The latest NHS Staff Survey paints a disturbing picture of a service with too few staff, not enough staff engagement and too many medical professionals suffering from burnout.
The annual survey of NHS staff does not make for happy reading. It shows worsening workforce experiences across several areas, including staffing levels, well-being, and engagement. At its most basic level, it reflects a health service that is struggling.
The 2025 NHS Staff Survey, which was coordinated by the independent charity Picker on behalf of NHS England, shines a light on staff experiences at work, with particular focus on delivery of the NHS England People Promise. The survey included all directly employed staff in secondary and tertiary care organisations, ranging from consultants to care assistants and from porters to paramedics.
“Every year, the NHS Staff Survey provides comprehensive insight into how NHS staff are feeling when they turn up to work every day. Recent surveys have shown experiences improving and stabilising following the tumult of the pandemic years, but results for 2025 show a worrying backward trend on some of these gains,” said Picker group chief executive Chris Graham.
“These results will make for concerning reading among employers and the government as the NHS undergoes a period of significant reform to deliver the ambitions outlined in the Ten Year Plan for Health,” he added.
Not enough staff
The proportion of staff who agreed that there are enough staff at their organisation to do their job properly decreased by one percentage point, from 34% in 2024 to 33% last year – although this remains significantly higher than the 27% recorded in 2021. Agreement with this question dropped across all trust types except Ambulance Trusts, whose results continued an upward trend: almost doubling from 20% in 2021 to 39% in 2025.
Results around burnout have improved since the pandemic, with notable falls in 2023 and largely static results in 2024. This year, there were some indications that experiences have worsened, with small increases in most measures. Almost a third (31%) of staff felt burnt out because of their work (up from 30% in 2024, but still down from 35% in 2021), and 37% of staff said their work frustrates them (up from 35% in 2024, but still down from 40% in 2021).
Staff agreement that their organisation takes positive action on health and well-being has also declined and is at a five-year low, at 55%, down from 57% in 2021.
Measures of staff engagement have also declined, with lower proportions of staff looking forward to going to work (52%; down from 54% in 2024) or feeling enthusiastic about their job (66%; down from 68% in 2024).
The survey suggested that a contributing factor may be a notable decline in the proportion who say that there are opportunities for them to develop their career in their organisation: this has fallen by 3.5% this year, and is now down to 51% after peaking at 56% in 2023.
A drop in engagement was also evident in the proportion of staff who would recommend their organisation as a place to work: across the NHS, this has fallen by 3% points from 61% in 2024 to 58% in 2025. Declines were particularly steep for staff in the wider healthcare team, including admin & clerical, general management, and central functions roles: each of these groups had declines of more than 4% points nationally.
Extreme pressure
The response from the sector was one of frustration.
The findings show a service under “extreme pressure”, said BMA representative body chair Amit Kochhar. He pointed out that less than a third of doctors said there were enough staff for them to do their job properly, and more than 80% said they faced unrealistic time pressures – with three-quarters of doctors working additional unpaid hours. “The impact on doctors’ wellbeing cannot be understated, with four in ten doctors saying they had been unwell with work-related stress and more than a third saying they found their work emotionally exhausting,” he added.
“This is not fair on individuals, not safe for patients and not sustainable for the health service, as more staff are ultimately driven away,” he continued.
This was picked by the public service union Unison. The union’s deputy head of health Alan Lofthouse talked about “a deeper malaise” in the NHS.
“Health workers’ worries about staffing shortages and the inability to meet all the demands on their time must be listened to and acted upon,” he said.
“A dramatic cultural shift is needed in the NHS or the service will lose experienced people who won’t put up with being treated so poorly,” he added.
Answers to the problems are not straightforward, though one was proposed by Nuffield Trust fellow Lucina Rolewicz.
“If the NHS wants to back up its commitment to develop enough staff trained within the UK for a stable workforce, this needs to change. Other countries use policies such as student loan forgiveness to reward staff for sticking around in public service, and we should be learning from them,” she said.
