A new report by researchers from University of Leicester and UCL warns that failure to retain a diverse workforce could leave the NHS facing severe staffing shortages, with international workers described as critical to preventing the system from “falling over.”
The study calls for staff retention to be placed at the centre of the forthcoming NHS Workforce Plan, due in spring 2026, and urges policymakers to better reflect the needs of an increasingly diverse workforce. Without action, researchers caution that more staff may leave the UK, putting additional strain on services.
Picture credit: University of Leicester
Lead author Katherine Woolf said retention strategies must address racism and inequality as core issues rather than add-ons. She warned that experienced clinicians cannot easily be replaced, adding that losing international staff would pose a serious risk to the health service.
Survey data collected between 2021 and 2024 shows a sharp rise in staff considering leaving, increasing from around 30% to 47%. Nursing and midwifery staff were among the most likely to quit, while workers from ethnic minority backgrounds were more likely to leave than white UK nationals. Researchers link this trend to discrimination, poor mental health, low pay and feeling undervalued.
The report follows a parliamentary roundtable held in Westminster in December 2025, hosted by Sarah Owen, which brought together academics and policymakers to discuss retention strategies. The findings form part of the NIHR-funded I-CARE study, a three-year project examining how to better retain NHS staff from migrant and ethnic minority backgrounds.
Co-author Manish Pareek said workforce planning must embed equity and anti-racism, warning that continued departures of experienced staff would create gaps that cannot be quickly filled.
The report sets out four key recommendations, including making retention a central pillar of workforce planning, assessing the impact of wider government policies, designing systems that reflect workforce diversity, and tackling racism as a core retention issue. It also highlights priorities for local action such as inclusion, fair career progression and improved mental health support.
Contributors including Ibrahim Abubakar said urgent reforms are needed to address workload, pay and visa barriers, warning that without change the NHS will struggle to attract and retain the staff it depends on.
