AI agents for business finance: what they can and can't do
What AI agents can do in bookkeeping, close, collections and compliance today, where a person must stay in charge, and how to judge a product.
The short answer
A nursing agency that only supplies nurses to hospitals, care homes or other providers that take responsibility for the care generally works as an employment agency or business and does not register with the CQC for that supply. Registration is needed when the agency itself provides nursing care, personal care or treatment to people, for example by sending nurses to patients at home under its own management. CQC's guidance turns on who is responsible for the care.
Nurses who have worked agency shifts often see the next step clearly: set up an agency, sign up colleagues, and supply hospitals and care homes. The first question is whether that needs Care Quality Commission registration. The answer depends on what the agency does, not what it is called. This guide explains the CQC position as its scope guidance sets it out, and what else an agency needs. It covers England, where CQC is the regulator; Scotland, Wales and Northern Ireland have their own regulators.
What CQC regulates
CQC registers providers of regulated activities. Its scope guidance names, among others, treatment of disease, disorder or injury; nursing care; personal care; and accommodation for persons who require nursing or personal care. A business that carries on one of these must register. A business that only supplies staff to someone else who carries it on is in a different position.
Supply only: the employment agency exception
CQC's personal care guidance says an employment or introductory agency that supplies care workers is excepted where the workers are supplied to another organisation that takes responsibility for providing the care, or to a person who arranges their own care through a personal budget or a private arrangement. The same logic applies to a staffing agency supplying nurses: the hospital trust, care home or clinic directs the nurse's work and is the registered provider for the care.
| Model | Who is responsible for the care? | CQC position |
|---|---|---|
| Supplying nurses to NHS trusts, care homes and clinics for shifts | The client provider | Generally not registrable for the supply itself |
| Introducing a nurse to a family who employ and direct them privately | The family | Excepted as an introductory agency |
| Sending your nurses to patients' homes to deliver care you plan and manage | Your agency | Registration needed for the regulated activities you provide |
| Running a clinic or treatment service with your own nurses | Your business | Registration needed |
CQC's pages do not address nursing agencies by name, so where your model sits close to the line (for example, an agency that also coordinates home visits), ask CQC directly before you trade, and keep its reply.
The rules that apply to a supply agency
- Employment agency law. Agencies and employment businesses in Great Britain operate under the Conduct of Employment Agencies and Employment Businesses Regulations 2003, which set rules on terms with workers and clients, fees and record-keeping. Read them before you write your contracts.
- Professional registration checks. Check every nurse's registration with the Nursing and Midwifery Council before each placement, and keep evidence. See our guide to the NMC PIN and its fees.
- Right to work and vetting. Right-to-work checks, references and enhanced criminal record checks for every worker.
- Insurance. Employers' liability insurance is compulsory if you employ the nurses (insurers describe the minimum as £5 million of cover). Clients will also ask for public liability and, often, professional indemnity or medical malpractice cover.
- Pay and tax. Decide whether nurses are paid through PAYE by you, or through other arrangements, and get advice on off-payroll and agency tax rules.
- NHS frameworks. Many NHS trusts book agency staff through approved frameworks; check what a trust requires before relying on it as a client.
Choosing your model
A supply-only agency is quicker to start: no CQC registration interview, fewer policies and no registered manager. Its margin is the gap between the charge rate and the pay rate. A registered home nursing or domiciliary care service takes longer and costs more to set up, but it can contract directly with councils, families and NHS commissioners. Many founders start with supply and add a registered service later. If personal care is your direction, read our guide to starting a care agency.
Recruiting nurses from Nigeria
Some founders plan to recruit Nigerian-trained nurses. A supply agency is not the employer of record in the way a hospital is, and sponsoring overseas staff through an agency brings its own conditions. Nurses must also complete NMC registration before practising in the UK. Check GOV.UK's current sponsorship guidance and the NMC process before you make any offer, and never charge a nurse a fee to find them work.
Worked example of agency margin
Example only: a care home pays £32 an hour for a nurse. The agency pays the nurse £24 an hour, plus employer costs of about £3.60 (holiday pay, National Insurance and pension). The gross margin is £32 − £27.60 = £4.40 an hour. On 1,000 shifts of 12 hours a year, that is £52,800 before office costs, insurance, software and bad debts. Clients often pay 30 days after invoice while nurses are paid weekly, so working capital matters.
Where Pryme fits
A Pryme Business Account can issue invoices to client homes and trusts and run weekly payroll; the Finance agent prepares the run and a person approves it. Outside Nigeria, Pryme works through regulated partners.
Questions people ask
Does a nursing agency need to be registered with CQC?
Not for simply supplying nurses to providers that take responsibility for the care. If your agency delivers nursing or personal care itself, under its own management, it must register.
Can I start a nursing agency as a nurse with no business experience?
Yes, there is no qualification requirement for running a supply agency, but you must follow employment agency rules, check NMC registration, vet workers and carry the right insurance.
Do I need a licence to run a recruitment agency in England?
Employment agencies in Great Britain work under the 2003 conduct regulations rather than a general licence. Check GOV.UK for any sector-specific licence before you trade, and register with CQC if you provide care yourself.
What insurance does a nursing agency need?
Employers' liability if you employ the nurses, and in practice public liability and professional indemnity or medical malpractice cover, which clients usually require.
Sources
- CQC: Scope of registration, personal care (updated 29 Jan 2025) · accessed Oct 2026
- CQC: Scope of registration, regulated activities (updated 29 Jan 2025) · accessed Oct 2026
- Lycetts: employers' liability insurance (modified 4 Feb 2025) · accessed Oct 2026
This article is general information, not financial, legal or tax advice. Products described are provided under the terms on this site and are subject to regulation and eligibility.