Written Answers from the Department of Health and Social Care – Reasons for leaving NHS

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

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.
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.


  1. Mark B
    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.

    1. Cuibono
      January 30, 2023

      Agree 100%
      Govts have worked SO hard at making people unhappy!
      As we now recognise…at war with their own electorate.

    2. glen cullen
      January 30, 2023

      Its always been about the money …and always will be

      1. Mickey Taking
        January 30, 2023

        so much for vocation then!

    3. Ian B
      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

    4. Peter
      January 30, 2023

      “Thank you, Sir John for asking these questions.”


      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.

      1. Mickey Taking
        January 30, 2023

        replace ‘politics’ with ‘control steps’ and you get closer to reality.

    5. Shirley M
      January 30, 2023

      Interesting that only 574 left voluntarily for better rewards. It appears that other factors matter more than pay.

  2. Ashley
    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.

    1. JoolsB
      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?

    2. Ashley
      January 30, 2023

      Single room rental in London now £900 PCM. Just a single room not a one bed or studio flat note.

    3. Ashley
      January 30, 2023

      Single room rental in London now £900 PCM. Just a single room not a one bed or even a studio flat note.

    4. a-tracy
      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.

    5. Mickey Taking
      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’.

  3. Cuibono
    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 can’t govts understand this? Leave people alone!
    Regulate to decimate…was that the idea with the workforce?

    1. Nigl
      January 30, 2023

      Utter tosh. I guess you haven’t 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.

      1. Cuibono
        January 30, 2023

        Let’s face it.
        Not a very successful strategy if people leave jobs because it isn’t implemented.
        Is “Utter tosh” motivation-speak?
        Seems a bit rude to me!

        1. a-tracy
          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.

    2. Original Richard
      January 30, 2023

      Cuibono : “I can remember a time ( and have been told about) when people loved their jobs”.

      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%.

      1. Cuibono
        January 30, 2023


      2. glen cullen
        January 30, 2023


      3. MFD
        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

      4. Berkshire Alan
        January 31, 2023

        O R


      5. Mickey Taking
        January 31, 2023

        and start by cutting the Chinese and Russian students out.

      6. a-tracy
        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 £16,000, 9% of every £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 £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.

    3. glen cullen
      January 30, 2023

      Sunak throwing another £2bn at more nhs beds & ambulances today ….having a newer ambulance doesn’t pay bills, having more beds without full time permanent nurses is ridiculous – but its good soundbites

      1. Cuibono
        January 30, 2023


      2. a-tracy
        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.

    4. Ian B
      January 30, 2023

      @Cuibono +1 It is Control and the fear of the People that drives Government stupidity

      1. Cuibono
        January 30, 2023


  4. Cuibono
    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 didn’t really win those wars.
    Did we?

  5. davews
    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.

  6. Philip P.
    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.

    1. glen cullen
      January 30, 2023

      Unknown = Agency (same job double the wage)

      1. a-tracy
        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.

  7. Dave Andrews
    January 30, 2023

    If they leave due to disillusionment with the NHS or career change, is that not recorded as a reason for leaving?

    1. Mickey Taking
      January 30, 2023

      They state 40% don’t even bother with a reason – sounds like thoroughly disillusion to me!

  8. agricola
    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.

  9. Anselm
    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.

    1. Sharon
      January 30, 2023

      I too had a conversation with a private consultant, who told me that many doctors who aren’t that good, go into management; and then make the rules for those doctors and surgeons who are good at their job!

  10. Nigl
    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 haven’t a clue.

    Successful change (management) needs the hearts and minds of the staff. In the public sector? Ha!

    1. Berkshire Alan
      January 31, 2023


      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.

  11. Bloke
    January 30, 2023

    Will Quince’s response is less sloppy than others he has made and does contain some useful information, even though it is in a raw state.

  12. rose
    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.

    1. glen cullen
      January 30, 2023

      They’d get full paid leave for pregnancy …that’s not recorded as leaving the job

      1. glen cullen
        January 31, 2023

        However its recorded a a temp vacancy

    2. Mickey Taking
      January 30, 2023

      They can take the first year out and decide on the last day. Maybe many are the unknowns?

  13. James Freeman
    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.

    1. a-tracy
      January 31, 2023

      good post James.

  14. Denis Cooper
    January 30, 2023

    Off topic, I have this short letter in the Belfast News Letter today:


    “The rest of UK still exports to the EU, without single market access”

    “Further to the letter from Jim Allister last Monday (‘Northern Ireland can’t be in EU single market without being subject to their laws,’ January 23, see link below) in 2021 the UK as a whole exported goods worth £154 billion to the EU, of which only £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 ‘unique’ access to the EU Single Market?”


    I am very concerned by what I have read here:


    “But if a workable deal is being hidden then it is being very well hidden. Here’s a choice quote from the FT:

    “Under 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.”

    Moreover, with EU rules comes ECJ oversight. ERG told this site in October that they would not let the Government “park the issue of ECJ authority”. 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.”

    1. a-tracy
      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.

  15. ChrisS
    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 £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.

    1. Mickey Taking
      January 30, 2023

      and we trail cyber skills which other ‘actors’ use relentlessly.

  16. a-tracy
    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.

  17. Margaretbj.
    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?

  18. onlooker54
    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

    1. onlooker 54
      January 30, 2023

      That’s good. There was no implication or insinuation in my comment.

  19. glen cullen
    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 …and yet they still come

    1. glen cullen
      January 31, 2023

      and as at today the Home Office are back in charge ….what are they going to do differently

  20. glen cullen
    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

    1. Mickey Taking
      January 31, 2023

      They don’t have an arduous life, mostly sat outside hospitals all day.

  21. agricola
    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.

  22. agricola
    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.

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