I asked this question to get NHS management to concentrate on high rates of turnover and loss rates from NHS employment. The easiest source of expanding the workforce must surely be to persuade more people to stay?
The Department of Health and Social Care has provided the following answer to your written parliamentary question (123841):
Question: To ask the Secretary of State for Health and Social Care, what the main reasons given by nurses and doctors are for leaving NHS employment. (123841)
Tabled on: 16 January 2023
Answer:
Will Quince:
Data is collected from staff leaving service in National Health Service trusts and commissioning bodies through the Electronic Staff Record on reasons for leaving but has a high percentage of instances where reasons are unknown, 39% for doctors and 41% for nurses and health visitors. Where reasons are provided, the highest number of NHS trust and commissioning body doctors left those bodies due the end of fixed term contracts. This is high as it covers junior doctors moving out of those settings to others, such as general practice, on rotation. This was followed by voluntary resignation reasons and retirement. For nurses and health visitors, the highest proportion of staff recording a reason, left due to voluntary resignation and reaching retirement age. A table of the reason of leaving and the number of staff is attached.
The following documents were submitted as part of the answer and are appended to this email:
1. File name: FORMATTED PQ123841 Leavers by reason for leaving and specified staff group, Jun21 to Jun22 (1).xlsx
Description: Attachment
| Reason for leaving | Hospital and Community Health Service (HCHS) doctors | Nurses and health visitors | |
| Bank Staff not fulfilled minimum work requirement | 16 | 14 | |
| Death in Service | 35 | 209 | |
| Dismissal – Capability | 17 | 202 | |
| Dismissal – Conduct | 23 | 109 | |
| Dismissal – Some Other Substantial Reason | 16 | 83 | |
| Dismissal – Statutory Reason | 3 | 7 | |
| Employee Transfer | 65 | 254 | |
| End of Fixed Term Contract | 3995 | 340 | |
| End of Fixed Term Contract – Completion of Training Scheme | 1299 | 32 | |
| End of Fixed Term Contract – End of Work Requirement | 196 | 62 | |
| End of Fixed Term Contract – External Rotation | 1433 | 2 | |
| End of Fixed Term Contract – Other | 466 | 84 | |
| Flexi Retirement | 57 | 304 | |
| Has Not Worked | 9 | 10 | |
| Mutually Agreed Resignation – Local Scheme with Repayment | 0 | 24 | |
| Mutually Agreed Resignation – National Scheme with Repayment | 2 | 4 | |
| Pregnancy | 0 | 5 | |
| Redundancy – Compulsory | 8 | 8 | |
| Redundancy – Voluntary | 5 | 30 | |
| Retirement – Ill Health | 44 | 287 | |
| Retirement Age | 1016 | 5490 | |
| Voluntary Early Retirement – no Actuarial Reduction | 43 | 361 | |
| Voluntary Early Retirement – with Actuarial Reduction | 50 | 191 | |
| Voluntary Resignation – Adult Dependants | 30 | 197 | |
| Voluntary Resignation – Better Reward Package | 61 | 574 | |
| Voluntary Resignation – Child Dependants | 40 | 413 | |
| Voluntary Resignation – Health | 61 | 879 | |
| Voluntary Resignation – Incompatible Working Relationships | 17 | 204 | |
| Voluntary Resignation – Lack of Opportunities | 35 | 233 | |
| Voluntary Resignation – Other/Not Known | 1437 | 3495 | |
| Voluntary Resignation – Promotion | 220 | 1496 | |
| Voluntary Resignation – Relocation | 798 | 3536 | |
| Voluntary Resignation – To undertake further education or training | 268 | 380 | |
| Voluntary Resignation – Work Life Balance | 380 | 4231 | |
| Unknown | 7743 | 16681 | |
| Total of leavers | 19846 | 40365 | |
| Source: NHS Digital NHS Hospital and Community Health Service (HCHS) workforce statistics. | |||
| Notes: | |||
| 1. Leavers data are based on headcount and shows staff leaving active service, this would include those going on maternity leave or career break, for example. | |||
| 2.Data are calculated on an annual basis in this analysis so leaver figures for 30 June 2021 to 30 June 2022 for example represent staff records that are present in June 2021 but are not present in June 2022. | |||
| 3. Leavers records are linked to a separate ESR Reasons for Leaving dataset. In many instances the Reason for Leaving record has not been completed, which accounts for the Unknown records. | |||
| 4. Totals for NHS leavers that are different to the sum of constituent parts indicate where staff have left the NHS in more than one post. | |||
| 5. ”-‘ denotes zero | |||
The answer was submitted on 24 Jan 2023 at 10:19.
