Between March 2023 and June 2023, nearly half (47%) of frontline staff checked job listings outside the NHS, and 1:7 (14%) reported having applied for one or more non-NHS jobs. Amongst applicants, the primary motivation was seeking higher pay. 1:4 (23%) of these applications were for supplementary paid work in addition to their NHS job.

The report, "Should I stay or should I go? Monitoring influences on NHS staff retention in the post-COVID-19 world", identifies psychological stress, workload, staff shortages and pay as the top four reasons why staff leave the NHS.

Other key findings from the report:

  • Reports of symptoms of burnout show a rising trend, with 1:2 reporting ‘feeling very tired or drained’ most days or every day.
  • Ratings of intrinsic job satisfaction (caring for patients) and personal commitment to the NHS have weakened year on year since 2020.
  • Staff confidence over improvement to working conditions and their future in the NHS were low, and for the majority of issues, notably workload and staffing and resources, more negative than in Wave 3 (summer 2022).
  • Only 1:4 NHS nurses would recommend working for the NHS to others. There was a 24-point drop (61% to 37%) in the proportion of staff who agreed with the statement ‘I would recommend working for the NHS to others’ between winter 2020/21 and spring 2023. The figure for nurses (26%; spring 2023) was markedly lower than the all-staff rate.

The report contains powerful testimony from frontline workers:

"Working for the NHS is soul destroying... I am now burnt out, emotionally drained and exhausted. Most days end in despair and tears. Having to currently work for the NHS is the quite possibly the worst thing I have ever done." Acute, Medical

"We are seeing talented and hardworking Paramedics have mental breakdowns and quit on a daily basis ... We see consistent impact on patient care, and every shift becomes more and more difficult." Ambulance Service, Emergency Medical Technician/Assistant

"I would not recommend working in health care to anyone and actively tell my daughter it is the worst career to go into..." Acute, Nursing

"…the public and the government do not care about how desperate the people working in the NHS are for change and it kills us …" Acute Medical

The lead researcher, Dr Andrew Weyman, said:

"Rising reports of shortages of resources, psychological stress, symptoms of burnout, coupled with low confidence of improvement to working condition, in the context of dissatisfaction with pay and evidence of weakening staff commitment to the NHS are particularly perturbing and potentially offer an explanation for the significant fall in the proportion of staff who would recommend working for the NHS to others."

Staff viewed improvement to pay, staffing levels, workload and recognition by Government as the top priorities for change to increase retention rates.

The report provides headline findings from the most recent (Spring 2023) of four waves of a tracking survey that commenced in 2020.

Core themes addressed were: reasons why staff stay/leave; what’s got better/worse; worries and concerns; burnout: confidence in the future; future work/retirement aspirations; non-NHS job seeking behaviour; strength of attachment to the NHS; what has changed and what needs to change.

The sample at each wave was sourced from the YouGov Panel (~2,000 UK-wide NHS employees at Waves One and Two, and ~1,500 England-wide at Waves Three and Four).