NHS staff report increasing pressure on staffing levels, wellbeing and engagement, according to world’s largest workforce survey.

A new survey of over 760,000 NHS staff shows worsening workforce experiences across several areas, including staffing levels, wellbeing, and engagement.

The 2025 NHS Staff Survey, which was coordinated by the independent charity Picker on behalf of NHS England, provides a comprehensive overview of 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.

Staffing levels and burnout

The proportion of staff agreeing that there are enough staff at their organisation to do their job properly decreased by one percentage point, from 34% in 2024 to 33% in 2025 – 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. For example:

• 31% of staff felt burnt out because of their work (up from 30% in 2024, but still down from 35% in 2021)
• 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.

Staff engagement

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). One 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.

Commenting on the publication of the NHS Staff Survey, Chris Graham, Group CEO at Picker, said:

“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. Declines in workforce engagement stand out, and they are not confined to particular sectors or staff roles.

“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. NHS staff will be expected to play a central role in driving change in the coming years; their buy-in and readiness for change are essential to the success of the plan.

“Patient groups, too, will be rightly concerned about the drop in the proportion of staff who believe that patient care is their top priority – especially following the decision to abolish the National Guardian’s Office and Healthwatch England.

“As always, employers should use the survey data to understand and act on the concerns of their workforce locally. At a national level, these results show that NHS staff feel they are working under sustained pressure. As the government seeks to finalise its Ten Year Workforce Plan and deliver the NHS Staff Standards, these results must be front of mind. Staff must be supported to flourish if the service as a whole is to meet its goals.”

ENDS

Notes to editors

• For media enquiries, please contact the Marketing and Communications team at [email protected], or phone: 01865 632 235.

• The NHS Staff Survey is coordinated by the Survey Coordination Centre at Picker on behalf of NHS England. Fieldwork for the survey was conducted between September and November 2025.

• Taking part in the survey is compulsory for all NHS trusts and voluntary for other NHS organisations such as Integrated Care Boards and Social Enterprises. This year, 238 organisations participated, including 206 NHS Trusts in England.

• As in previous years, all participating organisations undertook a census of all eligible employees. Overall, 766,285 people responded to the survey from 1.5 million who were invited: a response rate of 49%, down 2% points from 2024. The vast majority of respondents (95%) completed the survey online. The survey is understood to be the world’s largest published workforce survey.

• National results include data from 751,088 staff at 206 NHS trusts.

• All staff in full-time or part-time roles employed in participating organisations on 1^st September 2025 were eligible for the survey. This includes staff on fixed-term contracts; on secondments; on sickness absence of up to 12 months; on parental leave; or suspended.

• Staff were not eligible for the survey if they were employed by sub-contracted or outside organisations or if they had been on long-term sick leave for more than a year. Staff working solely on the bank were invited to participate in the NHS Staff Survey for bank only workers. The 2025 results of this survey will be published in April.

• Full results of the survey are available from www.nhsstaffsurveys.com.

Picker’s team of researchers and data scientists are available to support organisations in understanding, measuring, and using workforce and user experience. For queries about our services or to request a call, please contact [email protected].