Staff turnover in the NHS

Too many staff leaving or joining the NHS may be potentially very costly and disruptive for the quality of services provided to patients. We look at turnover of NHS staff groups working in England.

What proportion of staff leaves and joins the NHS every month?

It is difficult to determine the ideal turnover rate for the NHS. Staff turnover can be good and bad. If it is too high, it can be disruptive and costly but at the same time can save costs and improve quality if employees who perform poorly are the ones who leave. Some variables found to be associated with staff turnover include job satisfaction, work pressure, flexible work options, appropriate training, experience of violence, abuse or bullying from patients or colleagues, a well-structured team environment, quality of line management and feeling of working in a safe environment (NHS Staff Survey).

Using data from NHS Digital we look at turnover of NHS Hospital and Community Health Services staff groups working in England. Turnover statistics include joiners to and leavers from the NHS in England within a specific time period based on headcount. Staff movement within the NHS is not included in these turnover calculations. The graph shows trends for all NHS staff excluding primary care staff, bank, locums and trainee doctors. The monthly rates of staff joining the NHS over the time period covered have been as low as 0.6% in December 2012 and as high as 1.9% in September 2014. There are also noticeable peaks in the proportion of staff joining in September of each year. Over the period covered the proportion of staff leaving ranged from a minimum of 0.6% (in November 2012 and February 2014) and a maximum of 1.7% in April 2013. Joining rates appear to be rising slightly over time (0.7% in August 2012 compared to 1.1% in August 2015).

Updated January 2017.

What proportion of doctors leaves and joins the NHS every month?

Leaving and joining trends for doctors resemble those for all staff. We can observe a 2.3% leaving rate peak in April 2013 and a 1.9% joining rate peak in October 2014. Over the period the lowest leaving rate came in March 2015 (0.6%) and the lowest joining rate in July 2015 (0.6%).

Updated January 2017.

What proportion of nurses leaves and joins the NHS every month?

We do not see such extreme leaving rate peaks for nurses as we do for all staff groups and doctors. Instead, there are joining rate peaks in the October of each year with the largest peak of 2.4% coming in October 2014. Over the period covered, in contrast to all staff and doctors, the proportion of qualified nurses leaving did not rise above 1.5%.

Updated January 2017.

How does the proportion of joiners and leavers vary across regions (Between November 2014 and November 2015)?

Here we look at variation across regional education and training boards at one point in time - between November 2014 and November 2015. The proportion of joiners is highest in Thames Valley (13.6%). The proportion of leavers is also highest in Thames Valley (10%) and in Special Health Authorities (14.5%). Special Health Authorities provide a health service to the whole of England, not just to a local community (e.g. National Blood and Transplant Authority, NHS Business Services Authority and NHS Litigation Authority. The largest difference between the proportion leaving and joining can be observed in South London with a leaving rate of 9.6% and a joining rate of 13.2% (a difference of 3.6%).

Updated January 2017.

About this data

Staff in organisations that have ceased to be NHS organisations are not treated as NHS leavers. A small number of staff that move between NHS non-ESR and ESR organisations will have a minor impact on the true numbers that join and leave the NHS in England.

Joining and leaving rates are calculated by dividing the number of joiners or leavers for a category of staff by the average of the number of staff in that category at the beginning and end of the period.

For more information about these data see NHS Digital, NHS Workforce Statistics.

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