous professional development.

This is something that some private healthcare companies (particularly smaller ones) can lack. When applying for a role in the independent sector, make sure to ask about training and mentoring. If the interviewer can’t outline the company’s career development opportunities or describe the career path of a similar employee, you may want to re-consider your application.

The work environment

Also think about what kind of working environment will suit you. For example, would you prefer to work as part of a team of nurses in an NHS hospital, or have the autonomy and responsibility of being the only nurse in charge of a team of care assistants in a private nursing home?

While some nurses feel more comfortable working within the structure of the NHS, which has clearly defined policies and procedures, others prefer working in the independent sector which can have less red tape making it easier to implement new ideas.

Of course, the best way to discover the pros and cons of working in the NHS and the private sector is to experience both. Signing up as an agency nurse will give you the opportunity to do just that, and also has the appeal of offering flexible working patterns.

Before you make a decision, it’s worth speaking to people who have switched from one sector to another. Although everyone’s experience will be different, you may pick up some useful insights.



Image Copyright: Syda Productions,


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