LONDON—August 9, 2024—High levels of workplace discontent among doctors and nurses in the UK’s National Health Service (NHS) make determined action to improve job satisfaction among clinicians critical to securing improved NHS performance, productivity and delivery, new survey-based analysis from Bain & Company concludes.

Findings from Bain’s latest UK Front Line of Healthcare Survey ¹ indicate that almost a quarter of doctors (23%) and half of nurses (50%) say they are considering switching careers, while 27% of doctors and 37% of nurses are contemplating switching employer.

The medical professionals surveyed cite burnout, excessive workloads and lack of recognition as the driving factors behind their desire for a change of workplace or career. More than 60% of surveyed UK clinicians report that they feel worn out by the end of the workday, and only two-fifths (41%) report feeling that their job meets their basic physical and mental needs, the findings, published today in Bain’s report Addressing the NHS’s Productivity Crisis Through Improved Clinician Satisfaction, also show.

The scale of the challenges facing NHS leaders over the need to improve morale and job satisfaction among doctors, nurses and other clinical staff while also improving service performance and productivity is underlined by the findings coming in spite of a steep rise in the number of full-time NHS employees, by more than 20% between 2019 and 2024, which contributed to a fall in vacancy rates for nurses from 11% to 8.4% in the period.

Even with the sharp rise in the NHS workforce, the survey findings show that nearly 90% of hospital managers still report experiencing organisational challenges in recruiting and retaining doctors and nurses. The retention challenge is emphasised by a continuing churn in the health service workforce, with a record 170,000 staff, including 41,000 nurses, leaving employment by NHS hospitals and community health services in 2022. At the same time, around 40% of doctors believe their organisation’s challenges with recruitment and retention are due to clinician job dissatisfaction.

The increased NHS workforce numbers, with 250,000 extra full-time equivalent staff and a 12% annual rise in spending on agency staff have meanwhile come alongside falling productivity with the yearly volume of hospital patients treated for elective procedures falling by 3% and average waiting times for hospital procedures climbing from eight to 15 weeks, adding some three million patients to waiting lists, Bain’s report notes.

Bain’s analysis concludes that job dissatisfaction among clinical staff is a key factor contributing to falling NHS productivity. After nearly two years of unprecedented and protracted pay disputes it notes that UK clinicians remain largely dissatisfied with salaries, professional demands and long-term career sustainability. Only about 40% of doctors report being satisfied with compensation, benefits, and staffing/workload, the survey shows. Nearly 70% do not believe they are compensated fairly for their duties.

“The pressing need to improve productivity and delivery in the health service has to go hand-in-hand with urgent requirement to address the high levels of clinician dissatisfaction with their jobs and careers that our survey reveals,” Jeremy Marlow, partner in Bain & Company’s UK Healthcare and Life Sciences practice, said. “Experience shows clearly that trying to deliver more, improve productivity, and control costs without taking measures to engage with the frontline medical staff and support their satisfaction with what they do every day backfires on NHS trusts and hospitals. Engaging proactively with clinical staff is essential not just to retain these vital people in their roles, but to unlock their energy and commitment to make performance improvement initiatives work to their full potential.”

Finding a treatment plan

Bain’s analysis recommends a range of measures to help the NHS make more concentrated efforts to improve clinicians’ job satisfaction.

Healthcare managers should put in place more effective systems to engage with, and act on, clinicians’ feedback and should prioritise areas for improvement identified by doctors and nurses as top concerns, the report suggests.

Noting that only half of surveyed clinicians say their organisation routinely assesses employee experience, the study concludes that more determined efforts to listen systematically to doctors’ and nurses’ concerns, and to implement initiatives to address feedback, can help to turn around job satisfaction levels. The report emphasises the importance when tracking and assessing feedback of accurately identifying the key drivers of satisfaction among individual clinicians or teams – given significant differences in how various staff types see workplace conditions, with varying perceptions between doctors and nurses of what concerns matter most.

Establishing and embedding a culture of support and recognition, including through mentorship, professional development, and access to resources is also a critical step in action to enhance morale, reduce employee turnover, and improve patient outcomes, Bain finds.

Unlocking the potential of AI

Bain’s analysis highlights potential for AI and other automation to improve NHS productivity of day-to-day operational inefficiencies, meaning that 63% of doctors report concerns over excessive forms and paperwork, while 53% feel they have to perform low-value, repetitive tasks.

In one example, Bain reports that one UK hospital expects to unlock £2 million in net cost savings each year through planned automation of HR processes, financial management and patient administration. At the same time, the hospital expects to increase its back-office efficiency by 15% to 20%.

To harness the potential of AI, however, the report underlines the importance of organisational readiness and infrastructure and staff training needs to ensure effective implementation of new technology rather than its use leading to unintended hurdles. Hospitals will need to take a range of critical steps to automate key processes, such as data collection for AI, to be successful in boosting efficiency, the report recommends.

Media contacts

For any questions or to arrange an interview, please contact:

Gary Duncan (London) — Email: gary.duncan@bain.com

Notes to Editors

1. Source: Bain & Company Front Line of Healthcare survey, March 2024.  UK provider survey covering  150 doctors and 70 nurses, total 273 clinicians.

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