One in nine staff leaves the NHS each year, and needs to be replaced if the number of people working in the NHS is to remain consistent, let alone keep up with growing need. The leaver rate of nurses and health visitors increased significantly over this decade, from 8.5% in 2010/11 to 10.7% in 2017/18, before recovering slightly to 10.2% in 2018/19. In nursing, around 2% of the workforce leave the NHS each year at retirement age, while 8% leave before that age. Finding ways to support these staff to stay will be part of the solution to reducing staff shortages in the NHS. It is also important because people leave for a reason – and looking at retention focuses attention on why people leave, and how to improve staff experience and morale. Choosing to leave a job is a complex, personal decision, which can be the result of a number of things, such as work-life balance, pay, morale and job prospects.

Reasons for leaving the NHS

Over recent years, work-life balance in particular has increased as a reported driver, with more than two-and-a-half times as many people citing it as a reason for leaving the NHS in 2018/19 than in 2011/12 (see Figure 20). While this is partly accounted for by more nurses leaving and increased data availability, it has grown from representing 17% of stated voluntary reasons for leaving to 23%, where we have the relevant information. However, the analysis we can do here is limited because the most common reason reported for leaving is ‘other/not known’.

Figure 20: Change in reason for leaving given by staff (for voluntary resignations), 2011–12–2018–19

Source: NHS Digital. NHS Workforce Statistics.

Movement within the NHS

Retention is an issue not just in terms of the number of staff leaving the NHS entirely, but also the movement of people from their organisation. Community trusts have much higher rates of staff leaving than other types of trust – and twice as high as acute teaching trusts (see Figure 21). Retention rates are also lower at smaller acute trusts than medium or large acute trusts. Some of these findings will be driven by other factors, such as the types of staff they employ and their geographical location.

Figure 21: Leavers from the organisation, by type, 2018/19

Source: NHS Digital. NHS Workforce Statistics.

While there are some early positive signs from the NHS Improvement retention programme, and some indication that leaver rates have slowed this year, future progress will rely on the NHS’s ability to embed and spread these efforts in the context of ongoing staff shortages.

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