January 30, 2023
Good morning.
Thank you, Sir John for asking these questions.
It seems voluntary leaving, for whatever reason, is responsible for the majority of turnover of staff. Of the two areas from this that are known, both work life balance and relocation seem to be the highest. It seems to me people are preferring a less stressful occupation(s) and a better quality of life, perhaps to more rural areas of the country.
The one factor that ALL employers, whether it be in the Public or Private Sectors, fail to see is, people work to live, they do not live to work and, if work / occupation becomes more troublesome compared to the monies they are getting for such work, they would probably do something for less money and be far happier doing it.
Money is for paying bills and having a few luxuries. It is not and end in its self and does not make you happy. I think the problem is on of unhappiness that pay.
January 30, 2023
Agree 100%
Govts have worked SO hard at making people unhappy!
As we now recogniseā¦at war with their own electorate.
January 30, 2023
Its always been about the money …and always will be
January 30, 2023
so much for vocation then!
January 30, 2023
@Mark B – Under this Conservative Government ‘Money is for paying taxes’ so it can be given away with out a care or responsibility attributed to it… If you are in surplus to what’s is needed for tax, they will becoming for you next
January 30, 2023
“Thank you, Sir John for asking these questions.”
Indeed.
Unfortunately it all seems a bit academic these days.
Sir John is a conviction politician and there do not seem to be many of them in parliament these days. Unfortunately, they are now given the runaround just like us voters.
Meanwhile, politics moves on and we don’t seem able to have much impact on what is happening.
Labour will eventually take power, just by virtue of not being the Conservatives. New parties seem unlikely to have a significant impact. It will get a lot worse before any upturn.
January 30, 2023
replace ‘politics’ with ‘control steps’ and you get closer to reality.
January 30, 2023
Interesting that only 574 left voluntarily for better rewards. It appears that other factors matter more than pay.
January 30, 2023
25% of junior doctors leave in the first 12 month 50% in total do not stay on. The main reasons I understand/believe is they are treated very badly and do not have the time or support to provide decent care to their patients which is very dispiriting for them.
Also they simply do not earn enough to live on (certainly in London) after student loan/interest payments, commuting costs, ULEZ, parking at work, child care, tax/NI and other cost of working. Many go to Australia/New Zealand many leave medicine altogether and work in jobs on double pay in the city or similar… What a dreadful waste of 5/6 years very expensive training.
January 30, 2023
Absolutely what a waste. My Junior Doctor son is one of them. After six years at Cambridge and two working in a busy London hospital he sees his peers from Cambridge who chose different careers earning twice and triple what he does and for that they do not have to work unbelievably long and unsociable hours, nor are they constantly dumped on from all directions. He sadly is one of those thinking of leaving the NHS as are many of his fellow Junior Doctors. Overworked, underpaid, under appreciated. By the time he has paid tax, N.I., student debt, buying his own equipment (stethoscope etc.) and hundreds a year to the BMC to allow him to practise and over a thousand a month for a small room in London, he has hardly anything left at the end of the month to show for all his hard work.
Student debt for all STEMM subjects should be scrapped. After all 78% of all student debt is written off for all the mostly wasteful degrees. Small step but relieving them of this massive millstone around their necks for most of their working lives might make them feel more appreciated. Also, why are we paying for 650 mostly useless and self serving MPs to live in London and yet not supporting front line services to do the same?
January 30, 2023
Single room rental in London now Ā£900 PCM. Just a single room not a one bed or studio flat note.
January 30, 2023
Single room rental in London now Ā£900 PCM. Just a single room not a one bed or even a studio flat note.
January 30, 2023
Where have you read this, Ashley?
I read that going back years graduates often go back to their country of origin or take a gap year so the figures of 25% aren’t accurate.
Why is it so difficult for so many managers and universities to give proper information on their students and staff. Surely everyone that leaves completes a leavers form, their resignation letter is stored and their manager’s comments noted as a minimum. I think you’re just getting fobbed off there, John. They can’t be this incompetent in HR.
January 30, 2023
Your last paragraph is true for an enormous number of workers in the London area, which has now spread its unaffordability to the ‘Home Counties’.
