Record number of NHS staff dismissed as ministers push tougher performance standards
NHS trusts have dismissed close to 7,000 staff during 2024 and 2025, marking the highest number of sackings since records began more than a decade ago and signalling a hardening stance on performance across the health service.
The figure represents a sharp increase from around 4,000 dismissals just two years earlier. More than half of the latest total relates to capability cases, where employees are judged unable to meet the basic requirements of their role under NHS rules. Other dismissals were linked to misconduct or redundancy.
The rise comes amid growing political pressure to tackle underperformance within the NHS’s 1.5 million strong workforce. Health Secretary Wes Streeting has been vocal in calling for tougher action, pledging a “zero tolerance” approach to inadequate performance and warning that there would be “no more rewards for failure”.
Mr Streeting has also previously indicated that senior NHS managers who perform poorly in newly introduced league tables could face dismissal.
Record number of NHS staff
The shift has been welcomed by the think tank Policy Exchange. Gareth Lyon, its head of health and social care, said: “People who cannot or will not do their job should be sacked. The NHS needs to raise its game and that will only happen with far more rigorous performance management.”
Analysis of workforce data shows that 1.8 per cent of NHS staff who left their roles in 2024 and 2025 did so through dismissal, compared with around 1.2 per cent a decade ago. Ministers have said this is the clearest indicator of performance related terminations.
Research by Skills for Health, based on freedom of information requests to every NHS trust and integrated care board in England, estimates that replacing each dismissed employee costs about £6,500.
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Even with record numbers, fewer than 0.5 per cent of the NHS workforce has been dismissed. That compares with the private sector, where between 2 and 3 per cent of employees are typically let go.
Jon Freegard, director of consultancy and research at Skills for Health, described the increase as “regrettable” but suggested it reflected long standing performance problems that were not addressed early enough.
“No one disputes that staff who are not up to the job should ultimately be dismissed,” he said. “But earlier intervention and proper support could help some employees improve and would reduce the high cost of replacement.”
Former health secretary Steve Barclay has also criticised what he called a deeply ingrained culture within the NHS, arguing that underperforming managers too often move between organisations without accountability.
A spokesperson for the Department of Health and Social Care said strong performance management was essential to improving patient care.
“As we work to fix the NHS, early intervention and proper support for staff will help prevent performance issues arising in the first place,” the spokesperson said. “Our 10 year health plan is focused on ensuring staff have the training and resources they need to thrive and deliver outstanding care.”
