Who is leaving the NHS, and from which roles?
A trust-wide leaver figure covers very different jobs. The ward nurse, the ward clerk, the physiotherapist and the porter leave for different reasons, and need different fixes.
On this page
Each staff group leaves for its own reasons, so report and act on leavers group by group.
Across the NHS organisations in our December 2024 – December 2025 exit dataset, 44% of leavers left because they were dissatisfied. That figure is useful for a board. It is not much use to a director of nursing, an AHP lead or the head of estates, each of whom needs to know what is driving their own people out. Report 3 of the series split the same leaver data by Agenda for Change and occupational staff group. It describes pattern and direction for each group rather than a percentage, and so does this summary.
Frontline clinical staff: conditions, not values
The registered clinical groups each tell a different story, but the pressure is mostly in the conditions of the work rather than the work itself.
Registered nursing and midwifery
One of the largest groups and one of the most at risk of avoidable turnover; the unhappy share is often above the dataset average. Workload and staffing felt unsafe, specialist posts meant moving employer, and support depended on the manager. Many leave reluctantly: see the nursing deep dive.
Allied health professionals
A two-sided story. They value the work, the patient relationships and their professional autonomy, then leave over progression (advanced practice and specialist roles seen as scarce), heavy caseloads and throughput targets, and frustration with service changes that put volume ahead of quality.
Medical and dental
A more mixed group. A relatively high share of exits are career-stage moves – rotations, fellowships, specialty changes. Where dissatisfaction appears, it centres on on-call and rota gaps, work–life balance, local culture and leadership, and confidence in how services are changing.
Support and non-clinical staff: different pressures again
In these groups, pay, banding, recognition and local circumstances come further forward.
Clinical support staff
Health care support workers and additional clinical services staff point to pay that does not match their responsibilities, and to routes into registered training that are hard to reach locally.
Admin and clerical
Leavers describe band ceilings, repeated restructures and a sense that administrative skill counts for less than clinical skill.
Estates, facilities and ancillary
Porters, catering, housekeeping and maintenance staff raise physical demands, pay, and feeling unseen in organisational priorities.
Scientific, technical and professional
These groups vary most: their reasons are often specific to a service or site, and their skills travel easily to other employers.
The deep dive on admin, estates and support staff covers the first three groups in detail.
What would have kept them
Report 3 sets out what would make the most difference for each group:
| Staff group | What the report points to |
|---|---|
| Registered nursing & midwifery | Safe staffing, workload and rota design; clearly communicated clinical career pathways; supportive, visible line management. |
| Nursing support / additional clinical | Recognise and reward the complexity of support roles; structured routes into registered training; involvement in team decisions. |
| Allied health professions | Credible local progression routes; AHPs involved in designing services, not only delivering them; watch staffing and caseload mix. |
| Medical & dental | Rota gaps, workload and work–life balance in pressured specialties; real influence over service change. |
| Admin & clerical | Explicit, accessible progression; visibly value administrative expertise; fewer restructures, or change communicated in ways that protect trust. |
| Estates & ancillary | Dignity, respect and recognition; safe, properly resourced conditions; a voice in wider organisational conversations. |
Four patterns that cut across the groups
Frontline pressure is real and unevenly spread
Registered nurses, AHPs and many support roles carry a physical and emotional load well beyond what their contracts describe.
Progression frustrates almost everyone
For nurses and AHPs it is advanced and specialist posts out of reach; for admin staff, band ceilings and restructures; for small professional groups, opportunities that sit outside the organisation.
Non-clinical staff can feel second-tier
Recognition tends to follow clinical work by default, even where nobody means it to.
Advocacy holds
In most staff groups a majority of leavers would consider returning, and many would still recommend their organisation – most strikingly among nurses.
Setting matters as well as role
Report 1 adds a second cut. In mental health and community settings leavers raise stronger concerns about well-being and working conditions; in acute settings, about pressure, staffing and safety; in care-sector organisations, about trust and management support. A nurse in a community team and a nurse on an acute ward may share a job title and still need different things from their employer.
What to do with your own data
We suggest reporting leavers by staff group as standard, not only as a trust-wide rate. Within each group, separate those who left for life reasons from those who left dissatisfied, because only the second group tells you what to fix. Read the free text group by group – the same theme, “progression”, means a different thing to a band 5 nurse and a band 3 administrator. Combine small groups so that no individual can be identified; groups of fewer than five are typically not reported. Then choose one or two levers per group from the table above and give each an owner. The NHS unhappy-leaver benchmark shows where your trust sits overall.
Source: great{with}talent, Who is Leaving & Which Roles?, NHS Workforce Intelligence Series Report 3 of 4, with the trust-wide figure and setting differences from Report 1, Why NHS Staff Leave. 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 and figures aggregated. The headline findings are in Disappointed advocates.
See what your own data already knows.
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