NHS workforce in a nutshell

We know the NHS is facing workforce challenges – but who works in the NHS, what are their roles, and how have numbers changed over time?

The NHS workforce is growing, but demand for care is also rising and health needs are increasingly complex. While headlines often focus on overall staff shortages, the reality is more nuanced.

How many staff work in the NHS?

As of August 2025, the NHS in England employs around 1.5 million people on a headcount basis (counting each individual member of staff) and 1.4 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.

There are many other staff groups that help provide NHS services but are not directly employed by the NHS – for example, there are nearly 150,000 FTE staff working in general practice and more than 25,000 dentists.

How have workforce numbers changed over time?

Since 2010, the number of NHS FTE staff has increased by more than 36%. 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 external 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). Since the onset of the Covid-19 pandemic in 2020, the workforce has grown at a faster rate.

The growth in the GP workforce has been more modest. Overall, there are over 3,400 more FTE GPs in 2025 compared with 2016, although this has been driven by an increase in the number of trainee GPs across the period.

How have staff groups changed in size over time?

Although overall staff numbers have been increasing, some staff groups have seen comparatively low rates of growth. Unmasking variation within staff groups reveals that while there have been significantly above average rates of growth among children’s nurses (94%), doctors (55%), and scientific, therapeutic and technical staff (48%), the growth rates are much lower for managers and senior managers (5%), and ambulance staff (25%). There have also been overall declines among some staff groups, including learning disability nurses and community health visitors.

One area that often receives attention is NHS management. The NHS has a low proportion of staff classed as managers and senior managers compared with international health systems. Fewer managers can limit efficiency, capacity for change or innovation, and place additional administrative burdens on clinical staff.

How many international staff work in the NHS?

The international workforce accounts for over 1 in every 5 people (21%) who work in the health service. Some roles are more reliant than others on international recruitment – for example, international staff make up 36% of doctors compared with just over 5% of managers and senior managers.

In recent years, the number of international staff from outside the European Economic Area (EEA) has doubled, from around 105,000 in 2020 to around 240,000 in 2025. At the same time, the proportion of staff from the UK has decreased by 6%.

Who makes up the NHS workforce?

Over three-quarters (76%) of NHS staff in England are women, and 30% are from an ethnic minority background – higher than the population average in England. Prevalence of disability among NHS staff in England are 7%, which is below the England average.

These rates vary by role – for example, the proportion of staff who are women ranges from nearly 100% of midwives to 48% of doctors, and the proportion of staff from a minority ethnic background ranges from 50% of doctors to 5% of ambulance staff. The proportion of staff with a disability ranges from 11% of scientific and technical support staff to 3% of doctors.

Over time, the proportion of staff who are women has remained stable, but the proportion of staff from a minority ethnic background has doubled, from 15% in 2009 to 30% in 2025. Over the same period, the proportion of staff with a disability increased from 2% to 7%, the proportion of staff who identified as LGBTQI+ increased from 1% to 4%, and the proportion of staff aged over 55 increased from 16% to 21%.

How many vacancies are there in the NHS?

Vacancies remain a concern, with an estimated 100,000 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 shrink the number of vacancies.

Vacancy rates are highest in mental health and community posts at 9% and 7% respectively. Although some substantive posts are filled temporarily by bank and agency staff, this can be costly to the NHS.

The rate of staff leaving each year has averaged 11% since 2011. Recognising this, the NHS Long Term Workforce Plan set out a target to reduce the leaver rate to a target range of 7.4%–8.2% by 2037.

Why do staff leave the NHS?

Resolving NHS workforce shortages is about both recruitment of new staff and retention of existing staff. More than half (54%) of NHS leavers are recorded as voluntary resignations. Common reasons for leaving include work-life balance (9%) and the employee’s health (3%). The number of staff leaving for these reasons has more than doubled since 2012.

What is the level of staff satisfaction in the NHS?

Staff satisfaction is important to ensure retention, but the 2024 NHS Staff Survey shows a concerning level of unhappiness among staff. It revealed that 43% of staff are dissatisfied with their level of pay, 44% are dissatisfied with the level of staffing in their organisation, and 29% state that they often think about leaving. In addition, 42% of staff have felt unwell in the past 12 months due to work-related stress, and 30% often feel burnt out because of work.

Worryingly, some frontline staff experience violence and abuse from patients, their relatives, and other members of the public. For example, over a third (37%) of operational ambulance staff experienced physical violence of this kind in the past 12 months, while over half (51%) experienced harassment or abuse. There are also problems with workplace culture, with nearly 1 in 5 (18%) staff reporting bullying or harassment from colleagues in the past 12 months.

The King’s Fund’s view

Despite significant growth in the NHS workforce, the number of people waiting for care has reached record levels in recent years. This suggests that staffing alone is not the only constraint on performance; the mix of staff, how they are deployed, and the tools and systems they work with also matter.

Recruitment and retention remain challenges, particularly in areas such as mental health and community services where vacancy rates are highest. The NHS continues to struggle to fill posts substantively and sustainably, and staff satisfaction remains low.

Staffing is the single largest area of NHS spending, and improving performance requires more than just increasing headcount. It means investing in the right mix of skills, supporting staff wellbeing, and ensuring that roles are designed to meet the needs of patients and services. Long-term solutions must focus on domestic education and training, and retention.

Meeting the NHS’s workforce needs – and the care needs of the population – will require sustained investment, strategic planning, and a commitment to improving the working lives of staff across all roles and settings.