Skip to content

We know the NHS is facing a workforce crisis, but how many people work in the NHS in England, and what are their roles?

The NHS workforce is growing, but not rapidly enough to keep pace with demand. This means that urgent action is needed to ensure that the NHS has enough staff in place to deliver high-quality care and to develop the service for the future. Solving this problem will require consistent and concerted action at both a local and national level in order to address wide-ranging issues, such as workforce planning, pay, training, and staff wellbeing.

Workforce by staff group

The NHS in England currently employs around 1.5 million people (on a headcount basis, counting each individual member of staff) and 1.3 million people on a full-time equivalent (FTE) basis. These figures include staff in ambulance, community, mental health and hospital services, as well as those in commissioning roles and central bodies such as NHS England, making it the largest employer in England.

Chart showing the makeup of the NHS workforce by staff groups

There are many other staff groups that help provide NHS services but are not directly employed by the NHS – for example, there are nearly 147,000 FTE staff working in general practice and more than 24,000 dentists.

Change in workforce numbers over time

Since 2009, the number of NHS FTE staff has increased by more than 30%. However, this growth has not been evenly spread across the years or staff groups. Changes to the workforce need to be seen within the context of events, each associated with different trends. The period of austerity following the global economic crash in 2008 saw a reduction in health workers – as NHS staff make up a large proportion of the NHS budget – and led to high staff turnover, with pay freezes over multiple years. The NHS reorganisation that took place around 2012 led to significantly fewer managers. In 2013, the Mid Staffordshire Public Inquiry led to higher numbers of key staff groups in order to improve quality and patient safety (the number of nurses started to increase around this time). Most recently, Covid-19 saw a sharper rise in workforce in response to the demands of the pandemic.

Graph showing the increasing NHS workforce, with some groups experiencing a faster growth rate than others

Change in staff groups over time

Although overall staff numbers have been increasing, some staff groups have seen a decline in numbers or a decline in growth. Unmasking variation within staff groups reveals that while adults and children’s nurses have increased since 2009, learning disability and community nursing have seen a combined loss of more than 4,000 nurses. Although some medical specialties have struggled to recruit trainee doctors, the overall number of consultants has continued to increase. For scientific, therapeutic and technical staff, a 40% overall increase conceals greater or smaller changes, such as a 54% increase in radiographers and an 8% increase in health care scientists.

A number of graphs showing the growth rate for different staff groups

International staff

The UK’s current immigration policy allows health and social care staff to apply for a visa to work in the UK for up to five years. The NHS would not be able to function without its international workforce, who account for nearly one in every five people who work in the health service. Some job roles are more reliant than others on international staff – for example, international staff make up 37% of doctors compared with just over 5% of managers.

Chart showing the percentage of international staff in different job roles in the NHS

In recent years, the overall number and proportion of international staff has grown due to an increase in staff from non-European Economic Area (EEA) countries. However, the proportion of staff from EEA nations has remained static.

Graph showing the proportion of international staff increasing

Demographics

Almost three-quarters (74%) of NHS England staff are female and 31% are from an ethnic minority background – higher than the population average in England; but disability rates among staff in NHS England are 7%, which is below the England average. These rates vary by role; for example the proportion of female staff ranges from nearly 100% of midwives to 46% of doctors, and the proportion of ethnic minority staff ranges from 54% of doctors to 5% of ambulance staff. The proportion of staff with a disability ranges from 10% of scientific and technical support staff to 4% of doctors.

Bar chart showing the proportion of ethnic minority staff in the NHS compared to the population

Over time, the proportion of female staff has remained stable, but the proportion of ethnic minority staff has increased from 17% in 2009 to 31% in 2023. Over the same period, the proportion of staff with a disability increased from 5% to 7%, the proportion of LGBTQI+ staff increased from 2% to 5%, and the proportion of staff aged over 55 increased from 15% to 19%.

Vacancy rates

Vacancies remain a big concern, with an estimated 111,000 posts currently unfilled substantively. Although the NHS workforce has been growing, demand for NHS services has been growing faster, and the health service has not been able to recruit and retain sufficient staff to keep up. As well as doctors and nurses, vacancy rates are high for other NHS staff, including allied health professionals such as physiotherapists and occupational therapists. Although some substantive posts are filled temporarily by bank and agency staff, this can be costly to the NHS.

Chart showing the number of unfilled posts in the NHS

Reasons for leaving

Resolving NHS workforce shortages is about both recruitment of new staff and retention of existing staff. More than half of NHS leavers are voluntary resignations; reasons given include relocation or dependants. However, the top two reasons for leaving are to improve work–life balance or because of health issues. The number of staff leaving for these reasons has more than tripled since 2013/14.

Chart showing an increasing number of staff are leaving the NHS due to work-life balance

Staff satisfaction

Staff satisfaction is important to ensure retention, but the 2023 NHS Staff Survey shows a concerning level of unhappiness among staff. Only 31% of staff are happy with their level of pay or the level of staffing in their organisation, and 29% state that they often think about leaving. There are also problems with workplace culture, with nearly one in five staff reporting bullying or harassment from colleagues.

Three bar charts showing less than a third of NHS staff are happy with pay or staffing levels and they're thinking of leaving

Conclusion

Despite an increase in the NHS workforce, there are not enough staff to match demand, as shown by the number of people waiting for care. Recruitment and retention are both problems, with high and growing vacancy rates, and low and falling staff satisfaction. Ethical international recruitment will be essential to addressing the current NHS workforce crisis, especially in the short term given the time it takes to train staff. But this is not a long-term solution. To provide the number of staff the NHS needs, greater investment in training and staff development will be needed, alongside improved retention rates.

Long read

The health and care workforce

Find out more about the challenges facing the health and care workforce and some potential actions in our long read.

Read now