Healthcare workforce crisis: Why are so many staff leaving the NHS?

The NHS has a healthcare workforce crisis. It is estimated that 40,000 nursing and midwifery posts currently stand vacant – enough to fill Hong Kong Stadium. Furthermore, 68% of junior doctors report that staffing gaps occur often, which they suggest sometimes put patients’ safety at risk. To try and plug these gaps, there has been a focus on upping recruitment, with strategies aimed at funding training places in the UK and attracting more staff from overseas. However, it has been suggested that rather than being a problem of poor recruitment, the crisis is primarily driven by too many staff leaving. A quick look at the data supports this view: around 200,000 staff have left their NHS jobs every year since 2011, adding up to a combined total of 1.6 million over 8 years. Why is this? Here I explore the NHS dataset on ‘why staff leave’ to try and understand this problem.

The dataset

The data on ‘why staff leave’ has been recorded in a consistent manner since 2011/2012 and is available to download in a single excel file. There are 38 categories, ranging from ‘Death in Service’ to ‘Voluntary Resignation – Promotion’ (to download the original dataset, click here).

Concerning trends 

Overall, the number of staff leaving jobs every year has been fairly stable with around 200,000 leavers per year. However, given the workforce crisis, there is a need to increase staff retention, and there is no sign that this is happening. There is also evidence that staff are increasingly leaving for specific negative reasons:

  • More staff are leaving due to poor work-life balance. In fact, more than twice as many cited this as their main reason for leaving in 2018-19 than 2011-12. This fits with broader data indicating increasing rates of burnout (see my previous blog post on burnout in mental healthcare staff for more on this).
  • More staff are leaving due to a lack of opportunities. Over 4800 cited this as their main reason in 2018-19 – more than twice as many who cited this as their reason in 2011-12.
  • More staff are resigning for health reasons. Similar to patterns seen with work-life balance and lack of opportunities, over twice as many staff cited this as their main reason for leaving in 2018-19 compared with 2011-12 – 4479 compared with 2126.

 

reasons for leaving

 

Positive trends

Sometimes staff leave their jobs for positive reasons, and the dataset reveals trends in some of these areas.

  • More staff are resigning due to gaining promotions. Over 15000 cited this as their main reason for leaving in 2018-19 – double the number who did in 2011-12.
  • More staff are leaving to take up education and training opportunities. Remarkably, the pattern is similar to that seen with promotions. Nearly 5000 left for this reason in 2018-19 – twice as many who said this was their reason in 2011-12.

 

positive reasons for leaving

 

The need for caution

These results highlight some concerning trends which suggest that dissatisfaction with work is one factor contributing to the current healthcare workforce crisis. However, they also reveal some positives – more staff than ever are leaving for education, training or a more senior post. When considering this data, there are two key issues to bear in mind. First, just because a staff member has left their job, it doesn’t mean they’ve left the NHS or even their organisation – they may simply have switched to another role. Second, if a person has had a few job changes over this 8-year period, they will be represented multiple times within the dataset. Both these issues could inflate the overall impression of the problem provided by this analysis.

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