A survey by a team at the universities of Bath, Sheffield and Leicester, says work stress, high workload and understaffing are the primary factors driving health professionals out of the NHS in the UK. During the summer and autumn of 2021, 1,958 NHS health professionals from across the UK completed an online survey to determine the relative importance they gave to eight factors as the key reasons for leaving NHS employment. The factors compared were: staffing levels; working hours; mental health/stress; pay; time pressure; recognition of contribution; workload intensity; and work–life balance.

In total, 227 doctors, 687 nurses/midwives, 384 healthcare assistants and other nursing support staff, 417 allied health professionals, and 243 paramedics completed the survey. Health professionals ranked work-related stress, workload intensity and staffing levels as the primary factors underpinning decisions to leave the NHS, while paramedics ranked work stress, work-life balance, work intensity and pay higher relative weighting than the other professions.

Pay was considered more important by healthcare assistants and other nursing support staff and paramedics, the researchers reported in BMJ Open.

“In common with the NHS annual staff survey and all other voluntary participation employee surveys, the potential for self-selection response bias cannot be discounted,” write the researchers. “Excepting paramedics, rankings of leave variables across the different health professional families exhibit a high degree of alignment, at the ordinal level, and highlight the primacy of psychological stress, staff shortages, and work intensity.”

Royal College of GPs chair Professor Kamila Hawthorne backed the findings of the study.

She said: “This latest survey highlights the point that resolving the workforce issues in UK healthcare is not about pay alone – we can’t expect issues which have been decades in the making to be resolved overnight. Many GPs are experiencing huge workloads, resulting in burnout, low morale and a sense of moral distress. We know that when GPs do leave the profession earlier than planned, it is often due to the pressures of the role which have worsened in recent years. In many instances, when a practice loses a member of staff, it is really difficult to find an equivalent replacement, intensifying the pressures on those remaining. College surveys have shown that this cycle is likely to get worse, with many of our fully-qualified GPs considering leaving general practice in the next five years.

“GPs and their teams have been working exceptionally hard for their patients, delivering millions more appointments per year in the last few years, but now with 952 fewer fully qualified, full-time GPs than in 2019. These pressures look set to continue for the foreseeable future as GPs deal with a growing workload, both in the growing number of patients and the complexity of their illnesses, over the coming months. This will continue to compound the workforce crisis we’re facing. The publication of the NHS Workforce Plan was a positive step but it will take time to see its promises take shape. A greater number of GPs, and other professionals across all branches of healthcare, will help to alleviate the immediate pressures, but we’ll also need to see long-term and sustained workforce planning and retention initiatives to keep the current GPs we have, to give our patients the care they need and deserve.”