January 30, 2023
I can remember a time ( and have been told about) when people loved their jobs.
Then successive govts decided to step in.
And they ruined everything.
Why canāt govts understand this? Leave people alone!
Regulate to decimateā¦was that the idea with the workforce?
January 30, 2023
Utter tosh. I guess you havenāt managed lots of people or learned things like maintenance and motivation factors. A key reason for people leaving across business is not speaking to them. The exit interview being the first time they realised the business was interested in them.
January 30, 2023
Letās face it.
Not a very successful strategy if people leave jobs because it isnāt implemented.
Is āUtter toshā motivation-speak?
Seems a bit rude to me!
January 31, 2023
Seems rude to me too. I have managed lots of people and built businesses up from scratch, and I agree with you Cuibono. Lots of people do get enjoyment and purpose from their work. I have had plenty of people carry on working past their retirement age, one chap to 75 until covid and his wife stopped him. I know people who could afford to stop working and they carry on part-time because they enjoy feeling useful and needed.
This constant battering of employers in the media is just so tiring and builds up lots of stress on people.
January 30, 2023
Cuibono : āI can remember a time ( and have been told about) when people loved their jobsā.
I think this is true. The reason for the change is the failed experiment to send 50% of young people to university instead of into jobs where they could start to earn (and spend!) money and gain useful skills leading to promotion and job satisfaction.
Instead they spend 3 years at university getting into serious debt whilst obtaining a useless duff degree and are subjected to far left propaganda leaving them intolerant, unhappy and with an attitude that the world owes them a living because they have a degree.
Cui bono? The overpaid, bloated educational establishment and we should cut back university education by at least 50% if not 75%.
January 30, 2023
+many
January 30, 2023
Agree
January 30, 2023
Well Richard ! Blame the Right Dishonourable Antony Bliar. The “one size fit all” does not work but he wanted them in a place where they could be brainwashed
January 31, 2023
O R
Agree
January 31, 2023
and start by cutting the Chinese and Russian students out.
January 31, 2023
Richard, the English grad, only has 9% of their earnings taken in graduate tax; if you do more and earn more, it takes years longer than it used to to get established. My son was paying graduate tax over Ā£16,000, 9% of every Ā£1 over that level for years. They need to earn 9% more than their Scottish, Welsh and Irish workmates to try to get level with them. So in a way, Blair’s education, education, education promises to them to earn more than people who don’t have degrees does owe them a living.
We hear all the time that taxes this month have gone up, but for earners under Ā£27k they have come down considerably. The 5% extra for their NEST pension makes them feel worse off and the 3% their employer contributes is then not 3% extra earning but side-swiped away by unreliable pensions savings vehicles.
January 30, 2023
Sunak throwing another Ā£2bn at more nhs beds & ambulances today ā¦.having a newer ambulance doesnāt pay bills, having more beds without full time permanent nurses is ridiculous ā but its good soundbites
January 30, 2023
+1
January 31, 2023
They need to redeploy skilled nurses with long covid onto other less labour intensive jobs like 911 call handling or give them extra skills in mental health nursing so that they can do telephone support in that. This ever lasting paid sick time off is killing the service.
January 30, 2023
@Cuibono +1 It is Control and the fear of the People that drives Government stupidity
January 30, 2023
+1
January 30, 2023
Surely the implicit govt promise after TWO WORLD WARS.
And all the terrible sacrifice therein ( for what? I might ask).
Was that we would be happy and free and prosperous?
Not hating beyond hatred our jobs in the health service.
Obviously we didnāt really win those wars.
Did we?
January 30, 2023
In 2021 into early 2022 many left due to the vaccine mandates. What category are these listed under. It would be useful to know how many did actually leave for this reason, suggestions are it was significant.
January 30, 2023
Nearly half of total departures, about 9,000 out of 19,000, are for reasons unknown. Perhaps the NHS should be more active in trying to find out why such people leave. Then adjust its management practices accordingly.
January 30, 2023
Unknown = Agency (same job double the wage)
January 31, 2023
That could be investigated very easily, glen. A revision of all agency nursing work history that surely each hiring trust gets from the agency to confirm their suitability.
January 30, 2023
If they leave due to disillusionment with the NHS or career change, is that not recorded as a reason for leaving?
January 30, 2023
They state 40% don’t even bother with a reason – sounds like thoroughly disillusion to me!
