Better patient care starts with better supported healthcare staff

Why did the NHS need Stream?

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.

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

Before Stream, calculating bank shift pay was a manual, error-prone process:

Financial anxiety was directly affecting patient care:

Staff shortages driven by financial stress were a visible and growing problem at organisation level.

What challenges did Stream solve?

Stream brought together a set of interconnected tools, each addressing 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 £120,000. 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.

Stream is used across the full spectrum of financial needs, not just Pay:

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.

What was the business impact?
- 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:

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:

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:

- A 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.

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 at NHS Frimley

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.

- Retention and vacancy rates at Royal Surry NHS Foundation Trust

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:  

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:

NHS16,000 employees

Newcastle upon Tyne Hospitals NHS Foundation Trust

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).  

• Shortlisted · Employee Benefits Awards 2023
• Highly Commended · Make a Difference Awards