NHS bosses dismissed a record number of staff in the 2024-25 financial year, with nearly 7,000 employees let go under a new government drive for higher performance standards.
Unprecedented Dismissals Under New Policy
The latest NHS workforce data reveals that almost 7,000 staff members were dismissed in the year, a figure that has nearly doubled from two years prior when around 4,000 were removed from their posts. This is the highest number recorded since such statistics were first gathered in 2011.
More than half of these dismissals were made on the grounds of 'capability'. The sharp rise follows Health Secretary Wes Streeting's November 2024 vow to bring a 'zero tolerance' approach to poor performance, declaring there would be 'no more rewards for failure'. He has also warned NHS managers they face being fired if they fail to perform in new league tables, due to be published for the first time this autumn.
A Costly but Necessary Culture Shift?
The dismissals account for 1.8 per cent of all staff who left NHS jobs in 2024-25, up from 1.2 per cent a decade ago. However, with a total workforce of 1.5 million, the 7,000 dismissals represent less than 0.5 per cent of all employees. This rate remains significantly lower than the estimated 2-3 per cent average dismissal rate in the private sector.
Think tank expert Gareth Lyon of Policy Exchange told the Telegraph: 'People who can't – or won't – do their job should be sacked. The NHS needs to significantly up its game, and that will only happen with a more rigorous approach to performance management.'
Despite the policy's intent, the high turnover carries a financial burden. Freedom of Information requests analysed by Skills for Health indicate that the average cost of replacing an NHS staff member is £6,500.
Balancing Accountability with Support
Jon Freegard, of Skills for Health, described the rise in dismissals as 'regrettable' but supported the policy, suggesting it reflected the rooting out of months or years of underperformance. He argued that while those not up to the job should be dismissed, more should be done to tackle incompetence early and support employees to improve.
Former Health Secretary Steve Barclay highlighted a 'deeply ingrained culture' within the NHS where complaints are seen as a problem rather than an opportunity. He criticised a 'revolving door' for failing managers and clinicians who continue working despite clear warning signs.
A Department of Health and Social Care spokesman stated: 'Performance management is essential in the NHS as we look to drive up standards... Early intervention and proper support for staff will prevent performance issues arising in the first place.' The statement referenced the government's 10-year health plan to provide staff with training and resources.
The policy shift comes during a challenging period for the health service, which has faced industrial action from junior doctors and pressure from seasonal illness outbreaks.
