Better patient care starts with better supported healthcare staff

Supporting NHS staff through financial pressure

NHS organisations are among the most people-focused employers in the country and the best of them know that financial wellbeing is part of looking after their people. Like workers everywhere, NHS staff feel the pressures of the cost of living: 78% worry about their finances daily, and 89% say financial stress directly impacts their work (Zellis, 2024).

Forward-thinking organisations chose to act. By deploying Stream as a Workplace Finance solution, they gave staff flexible pay access, earnings visibility, savings, budgeting, coaching and rewards. All in one place.

"Our job's probably one of the most stressful jobs that you can have. So having the sort of financial weight lifted with using the Stream app sort of counterbalances."
NHS frontline worker, Roundtable participant

The situation was reflected clearly in what NHS staff told us directly:

• Before Stream, calculating bank shift pay was a manual, error-prone process: "I had a spreadsheet and I had to very delicately make a spreadsheet... quite often I'd not calculated correctly when my payslip came."
• Financial anxiety was directly affecting patient care: "When I go to work feeling stressed about money, it's something that would not be good for my patients."
• Staff shortages driven by financial stress were a visible and growing problem at organisation level.

A complete Workplace Finance solution, built for the NHS

Rather than a single product, Stream offers a suite of over ten interconnected financial wellbeing tools, each designed to address a different dimension of financial pressure:

• Track:  Real-time earnings visibility, integrated with shift rostering. Staff can see exactly what they have earned, including unsociable hours enhancements, as soon as a shift is completed.
• Budget: Tools to help employees plan and manage their finances across the pay period, keeping them on track to meet their financial goals.
• Save: A workplace savings account with bank-beating interest rates and FSCS protection up to £85,000. Enables staff to automatically set aside money each payday.
• Rewards: Personalised discounts on everyday essentials, informed by the employee's own spending patterns, with cashback linked to Savings pots.
• Pay: On-demand access to up to 50% of earned, unpaid earnings. Used by around 33% of enrolled NHS employees per month.
• Coach: A personalised financial education hub with coaching, a Financial Health Check, and debt advice services tailored to NHS employees.
• Benefits checker & debt support: Checks benefit entitlements in under three minutes. NHS members are entitled to an average of £559 per month in unclaimed benefits.

"The good part of it is the saving tools. There's an interest that comes with the savings, when you save, you get interest... And all the coaching tools. I love the coaching tools with the AI. It pops up and says, did you know you spent such and such? And you could save by using this voucher."
NHS frontline worker,  Roundtable participant

Stream is used across the full spectrum of financial needs, not just Pay. Among NHS members, 83% actively engage with Track and Budgeting tools, using real-time earnings data to plan ahead. 65% use the Financial Health Check, and 57% are actively building savings, with 70% of those nudged by the app going on to save. Flexible Pay, while the feature most organisations launch with, represents just one dimension of the platform: 35% of employees on Stream use it each month, alongside a suite of tools that together address financial resilience at every stage of the pay cycle.

This breadth is why 90% of NHS organisations expand beyond bank-only access once live. The impact is measurably stronger when the entire workforce can engage with the full platform.

From spreadsheets to real-time clarity

The impact of Stream on NHS employees has been measured across 171,000+ members. The findings show a consistent and significant improvement in financial confidence, behaviour, and wellbeing:

• 80% feel more in control of their finances
• 76% feel less stressed about money
• 91% feel more positive about their employer
• 60% are more aware of how much they are earning
• 38% are more aware of how much they are spending
• 37% borrow less from friends and family
• 22% sleep better at night
• 29% are better able to focus on doing a good job at work
• 13% say they are more likely to work for their employer for longer

The shift in daily experience for bank staff has been particularly marked. Track,  which gives real-time visibility of earned wages broken down by shift, has transformed what was previously a stressful guessing game into a motivating, clear picture:

"Since Stream, I can see what I've earnt in every bank shift and I can literally see it as soon as I've completed the shift. Not only see how much money is available, how much money I've earnt within that shift, but a trajectory, and it's quite inspiring and really motivating actually, to sort of want to book more shifts."
NHS bank staff member, Roundtable participant

The emotional dimension of this change is significant, and staff speak candidly about the connection between financial security and the quality of care they deliver:

"When I go to work feeling stressed about money, it's something that would not be good for my patients, because I would probably wear a grumpy face or a grumpy look. So, I want to be in charge of my finances, happy about what I do and go with the right spirit when I'm at work."
NHS frontline worker, Roundtable participant

Savings milestone

Across the NHS member base, staff have opened over 50,000 savings accounts and deposited more than £20 million through the Stream platform, with £338,000 paid back in interest.

"Using the savings builder has been a God send, because even when I have dipped into my normal savings account, I have still had the pot in Stream that I have just been able to forget about and let it build up."
NHS frontline worker, Roundtable participant

Stream's measurable impact on NHS organisations falls into three areas: a reduction in agency spend and improvement in shift fill rates, stronger staff retention and lower vacancy rates, and a direct connection between employee financial wellbeing and patient care. Each is explored below.

Reducing agency spend and improving shift fill rates

When employees have real-time access to their earnings and the ability to draw income between paydays, the incentive to do agency shifts, where faster payment has traditionally been the main draw, is significantly reduced.

Employees using Stream work 11% more hours per week, with NHS employers seeing an average increase of 5 hours worked per bank assignment, directly reducing reliance on costly agency labour.

"There has been a reduction in agency, staff feel more comfortable and willing to take on more bank work. We've also seen an increase in our bank fill percentage also, because it's allowing competition with the agencies on giving bank staff more regular access to their wages."
Rob Shuttleworth,  Head of Workforce Intelligence,  NHS Frimley

Retention and vacancy rates

The impact on retention has been equally significant. At Royal Surrey NHS Foundation Trust, Stream is cited as one of the contributing factors in a sustained improvement in workforce stability:  

"In the last 12 months, the Trust has done very well with decreasing our vacancy rates which are down about 30%. Staff turnover has also decreased and with that our agency spend."
Tom White,  Human Resources Director,  Royal Surrey NHS Foundation Trust

For nursing teams, the most visible change has been the return of agency workers to substantive or bank employment, a shift that directly strengthens service continuity:

"Staff who were doing agency shifts to access that money straightaway have now come back and are doing the shifts here, which is great. Compared to a year ago we've got a much better fill rate on our bank and shift uptake."
Julie Burgess,  Head of Nurse Surgery,  Royal Surrey NHS Foundation Trust

Newcastle upon Tyne Hospitals NHS Foundation Trust

16,000 employees | NHS

When the cost of living crisis hit, Newcastle Hospitals didn't look for a single benefit to patch the problem, they deployed Stream's full suite. From flexible pay and spending budgets to savings, Rewards, financial coaching and expense claims, the organisation gave staff the tools to manage their finances in the round, going live within a month via Allocate.

74% of employees who use Stream say they feel less stressed. The organisation was also shortlisted at the 2023 Employee Benefits Awards (Best Public Sector Benefits) and awarded Highly Commended at the Make a Difference Awards (Best Support of Financial Wellbeing).  

"You know, anything we can do to make staff's lives better has an impact right the way along and ultimately impacts patient care."
NHS frontline worker, Roundtable participant  

"If you've got staff who are less stressed, you've also got staff who are less likely to suffer illness. So their attendance at work is going to be better. We've all experienced staff shortages due to staff sickness, and stress is one of the big reasons for staff sickness in the NHS."
NHS frontline worker, Roundtable participant