Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/337434 
Year of Publication: 
2026
Series/Report no.: 
IFS Report
Publisher: 
Institute for Fiscal Studies (IFS), London
Abstract: 
More than 1.5 million staff work for the NHS in England, across a wide range of occupations. Progression within these occupations - for example, from nurse to senior staff nurse - has long been a focus of workforce policy in the NHS. Transitions between broad occupation groups - such as healthcare assistants who train to become nurses - are less prominent, but have become increasingly common over time. For staff members, these transitions can provide important opportunities for career progression and development, whilst for NHS trusts they can be a valuable way to fill 'skills gaps' with staff they already know well. They might also be a way for the NHS to invest more in the skills and workforce of its local communities, an ambition emphasised in the recent '10 Year Health Plan for England'. However, there is little large-scale evidence to date on these types of transitions in the NHS, making it difficult to judge how far they can contribute to each of these goals. In this report, we use data from the Electronic Staff Record (ESR), the monthly payroll of the NHS, to set out which staff transition between which occupations, and how this has changed over time. We place a particular focus on transitions from clinical support occupations - such as healthcare assistants and nursing auxiliaries - to registered clinical occupations, such as nurses, midwives and physiotherapists. Recent governments have created new routes into nursing that have a particular policy focus on recruiting from clinical support roles into registered nursing roles, and these transitions are now a much bigger source of nurse recruitment. However, they remain much more common in some NHS trust types and some parts of the country. We analyse how the local labour market might affect the frequency of these transitions and discuss the implications for future workforce policy.
Subjects: 
Health and social care
Health
Healthcare
Human capital
NHS
Social mobility
Training
Persistent Identifier of the first edition: 
ISBN: 
978-1-80103-243-8
Document Type: 
Research Report

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