Early career nurses and other NHS staff have become more stressed, unhappy and dissatisfied over the past decade, new analysis has revealed.
The findings, published today by the Nuffield Trust, are based on 20 years of data from the NHS England Staff Survey and claims to be the first study of its kind to examine how responses have changed over time between different age groups.
Royal College of Nursing (RCN) chief executive and general secretary Professor Nicola Ranger said the findings – which cover a range of clinical staff including nurses, health visitors and midwives – were a ‘ticking time bomb’ for the NHS.
Rising work-related sickness
More than half (52%) of NHS staff aged 21-30 reported being made ‘unwell’ by work-related stress in 2023 – up from 38% in 2013.
At the same time, the number of NHS workers aged 51-65 who reported being made ill by work-related stress reduced slightly during this period, from 43% in 2013 to 40% in 2023.
Pay dissatisfaction
The analysis shows that the number of staff aged 21-30 who are unhappy with their current pay more than doubled between 2013 and 2023 – from 10% to 22%.
This contrasts with a 1% increase among staff aged 51 to 65 feeling unhappy with their pay – rising from 11% to 12% in the same period.
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Burnout and job satisfaction
Increasing overtime and growing pay concerns is impacting on the burnout and job satisfaction levels reported by NHS staff survey respondents between 2013 and 2023, researchers suggested.
During this time, staff aged 21-30 reported enjoying their work less, with 15% of respondents in this age group ‘not looking forward’ to their jobs in 2023. This was up from 12% in 2013.
Among older workers, aged 51-65, 10% said they ‘rarely or never look forward to work’. This was down slightly from 13% in 2013.
As a whole, the proportion of staff aged 21-30 who ‘do not feel enthusiastic about work’ has also risen marginally from 4% to 7%. For NHS staff aged 51-65 this figure has remained unchanged at 6%.
Overtime concerns
According to the Nuffield Trust analysis, all NHS staff undertook more unpaid overtime during the pandemic, however 2023 rates of overtime were comparable or lower than those reported by all age groups in 2013.
Older staff – especially those in the 41-50 and 51-65 age group – are the most likely to do unpaid overtime of all NHS staff.
In total, 16% of workers from those age groups reported completing at least six hours of unpaid overtime per work in 2023.
This is compared to 7% of those aged between 21 to 30.
Overall, all age groups are doing more paid overtime shifts in 2023 than they were in 2013 – ‘especially the youngest’, the research found.
In 2023, nearly a third (30%) of NHS staff aged 21 to 30 completed a minimum of six hours paid overtime per week – up from 20% a decade before.
‘A ticking time bomb for the NHS’
Responding to the findings, Professor Ranger said: ‘Young nursing staff are the future of the workforce, but those at the start of their careers are the most unhappy.
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‘A new nurse today is likely to face extreme pressure in severely understaffed services, with stagnant pay and little prospect of progression.
‘In these conditions, it is little wonder so many feel undervalued and overworked.’
Nuffield trust chief executive Thea Stein said young people’s start into the NHS ‘has got tougher than ever’, with newly qualified staff facing more ‘early career demands’, alongside ‘overstretched services’ and rising living costs.
‘The future of the health service depends on these workers,’ she said.
‘It is vital policymakers and employers now act on what the NHS’s own staff poll shows us about what the next generation of clinicians need to stay and thrive in the NHS.
An NHS England spokesperson said NHS organisations have ‘done a huge amount’ to improve working conditions in recent years, and that staff retention levels are among the highest in more than a decade.
‘The NHS is fully committed to ensuring staff get the support they need, and the health service is now offering more flexible working options than ever before, as well as a range of mental health support available for staff, including access to coaching and wellbeing resources,’ they added.
The RCN is calling on ministers to introduce a ‘proper pay rise’ and bring ‘new investment’ to grow the nursing workforce and improve job satisfaction.
A Department of Health and Social Care spokesperson said: ‘NHS staff have been overworked for years, and we understand the stress and moral injury that comes from working within a broken system.
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‘Through our Plan for Change we are turning the NHS around and giving staff the tools they need to deliver the best possible care for patients.’
In December, an exclusive Nursing in Practice survey found that more than a quarter (28%) of general practice nursing staff are considering leaving their role in the next year.
Last October, RCN data found the number of people studying to become a nurse had fallen in every region in England.
In July, the annual data report from the Nursing and Midwifery Council (NMC) found that 5,500 early-career nursing and midwifery staff has quit the profession in the last year.