January 30, 2023
Possibly they are not asking the right questions. Said because the answers received tell us very little. I would consider a private survey, no names just answers. It would be informative to compare the attrition rates between medical members of the NHS and the ever growing administration.
January 30, 2023
Let’s think outside the box.
In the ancient film, “O what a lovely war” the generals were pictured partying while the men suffered in the trenches. In the current war in the Ukraine, Russian generals are said to line their men up in a battle zone, to order the men to dig in and then to retire well behind the lines for a good dinner. The men are left with one entrenching tool per thousand men, paint ball masks and children’s gloves. Their ancient rifles are often painted over to cover the rust.
I think the NHS is a bit like this. Lots of would be generals in Head Office. Never go near a ward. Ask a lot of sensible questions and give sensible directives and then have another cup of coffee. They never feel at home in the wards/A&E. When dear old Steve (our local MP) goes for a photo op, he takes off his jacket and tucks his tie into his shirt. Then everyone looks polite until he leaves.
Good generals – from Julius Caesar through Ulysses S Grant to Montgomery, lived on the battlefield with the men.
So when you, Sir John, ask your sensible question, you get a bureaucratic response which, of course, is totally correct. And utterly misleading. The generals are all in the distant mansion having luncheon.
I talked to my (excellent) surgeon one to one in his office after an operation during covid. I learned an awful lot.
January 30, 2023
Anselm
I too had a conversation with a private consultant, who told me that many doctors who arenāt that good, go into management; and then make the rules for those doctors and surgeons who are good at their job!
January 30, 2023
An incompetent answer to an incompetent survey, as ever too many categories and incomplete. A typical box ticking exercise rather than a strategic management tool.
I used to hammer the message home to businesses I worked with that employee turnover is far more expensive in terms of cost of recruitment, business disruption and training new recruits than proper on going people management that, anyway, is a key requirement for a successful business. Staff cost is (one of) the main expenditure items, it behoves a good management team to get the most out if it.
My partner works in a large Surrey health trust on the admin side, having worked in mainly in the private sector. Management in terms of people is appalling/non existent, staff cynical and morale on the floor.
Steve Barclay coming up with systems solutions, integrated working practices, blah blah. No doubt they may have some impact but overall politicians havenāt a clue.
Successful change (management) needs the hearts and minds of the staff. In the public sector? Ha!
January 31, 2023
Nigl
Family mender has had same experience as your Partner with regards to Administration and management in the NHS, it is a completely different world and thought process to that found in Commercial business.
January 30, 2023
Will Quinceās response is less sloppy than others he has made and does contain some useful information, even though it is in a raw state.
January 30, 2023
0 doctors left because of pregnancy and only 5 nurses and HVs. Does that strike you as not entirely true to life? Others must have been carrying the expectant and nursing mothers at some point.
January 30, 2023
Theyād get full paid leave for pregnancy ā¦thatās not recorded as leaving the job
January 31, 2023
However its recorded a a temp vacancy
January 30, 2023
They can take the first year out and decide on the last day. Maybe many are the unknowns?
January 30, 2023
Good morning Sir John
This data is not very useful. By Googling ‘NHS ESR exit questionnaire’, it is possible to find the source of the data they provided you. There are about 13 questions, which shows better analysis available than offered. I would not be surprised if someone had already done this.
For example, the questionnaire asks if the person is staying within the NHS. It is possible to understand better the reasons for leaving by excluding those moving within the NHS family.
If you persevere and ask a slightly different question again, you might get closer to understanding why staff are leaving.
January 31, 2023
good post James.
January 30, 2023
Off topic, I have this short letter in the Belfast News Letter today:
https://www.newsletter.co.uk/news/opinion/letters/letter-the-rest-of-uk-still-exports-to-the-eu-without-single-market-access-4005872
“The rest of UK still exports to the EU, without single market access”
“Further to the letter from Jim Allister last Monday (āNorthern Ireland canāt be in EU single market without being subject to their laws,ā January 23, see link below) in 2021 the UK as a whole exported goods worth Ā£154 billion to the EU, of which only Ā£5 billion were sent from Northern Ireland.
