The NHS Great Resignation

The last two years have put immense pressure on NHS staff, who have worked tirelessly to treat patients and protect the public throughout the Covid-19 pandemic.

NHS workers have been on the front line through numerous waves of Covid-19 – and after a prolonged and turbulent period for health services and those who work to provide them, we wanted to look at how many medical professionals have left the NHS in this time.

Google searches for “leaving the NHS” are up 129% year-on-year – showing more people may be considering leaving the health service, despite life outside of work largely returning to normal and most Covid restrictions now being lifted. There were peaks in search volume in March and December 2021, which could indicate fatigue in the light of coronavirus case surges.

As experts in medical negligence claims, we know the impact that instability in NHS departments can have on the quality of patient care.

We looked at NHS Workforce statistics to find out the volume of staff leaving the NHS in recent years, which roles are coming under the most pressure due to staff resignations, and which areas of the country are feeling the most strain.

How has the number of staff leaving changed?

Analysing figures starting from Q1 2020, which ended with Prime Minister Boris Johnson implementing nationwide lockdown measures aimed at suppressing the spread of the virus, we found that 171,276 staff have quit the NHS in total in the roughly two years of Covid-19.

Looking at yearly figures for total resignations we found that in 2018, 117,340 staff resigned in total while 2019 saw similar numbers – 115,518 NHS staff left their roles in the year preceding Covid-19.

The onset of the pandemic looks to have curtailed these numbers slightly – perhaps due to would-be leavers staying on to support efforts against Covid-19. In 2020, the total number of resignations fell 13%, with just 101,435 staff leaving in the first year of the pandemic.

But the data shows that this reduction didn’t last – comparing resignations in Q2 2021 shows that year-on-year the number of staff leaving increased by 31%, with 41,126 staff leaving. More people resigned in this quarter than in the same periods in 2020 (29,883) and 2019 (33,557), meaning people are leaving the NHS in higher volumes post-Covid than they were before the virus emerged.

The most common reasons for leaving the NHS

NHS data on the reasons leavers cited for resigning indicates dissatisfaction in the role as the primary factor in people moving away from their careers in the NHS.

In our analysis of the Q2 2021 resignation data, we found that the most common reason given for people leaving the NHS was work life balance, suggesting the stresses and strain on NHS workers is having an impact on staff retention.

Also in the top five common reasons cited are staff desiring a better reward package and a lack of opportunities within the NHS.

Most common reasons cited for leaving NHS (Q2 2021-22)*: 

1. Work life balance (6,756)  
2. Health (1,917) 
3. Better reward package (1,544)  
4. Lack of opportunities (1,011) 
5. Child dependants (822) 

In the first half of 2021 NHS resignations for health-related reasons rose 30% year-on-year, from 2,559 in the first six months of 2020-21 to 3,328 in 2021-22.

And issues around satisfaction in the role are increasing with more people resigning for these reasons - the NHS saw a 57% y-o-y increase in staff resignations referencing work life balance as the reason, from 7,690 to 12,060 staff.

Resignations citing a “better reward package” more than doubled (+105%) y-o-y, from 1,285 in 2020-21 to 2,630 in 2021 Prior to 2021, this had been a decreasingly common reason each year for NHS staff to resign, indicating that post-Covid NHS staff want better compensation for their roles.

Reasons with largest % increase y-o-y (Q2 figures)*: 

1. Better reward package (105%)  
2. Lack of opportunities (68%)  
3. Work life balance (57%) 
4. Incompatible working relationships (51%)  
5. Health (30%) 

How has this affected the stability of the NHS workforce?

While the NHS had many staff members leaving the service, they were also hiring new staff to replace the medical professionals leaving the service. To calculate the impact this staff turnover has on the service, the NHS have calculated a stability percentage across the service, along with a more detailed analysis at regional and role levels.

Analysis of the stability of NHS role categories shows that, across NHS England, stability among all staff groups was at 89.5% in the two quarters preceding the first wave of Covid-19.

Stability improved as coronavirus took hold, up to 90.1% by the quarter ending June 2020 and peaking at 91% by March 2021. This would again suggest that would-be leavers stayed in their roles when Covid-19 took hold.

However, subsequent data shows stability trending towards pre-pandemic levels, and sits at 89.7% by the quarter ending September 2021.

Roles categorised as “Staff Grade” have taken the biggest hit to stability through the pandemic, with the most recent stability index being -3.7% on pre-Covid levels – just 82.5%. These roles are made up by specialty doctors and specialist grade doctors with at least four years of postgraduate training, highlighting how the NHS may be struggling to keep hold of those with the hands on experience of working with patients.

Associate Specialist (-0.9%) and ambulance staff (-0.8%) are the next largest dips in stability compared to pre-pandemic levels.

The job category with the lowest stability as of December 2019 was Year Two Foundation Doctors at 52.7%, and while this is still the role with the lowest stability, it has improved when compared against pre-Covid levels and is now at 55.2%.

The role category with the highest stability is Consultants – this was 94.8% in December 2019 and as of September 2021 has improved to 95.1%.

Overall, NHS England improved stability by 0.2% when comparing December 2019 to September 2021, but these figures are trending downwards which may suggest further resignations and more instability as we progress through the Covid-19 pandemic in 2022.

Stability by region

According to the latest NHS figures, the South East is showing the least stability in terms of staffing levels, with an NHS ranking of 89.1%, suggesting pressures on staff may be at their highest here.

Meanwhile, the North West is showing the highest rate of stability with 90.3%.

London’s stability across all NHS roles is 89.2% according to latest figures, which is -1.1% lower than pre-pandemic.

London is also seeing the biggest issue with Year Two Foundation Doctors, with 479 leaving the service and a stability level of only 51.1%. This is followed by Staff Grade employees (68.9%) and Year One Foundation Doctors (79.6%). Staff Grade employees in particular are less stable than pre-Covid, with the most recent stability figure -9.2% lower than pre-pandemic.

The South West is struggling most with Year Two Foundation Doctors (60.9%), Speciality Registrars (73.9%) and Year One Foundation Doctors (79.8%). 

The South East is struggling most with Year Two Foundation Doctors (60.8%), Speciality Registrars (76.9%) and Year One Foundation Doctors (81%). 

Conclusion

While the number of staff leaving, and the overall stability of the NHS workforce, improved in the first year of the Covid-19 pandemic, recent data is showing a trend back towards – and in some cases dropping below – pre-pandemic levels.

This suggests difficulty in retaining staff with hands on experience after almost two years of unprecedented strain. This is also reflected in the reasons cited in staff resignations, with health, work life balance, lack of opportunities and desiring a better reward package all becoming more prominent reasons for staff to leave the NHS.

With this indicating NHS departments and medical professionals will continue to be under more strain due to losing staff, this could have knock on effects when it comes to patient care.

Whether it’s a longer wait for treatment, delays in referrals, or insufficient care when in hospital, pressures on NHS staff can inadvertently lead to complications for patients.

If you would like to discuss any potential issues related to how a delay in seeing a medical professional could lead to a medical negligence claim, please call us on 0800 124 4845.

 Methodology:  

NHS Staffing Data and Reasons for Leaving taken from NHS Hospital & Community Health Service (HCHS) monthly workforce statistics provided by NHS Digital (https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics)