The NHS workforce crisis is usually framed as a numbers problem. The NHS has more than 100,000 vacancies, outnumbering the global workforces of BT, BP and AstraZeneca. The usual response is to fill more posts, increase training places and launch recruitment drives.

It's a practical response, but it overlooks generational differences. The NHS workforce is not a monolith. It is multi-generational and each generation brings different motivations, outlooks and expectations to work. Experienced staff are leaving early due to burn out, while younger generations have different career expectations.

One thing unites all these generations. All staff undertake more administrative tasks than necessary, allowing less time for staff to practise at the ‘top of licence' or with patients. This is where there are opportunities to improve the workplace. Modernising the NHS through technology and automation isn't just an efficiency measure; it is a workforce retention strategy for every generation and allows more time for patient contact.

The organisational knowledge the NHS cannot afford to lose

For most organisations, the majority of staff are mid-career, with lower proportions of new starters at one end and people approaching retirement at the other. That balance keeps experienced colleagues on hand to train those coming through.

In many parts of the NHS, this balance is compromised, particularly since the pandemic. When I led the Greater Manchester Pathology Network, an audit found around two-thirds of the workforce were under 45. It was observed the number of staff aged 55 and over had reduced due to early retirements, and more so, many staff who had retired and returned simply did not return to work after the pandemic.

Many of those leaving were Generation X staff, now in their 50s, and the pattern is common across many NHS staff groups. Therefore, the NHS is losing not just headcount, but the organisational leadership, knowledge and experience needed to develop the future workforce.

Staff still care about patients, but many are at risk of burn out. The 2025 NHS Staff Survey found nearly one in three describe themselves as burnt out, with burn out rising among those with six or more years of service. Reducing administrative burden through automation can lower the risk of burn out.

A new generation with different expectations

Looking at the younger workforce, the pressures appear similar, but the explanation is different. Thousands of nurses and midwives leave the register within their first decade, with burn out among the top reasons.

Gen Z have grown up watching their Generation X parents work long hours and burn out. Gen Z are stereotypically very financially savvy, and many already plan to retire early. They have also grown up with technology as commonplace. What older generations call ‘cutting-edge technology' is, to them, just technology. Careers not built around technology will struggle to attract them. This is not impatience; it is a reasonable judgement about how to spend a working life.

Different generations, shared problems

Generational labels cannot explain everything, but the pattern points to one shared problem. Experienced staff are exhausted by administrative burden and newer staff are less likely to tolerate it. With demand rising for decades as people live longer, and a shrinking share of the population at an employable age, the NHS cannot recruit its way out of that gap, even if it could afford to do so.

The good news is that much of this burden is exactly the work automation does best. It is structured, repetitive and rules-based. It includes moving information between systems, booking appointments, requesting tests and tracking results. This offers a solution for reducing administrative burdens and cognitive load across the workforce.

Automation as a retention strategy

Digital Workforce's intelligent automation and AI take on that work through digital workers that run 24/7 alongside existing systems such as electronic patient records. The results are already visible. At East Cheshire NHS Trust, automating cancer services administration cut processing time from three to five minutes to 27 seconds, freeing 1,300 human hours per year.

For more experienced staff, that means regaining time for the complex work they trained for. For younger colleagues, it means an organisation that values their time and works the way they expect. For patients, it means faster pathways and more time spent with health professionals.

The NHS has committed to becoming not only the country's biggest employer but its best. Recruitment alone will not deliver that. Modernising how work gets done will. Automation is how the NHS keeps its people, across every generation.