Record Number of NHS Staff Dismissed for Poor Performance: Key Reasons Explained.Health Secretary Wes Streeting’s new “zero tolerance” stance on ineptitude has resulted in the dismissal of a record number of NHS employees. Nearly 7,000 employees were let go in 2024–2025—nearly twice as many as the 4,000 employees who were let go in 2024–2025—according to NHS data.
Since records started being kept in 2011, this is the most dismissals that have occurred. Over 50% of those fired were removed on the grounds of “capability,” which denotes that they were judged incapable of carrying out their duties to the necessary level.
Numerous nurses who were deemed incapable or unfit to practise were among the 7,000 dismissed, according to reports. A number of infractions resulted in suspensions or terminations. The following instances were used by the Royal College of Nursing (RCN) panel to determine that a nurse’s “fitness to practise was impaired” in multiple cases:
Applying too much pressure during a subcutaneous injection can result in the needle bending.
Not removing every surgical clip from a patient’s incision
During the hiring process, dishonesty was demonstrated by making false claims about having two or more years of nursing experience when this was not the case.
purposefully lying to a potential employer about having the necessary amount of experience
Working shifts for one or more agencies while collecting sick pay from a significant NHS employer and/or being approved as medically unfit
Working dishonestly while on sick leave (as evidenced by admission)
Inappropriate communication with dementia sufferers, such as using patronising or condescending phrases like “well done” or “good girl”
yelling, “I give, I give,” while waving an insulin injection in front of a patient’s face
showed a lack of competence in areas like moving and handling patients, failing to satisfy the necessary requirements of knowledge, abilities, and judgement as a Band 4 nurse, controlling the workload, Interaction
Inept evaluation and administration of medications
Not identifying and reporting patients who are becoming worse
being accused with two charges of poisoning with the intent to endanger life or cause serious bodily damage and two counts of attempted murder
Communicating with people who are thought to be children for sexual purposes
Being dishonest by pretending to be certified to give intravenous medication without having completed the necessary test
convictions for two children’s attempted murders
The increase in terminations comes after Wes Streeting threatened to terminate NHS managers if they did not do well in the league tables, which were first released in the autumn of 2024. He promised in November 2024 that there would be “no more rewards for failure” and that there would be “zero tolerance” for subpar performance.
“Those who can’t—or won’t—do their job should be fired,” stated Gareth Lyon, head of health and social care at the research tank Policy Exchange, to The Telegraph. The NHS must drastically improve, and the only way to do so is with a more stringent approach to performance management, which includes terminating underperforming employees.
According to NHS data, the percentage of employees who were fired increased from 1.2% ten years ago to 1.8% in 2024–2025. The non-profit group Skills for Health examined FOI requests and found that the average cost of replacing an NHS employee is £6,500 per person.
The dramatic increase in terminations was deemed “regrettable” by Skills for Health’s director of consultation and research, Jon Freegard, who also defended the new policy, pointing out that it represents months or even years of poor performance being finally addressed. He remarked that ineptitude needs to be addressed more and that some employees could get better with the right help.
According to Mr. Freegard, “no one can argue against those who are not up to the job being dismissed.” “But there’s more to think about: why is it so expensive to replace underperformers?”
According to former health secretary Steve Barclay, the NHS has a “deeply ingrained culture” that views complaints as issues rather than chances for progress and is reluctant to hold people accountable. He emphasised the “revolving door” of clinicians and management who, in spite of setbacks, had persisted in working and endangering patients long after warning indicators became apparent.
NHS dismissal rates are still lower than in the private sector, despite the increase. The NHS employs about 1.5 million people, therefore the 7,000 layoffs represent less than 0.5% of the workforce in 2024–2025. In comparison, the typical dismissal rate in the private sector is thought to be between two and three percent.
The numbers coincide with the NHS’s challenging year, which has seen hospitals under strain due to a serious flu outbreak and junior doctors’ strikes earlier this month. Despite being informed that their absence would result in patients having to stay in the hospital over Christmas because of staff shortages, the strikes went forward.
A representative for the Department of Health and Social Care responded to the dismissal statistics by saying: “As we strive to improve standards and guarantee that patients receive the care they are entitled to, performance management is crucial in the NHS. Performance problems can be avoided in the first place with early intervention and appropriate staff support. Following years of harm, our 10-year health plan is making sure that employees have the tools and training they require to flourish and provide exceptional care.