Is the NHS Running Out of Staff?

The NHS had 112,000 vacancies in 2024 — roughly 1 in 10 of all posts. This represents a partial recovery from the 133,000-vacancy peak in 2022, but remains more than double the pre-pandemic level. Nursing shortages are most acute: 34,200 nursing posts sit unfilled, representing 1 in 9 of the total nursing establishment.^[1] The Royal College of Nursing estimates that safe staffing requires the NHS to recruit and retain 40,000 additional nurses over the next decade.

International recruitment has become the primary mechanism for workforce growth. In 2024, 32,400 internationally trained nurses joined the NHS — up from just 4,100 in 2015.^[2] The majority came from the Philippines and India. This has stabilised total nursing numbers, but it masks a domestic training pipeline that has not kept pace with demand. The removal of NHS bursaries for student nurses in 2017 reduced applications by 30%; the bursaries were partially restored in 2020, but take-up has not fully recovered. The domestic training system simply cannot produce nurses fast enough: undergraduate courses take three years, and attrition rates during training are around 20%.

Staff sickness absence — running at 5.6% of contracted hours, compared to 3.8% in 2019 — further depletes effective workforce capacity.^[3] Burnout, post-COVID trauma, and unmanageable caseloads drive both absence and resignation. The pay dispute of 2022–23, which saw nurses strike for the first time in NHS history, reflected a real-terms pay cut of around 20% since 2010. The 2023 pay settlement of 5% remained below inflation. Agency and bank staff filled an estimated 8% of NHS shifts in 2024, at a cost of £3.2 billion — more than double the pre-pandemic agency spend.