Why do staff leave the health service? 

New HSE statistics provide information on reasons for staff leaving, or moving within, the health service.

In October 2024, the Medical Independent (MI) reported that the HSE was looking to gain feedback on why staff leave their positions or transfer to different areas within the organisation.

At the time, an Executive spokesperson said that a “leavers’ report” would help provide a “strong foundation” for developing staff retention strategies.

The questionnaire is now incorporated into a revised HR106 form. The HR106 form is required when an employee is leaving the HSE or transferring to another payroll area. It serves to notify payroll, human resources, and pensions departments of changes to staff status, initiating the process of updating relevant systems.

According to a HSE spokesperson, the “leavers’ report” project was undertaken to improve the data collected on why staff leave HSE services and where they go after leaving.

The feedback collected through this process is reflected in the recently published Health Sector Workforce Turnover Report for the first quarter of this year.

Data

According to the report, the turnover rate across all HSE staff categories was 1.8 per cent.

This represents a slight increase of 0.1 percentage points compared with the previous quarter, while remaining unchanged from the first quarter of 2025.

Overall, the initial 2026 data is consistent with the downward trend that has occurred since the first quarter of 2022, when the turnover rate was 2.4 per cent.

Specific figures for consultants show a turnover rate of 2.6 per cent in the first quarter of this year. This represents a slight increase of 0.2 percentage points compared with the same period of last year. By comparison, the turnover rate reached 2.8 per cent in the first quarter of 2022.

Of the 2.6 per cent turnover among consultants, 0.6 per cent represented “external movement” (ie, leaving the HSE).

A further 0.6 per cent represented internal movement within the HSE, while the destination of the remaining 1.4 per cent was not disclosed.

Overall, the report indicated a return to pre-2020 turnover rates, while noting the impact of recruitment measures implemented across services over the past year.

The marked increase recorded in 2022 was significantly influenced by Covid-19 factors, the HSE spokesperson told MI.

These factors included the lifting of restrictions on international travel, the reopening of national borders, and staff retirements among those who deferred such decisions in the pandemic years to remain and support the national Covid-19 public health effort.  

In terms of regions, HSE Dublin and South East recorded the highest turnover rate across all staff categories at 2 per cent. This marked an increase of 0.4 percentage points compared to the final quarter of last year. It was followed by HSE Dublin and Midlands at 1.9 per cent and HSE Midwest at 1.8 per cent.

Reasons

Reasons for leaving are initially categorised under the terms ‘retirement’, ‘voluntary’, or ‘involuntary’. The report defines ‘involuntary’ departures as those arising from the end of a contract, including temporary or training contracts, or from dismissal.

The ‘voluntary’ category is the principal focus of the report and is defined as “staff that have made a personal decision to leave their current job”.

Of all departures, 27 per cent were attributed to ‘retirement’, 10 per cent were ‘involuntary’, and 63 per cent were ‘voluntary’.

A breakdown is then provided in the ‘voluntary’ category. ‘Career opportunities’ was the most commonly cited reason, accounting for 37 per cent, followed by ‘personal’ reasons at 25 per cent and ‘job satisfaction’ at 21 per cent. ‘Emigration’ accounted for 6 per cent, while ‘permanent infirmary’ was cited in 5 per cent of cases. All other reasons accounted for less than 5 per cent each.

Of the staff who voluntarily left the public health service, 37 per cent said the decision was taken for ‘personal’ reasons. This may include work/life balance, family, or caring reasons, according to the report.

The next most common factor was ‘career opportunities’ at 27 per cent, while ‘job satisfaction’ and ‘emigration’ each accounted for 15 per cent. All other reasons were cited by fewer than 5 per cent of departing staff.

Of those who voluntarily moved somewhere else within the public health system, ‘career opportunities’ (51 per cent) and ‘job satisfaction’ (30 per cent) were the primary factors by a significant margin.

This type of turnover data provides “valuable information” on workforce movements within the HSE and section 38 sector, the spokesperson told MI.

By monitoring the number of employees leaving the organisation, HSE services can identify workforce trends, assess retention challenges, support workforce planning, and inform recruitment strategies.

“Accurate turnover data helps ensure that the health service can plan for future workforce needs and maintain safe, effective health, and social care services.”

The spokesperson added the data would help inform retention strategies included in the HSE People Strategy 2025-2027.

Destination

The new quarterly report also captures some information regarding the destination of all departing staff.

It identifies that 21 per cent of movement is within the Irish public health service (ie, those leaving one part of HSE services to join another part), and 20 per cent relates to those exiting the public health service.

Some 59 per cent of movement is to undisclosed destinations, while less than 1 per cent related to other movement (ie, ‘dismissal’, ‘death in service’).

Of the 20 per cent who exited the public health system, 6 per cent said that “they were taking a break from employment”.

A further 6 per cent had entered the private medical sector, 5 per cent had entered work outside of healthcare, and 3 per cent had left to work in healthcare in other jurisdictions.

The report noted that categorising departures as ‘external movement’, ‘internal movement’, or ‘not disclosed/other’ has enabled “greater insights into the reporting on turnover to better understand and inform decisions”.

However, the report said the fact that such a large percentage of departing staff did not disclose their final destination “limits our ability” to gain “further insights”.

Nevertheless, it noted that employment levels continue to show strong growth across the health service. This may reflect internal movement within the HSE, strong recruitment, or inaccurate reporting of departures where staff are undergoing contract changes.

The report noted that due to the absence of information on final destination for many staff departures, it is “important to interpret these responses with some caution”.

Asked about the high level of non-disclosure, a HSE spokesperson pointed out that providing information on an employee’s destination when leaving is a voluntary field in the reporting process.

“We remain engaged at all times with our services to improve reporting on leaving destination, while maintaining this field as voluntary to enable all other necessary processing of leaving employees,” the HSE spokesperson told MI.

“As a result, this information is not consistently available across all reporting organisations. We will continue to link with colleagues to improve the population of this data on leaving forms/templates.”