Is it not amazing that businesses in the rest of the UK managed to export anything to the EU, when they did not enjoy Northern Ireland’s āuniqueā access to the EU Single Market?”
https://www.newsletter.co.uk/news/opinion/letters/jim-allister-northern-ireland-cant-be-in-eu-single-market-without-being-subject-to-their-laws-3996708
I am very concerned by what I have read here:
https://conservativehome.com/2023/01/30/why-a-rushed-protocol-deal-that-ducks-the-constitutional-problems-will-fail/
“But if a workable deal is being hidden then it is being very well hidden. Hereās a choice quote from the FT:
āUnder the terms of the deal, Northern Ireland will follow EU rules for goods, VAT and state aid policy, which both Conservative Brexiters and the Democratic Unionist party in Northern Ireland have said impinged unacceptably on UK sovereignty.ā
Moreover, with EU rules comes ECJ oversight. ERG told this site in October that they would not let the Government āpark the issue of ECJ authorityā. Senior sources have since indicated that it might endorse a truly independent arbitration mechanism, but not one linked to the Court. This does not, if the briefing to the FT is any indication, sound like that sort of deal.”
January 31, 2023
Denis just wanted to let you know I read your research and suggestions. Its a shame others, more critical to decision making, don’t pay attention.
January 30, 2023
No apology for this being off topic :
The reported comments by a US General are confirmation of what sensible observers have all been thinking but we don’t want admit :
Our armed forces are now so depleted that they are no longer considered first rate, behind even those of France.
We might have two shiny new aircraft carriers, but we don’t have enough aircraft for one of them, so its just as well that HMS PoW is out of commission due to its shoddy build quality.
The RAF has less than a third of the Poseidons it really needs to defend our airspace and watch over the seas around our island.
Nobody ever thought the idea of reducing the army by a third was ever sensible, and that was before the increased threats from Ukraine and China.
Reducing our tank force to 150 Challenger 3s is absolutely crazy, unless we never intend to comply with our NATO obligations.
Sunak could use the Ā£4bn windfall that Bailey made from buying back gilts to give an immediate shot in the arm for our forces. The fact that he hasn’t is the best indication yet that he doesn’t understand the threat or our own defence needs.
January 30, 2023
and we trail cyber skills which other ‘actors’ use relentlessly.
January 30, 2023
6506 – Retirement
4932 VR – Not asked why
4611 VR – Work-Life Balance
4335 End of Fixed term contract
4334 VR – Relocation (Did they take up other posts in the NHS elsewhere?)
Doesn’t the NHS HR system record all Leavers’ info? Don’t they have an electronic leavers form to complete and a log of their resignation letter? It’s very odd.
Its actually a very low number of leavers given their total employee numbers.
January 30, 2023
In the 90,s I had a fixed term contract with clauses which stated relocation in consultation with the trust.The relocation was not honoured and I was forced into agency from a senior position. How many more?
January 30, 2023
In the Andrew Bridgen video he tells how he stood up for the subpostmasters. He is a strong person.
Reply So did I demand justice and compensation for them
January 30, 2023
That’s good. There was no implication or insinuation in my comment.
January 30, 2023
The data below is for the 24-hour period 00:00 to 23:59 29 January 2023.
Number of migrants detected in small boats: 189
Number of boats detected: 5
One of Sunaks five priorities ā¦and yet they still come
January 31, 2023
and as at today the Home Office are back in charge ….what are they going to do differently
January 30, 2023
I certainly hope that all the new ambulances that Sunak promised today are Vauxhalls built in England and not the Ford built in Turkey
January 31, 2023
They don’t have an arduous life, mostly sat outside hospitals all day.
January 30, 2023
Frankly SJR we should be discussing fundamentals rather than questions and none answers from the scribes. You are in a position of experience to have a very clear idea of what is going on in the bubble. For instance I detect a mighty struggle between those who had power when we were in the EU and have since lost it post Brexit to the democratically elected HoC. They seem patently reluctant to cede such power and are working flat out to oppose, block, or trip any individual who has the temerity to get in their way. Democracy has no place in their thinking and if necessary they will trash it. For example the Liz Truss coupe. I would rather read your views on this than any details depicting scribes avoiding answering legitimate questions.
January 30, 2023
How about Rishi in the North East today for rhetoric and no credibility. Apparently a few hundred ambulances and even more hospital beds will solve our NHS problems. I do not dispute our ability to manufacture or import them, but telk me who will man the ambulances and where is the excess ward capacity to put the beds, never mind the nursing staff to support them. The failure of Nightingales was not a lack of beds but a lack of anyone to man them. Things have got worse since, so whats it all about Rishi.