NHS staff retention schemes have helped cut the number of workers leaving the health service to one of its lowest levels in over a decade, according to new analysis.
1 in 10 (10.1%) hospital and community healthcare workers left the NHS in the 12 months up to September 2024 – nearly 21,300 fewer than in the same period up to September 2022, when 1 in 8 (12.5%) left the health service.
The proportion is the lowest since the pandemic, when the leavers rate fell to 9.2%, and the second-lowest since 2010 when the rate was at 10.0%.
The fall in the number of leavers has been supported by an initial 2-year programme aimed at finding new ways to improve retention in the NHS. There has also been a reduction in sickness and absence rates, and an improvement in productivity.
A new review published today of the NHS’s People Promise staff retention initiative found that the number of leavers fell by an average of 11.8% for organisations involved in the pilot – with those implementing more interventions improving their leaver rates the most.
The programme, which has been led by NHS England since April 2022, supported 23 NHS organisations and has since been expanded to support a further 116 organisations – including more mental health and community trusts, as well as primary care and ambulance services.
Around 4,500 staff members were supported to stay in the health service thanks to the programme. The report found that efficient use of e-rostering, supporting flexible working and flexible retirement, and local listening sessions for staff had the biggest impact on improvements to leaver rates.
Professor Em Wilkinson-Brice, Director for Staff Experience and Leadership Development at NHS England, led the programme and said: “NHS organisations have done a huge amount to improve the working environment for staff over the past couple of years and it’s fantastic to see the impact it’s having, with over 21,000 fewer staff leaving the health service in the last year.
“We’re also seeing improvements to sickness and absence rates and to the NHS’s overall productivity – so more staff are available to get patients the treatment they need sooner.
“Our People Promise staff retention programme shows what’s possible when you work closely with staff to make changes that improve their lives, whether supporting flexible working or making simple alterations to rostering processes.
“I’m delighted that we’ve been able to expand the initiative to a further 116 organisations so that we can provide a world-class service that’s appreciated by both staff and patients across the country.
“I’d encourage all NHS organisations to prioritise retention by making changes that will improve the everyday working experiences of their teams.”
Minister for Health, Stephen Kinnock, said: “NHS staff have been overworked for far too long, but it’s great to see initiatives like these keep thousands of them in the workforce.
“We know there’s still a lot to be done to alleviate pressures on staff and to fix the broken NHS.
“Through our Plan for Change we are turning the NHS around, boosting productivity and giving staff the tools they need to deliver the best possible care for patients.”
Liverpool University Hospitals NHS Foundation Trust piloted team-based rostering at part of the retention programme – allowing staff to have more control over the pattern of a working week.
Staffing levels and skill mix required hour-by-hour throughout the working day were agreed in advance and staff were then able to go online to request their shifts.
The pilot resulted in staff and teams feeling they had more control over their working life, which allowed them to improve their travel to work and family time.
Staff members said they felt less stressed, more informed and were able to work around home commitments. This led to lower-than-average sickness levels and lower staff turnover across the wards it was implemented on.
Phoebe, a nurse at Liverpool University Hospitals, said: “I do request shifts because I’m in university, so it helps a lot with balancing – I can be in university and not be under pressure with coming into work or having the shift. I get enough time to rest and do what I need to do at home as well.
Andrew, a nurse, said: “My wife and I have 2 kids, and we work at the same hospital so it’s very, very helpful for us to request the days we can work so that we don’t work at the same time and we can look out for our children.”
Shaun, a nurse, said: “It works really well for me with my family and friends. If I want to spend some time with them, I can plan in advance and use the Allocate Me app to get time off around that period.
“Every month, at least once a month, I have a family event that always takes place on the same day. If I was working anywhere else, I’d be worried whether or not I could get that time off because I know it would be a lot to ask.
“But with this ward, I know I can always get that time off. I can request it months prior, making sure I do get the time off around that period.”
Barts Health NHS Trust implemented 23 interventions – from offering pension seminars and clinics, enhancing the induction process for international medical graduates, promoting flexible working by developing and implementing a flexible and agile working policy, and improving rostering – which led to its leaver rate being reduced by 17%.
Daniel Waldron, Group Director of People at Barts Health NHS Trust, said: “At Barts Health, we’ve made staff experience a priority, and the People Promise exemplar programme has been transformational.
“Initiatives such as improved rostering, better access to flexible working, increased pension support, and our new recognition platform, Barts Hearts have fostered a culture of kindness, support, and collaboration.”
United Lincolnshire Hospitals NHS Trust also advertises flexibility in all its roles and includes flexible working within their recruitment training for managers.
They have saved over £10 million in temporary staffing costs this year in correlation with improvements in retention, recruitment and transition from using agency to bank working.
NHS England has published its annual guidance for the NHS for the next financial year which will focus on delivering faster treatment for hundreds of thousands of patients.
All local NHS organisations are expected to reduce their reliance on temporary staff and deliver at least a 30% reduction in agency spending (based on current spending), equivalent to around £650 million to invest in the frontline.
More details on the People Promise staff retention programme are available on the NHS England website.
The latest turnover statistics for NHS Hospital and Community Health Services (HCHS) staff are available from the NHS Digital information and data webpages.
