Disappointed advocates: what a year of NHS leavers told us.
Most NHS retention work starts with the staff survey: people who are still there. This is the other group — a year of leavers, in their final weeks, with every reason to be honest.
On this page
The avoidable turnover is driven by growth, teamwork and progression rather than pay, and much of it is recoverable.
Between December 2024 and December 2025 we collected exit questionnaires across acute, mental health and community trusts, and care providers delivering NHS services. Here is what they said, with the numbers.
Just over half left happy
56% left for life reasons — a move, a course, retirement, a promotion somewhere else — and described their organisation warmly. 44% left because of dissatisfaction with the job, the organisation, or, most commonly (51% of that group), both. That second group is the avoidable turnover, and it is not small.
The reasons are not a mystery
Four factors sit at the top of the reasons leavers gave, almost level. Three more follow, and pay comes after them.
| Reason for leaving | Share of leavers citing it |
|---|---|
| Personal growth | 40% |
| Teamwork and cooperation | 40% |
| Career progression | 39% |
| Well-being | 38% |
| Loyalty and trust | 32% |
| Relationship with the line manager | 30% |
| Confidence in the organisation | 30% |
| Reward and recognition | 25% |
Pay is there, but it is a secondary factor, not the driver. Anyone building a retention plan around pay first has the order wrong.
Trusts are not all the same, and the difference is large
Across the organisations in the dataset the unhappy-leaver rate ran from 33% to 55% — a 22-percentage-point spread. Willingness to recommend the organisation ran from 52% to 80%. That is not noise; those are different working environments, and the variation between teams inside one trust is often driven more by local management practice than by anything in a policy.
The finding we did not expect
Half of the unhappy leavers — people who left because they were dissatisfied — said they would consider coming back. In our experience, few trusts have a structured way of asking them.
What this points to
Three things, none of them expensive.
- Visible, fair internal career pathways. Progression is the most consistent avoidable reason across almost every staff group.
- Consistent line management. The manager is where the policy meets the person, and the data shows that is where the variation lives.
- A returner strategy. Treat leavers as alumni rather than as losses: the data says a large share would answer the phone.
We publish these findings because we think the point of collecting exit data is to act on it, and because every number above can be traced back to a questionnaire a real person filled in. If you would like to know where your own organisation sits against the 33–55% range, that is a conversation we are always glad to have.
A note on the numbers: the interactive NHS unhappy-leaver benchmark uses each trust’s latest twelve months of data rather than this report’s December 2024 – December 2025 window, so its ranges differ slightly.
Source: great{with}talent, Why NHS Staff Leave, NHS Workforce Intelligence Series Report 1 of 4. Exit questionnaires collected through LastOpinion across NHS trusts in acute, mental health and community settings and care providers delivering NHS services, December 2024 – December 2025. Organisations are anonymised; figures are aggregated across the dataset.
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