The NHS is taking tough action against incompetence and has let go a record number of staff on 'capability' grounds.
There were around 7,000 dismissals in 2024-25, up from about 4,000 two years ago and a record since figures were first collected in 2011, according to media reports.
More than half of these were capability-related terminations, which, as per the NHS guidelines, happen when employees cannot meet the fundamental requirements of their position.
The other commonly stated grounds for dismissal include misconduct and redundancy.
The NHS England had, in September, introduced a football-style league table, a quarterly ranking system for its trusts.
The top performers have been accorded more freedom on how they spend their money and those lower down are encouraged to learn from the best trusts and receive support from national officials.
Health secretary Wes Streeting had then warned that NHS managers failing to meet standards in the league tables would face dismissal.
Gareth Lyon, the head of health and social care at think tank Policy Exchange, has welcomed the shift in approach.
He wants the NHS to "significantly up its game" and take a more rigorous approach towards performance management.
A Department of Health and Social Care spokesman has said that performance management was essential and early intervention and proper support for staff will "prevent performance issues arising in the first place."
