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Contracts and shift work

Zero-hours contracts in healthcare

Bank and casual work: the rights you have now, and the reforms the government plans for 2027.

By , Editor Updated How we check sources

Where this applies

This guide covers England, Wales and Scotland. Northern Ireland has no ban on exclusivity clauses in force and is consulting on its own zero-hours reforms through the Department for the Economy's Good Jobs plans. Check current rules with the Labour Relations Agency (opens another website) or nidirect (opens another website).

Short answer

On a zero-hours contract your employer does not have to offer you work and you do not have to accept work. You are usually a worker, which gives you the National Minimum Wage, paid holiday, rest breaks and protection from unlawful deductions. Your employer cannot stop you working for someone else.

The Employment Rights Act 2025 contains new rights on guaranteed hours, notice of shifts and pay for cancelled shifts. The government plans to bring these in during 2027. They are not yet in force.

Key facts

Exclusivity
Clauses banning work for other employers are unenforceable for zero-hours workers in Great Britain (Employment Rights Act 1996, section 27A).
Holiday
5.6 weeks a year. For leave years starting on or after 1 April 2024, irregular-hours workers build up holiday based on hours worked.
Sick pay
From 6 April 2026, Statutory Sick Pay has no lower earnings limit and no three waiting days.
Planned reforms
Guaranteed hours offers, reasonable notice of shifts and payment for short-notice cancellation. Planned for 2027, subject to consultation and regulations.

Your status on a zero-hours contract

GOV.UK describes zero-hours contracts as casual contracts where the employer does not have to offer work and the worker does not have to accept work. Most zero-hours staff in healthcare are workers. NHS bank staff, care home relief staff and casual pharmacy staff often fall into this group.

Some zero-hours staff are employees, which brings extra rights such as statutory notice and, after the qualifying period, protection from unfair dismissal. A long run of regular shifts with an expectation you will accept work points towards employee status. Our employment status guide explains the tests.

Rights you have now

  • Pay: at least the National Minimum Wage for every hour worked.
  • Holiday: 5.6 weeks' paid holiday a year. For leave years starting on or after 1 April 2024, holiday for irregular-hours workers builds up at 12.07% of hours worked in each pay period.
  • Rest: rest breaks, 11 hours' rest between working days for adults, and the 48-hour average weekly limit unless you opt out.
  • Sick pay: if you are an employee for National Insurance purposes, check Statutory Sick Pay. From 6 April 2026 the lower earnings limit and the three waiting days were removed.
  • Pay deductions: protection from unlawful deductions from wages.
  • Protection: from discrimination, and for whistleblowing under the protected disclosure rules.

Working for more than one employer

Since 2015, an exclusivity clause in a zero-hours contract has been unenforceable in Great Britain. GOV.UK says you can ignore a clause banning you from looking for or accepting work with another employer. Your employer must not dismiss you or treat you less favourably for working elsewhere. Our exclusivity clauses guide covers the low-income extension and how to raise a dispute.

Reforms planned under the Employment Rights Act 2025

The Employment Rights Act 2025 became law in December 2025. Its zero-hours measures include:

  • a right to be offered guaranteed hours reflecting the hours you regularly work
  • reasonable notice of shifts
  • payment when a shift is cancelled, moved or cut short at short notice

The government's timetable puts these measures in 2027. Consultations on the detail closed in August 2026 and the government has not yet published final regulations. Until the regulations are made and in force, these rights do not apply. Check the business.gov.uk employment changes page (opens another website) for confirmed dates.

An NHS bank example

Say a healthcare assistant has worked bank shifts at one hospital for 18 months, about three shifts a week. The ward often cancels shifts the night before. Under current law, the assistant has no right to payment for a cancelled shift unless the bank's terms provide for one. The assistant keeps a record of booked and cancelled shifts. The record shows a regular pattern, which helps if the guaranteed hours rights come into force, and helps an adviser assess employment status now.

Keep a record of your shifts

  1. Save every booking confirmation and cancellation message.
  2. Keep a simple log: date, hours booked, hours worked, cancellations and notice given.
  3. Check each payslip for hours paid and holiday pay.
  4. Ask the bank office for the written terms, including any cancellation rule.
  5. Raise errors in writing and keep copies.

Variable income makes budgeting hard. Our money worries guide lists support for healthcare staff, and sleep and night shifts covers recovery around irregular rotas.

Questions to ask an adviser

  • Am I a worker or an employee in this arrangement?
  • Am I receiving the correct holiday pay for irregular hours?
  • Do I qualify for Statutory Sick Pay?
  • Can I claim for shifts cancelled at short notice under my current terms?
  • When will the guaranteed hours rights apply to me?

Where to get advice

  • Acas helpline: call 0300 123 1100. See our Acas guide.
  • Labour Relations Agency: for Northern Ireland, call 03300 555 300.
  • Your union or professional body: the RCN represents bank and agency nursing staff, Unison and other unions cover healthcare support workers, and the PDA covers pharmacists.
  • Citizens Advice: help with holiday pay, sick pay and benefits. See Citizens Advice for work problems.
  • An employment solicitor: for a status dispute or a dismissal.

Common questions

Do zero-hours workers get holiday pay?

Yes. Zero-hours workers are entitled to 5.6 weeks' paid holiday a year. For leave years starting on or after 1 April 2024, holiday builds up based on the hours you work.

Can a zero-hours employer stop me working elsewhere?

No. Exclusivity clauses in zero-hours contracts are unenforceable in Great Britain, and your employer must not treat you worse for working for someone else.

Have zero-hours contracts been banned?

No. The Employment Rights Act 2025 adds a right to be offered guaranteed hours, notice of shifts and pay for late cancellations, planned for 2027. Zero-hours contracts remain lawful.

Do I get paid if a bank shift is cancelled?

Only if your terms provide for a cancellation payment. A legal right to payment for short-notice cancellation is planned under the Employment Rights Act 2025 but is not yet in force.