Leaving the NHS: the practical checklist

The part no leaving speech covers: notice, pension, registration, references, and the admin that quietly follows you if you skip it.

You have decided, or you are almost there. Work this list in order. None of it is hard. Most of it is just easy to forget until it costs you time or money.

One thing before the list. This is general information, not financial, legal, or pension advice. Check your own contract, and check the relevant official body, before you act on anything here.

I hire for a living, most recently across UK health and life sciences at Meeveem, and I watch people leave the NHS well and leave it badly. The difference is rarely the decision. It is the handover. If you have not fully decided, or you are unsure where you are heading, two guides cover that ground: the main guide to leaving and the roles clinicians actually move into. This page assumes you are past that.

Start with your notice period

Read your contract first. Notice is agreed locally rather than set nationally, so it varies by employer. The common trust pattern is one month for Bands 1 to 4 and three months for Bands 5 to 9. Medical and dental contracts usually ask for three. If you are Band 5 or above, plan for three months unless your contract says otherwise. That assumption catches people out, because a new employer will often want you sooner than you can lawfully leave. Your contract is the only version that binds you, so find it before you name a start date.

Count backwards from your ideal start date, then add a buffer. New employers move slower than they promise. You want to leave on good terms, at a pace you chose.

The NHS pension: do nothing hasty

This is the one people get wrong. The NHS Pension Scheme is a defined-benefit scheme, which makes it genuinely valuable, and worth far more than the monthly figure on your payslip suggests.

When you leave you have three options. You can defer, leaving the benefits in the scheme to pay out later. You can transfer, moving that value out to another arrangement. With under two years of qualifying membership you can also claim a refund of your contributions. For most people, leaving a defined-benefit pension where it sits is the cautious default. Moving out of a scheme like this is a serious decision, and sometimes an expensive mistake. Do not take it on a hunch.

One rule deserves its own paragraph, because it is the costliest thing a leaver can get wrong. A break of more than five years counts as a disqualifying break. If you hold older 1995 or 2008 benefits, that break can sever the final salary link, so those benefits are then calculated on your pay when you left rather than your pay at retirement. Returning inside five years usually protects it. Check your own position with NHS Pensions before assuming a long break is harmless.

Get regulated advice before you move anything. Talk to NHS Pensions about your own record, and talk to a regulated financial adviser about your options. I am not qualified to tell you what to do here, and neither is anyone on Reddit. The pay-versus-pension trade-off is part of the wider salary picture, which is worth reading before you weigh anything up.

Keep your registration live

Your registration is your way back. Keep it open.

Whether you sit on the NMC, GMC, GPhC, or HCPC register, staying registered costs an annual fee and keeping up what your regulator asks, whether that is revalidation or periodic renewal and CPD. That is a small price for an open door. Let it lapse, and returning later means slow re-entry processes that are sometimes painful. While it is live, you can pick up a bank shift, keep your clinical identity, and walk back in if industry turns out not to suit you. Check your regulator by name for current fees and renewal or revalidation timing, then diary the dates.

Bank or locum shifts as a bridge

You do not have to stop clinical work the day you start something new. A bank or locum arrangement keeps a foot in both camps.

It does three useful things: it tops up income while you find your feet, it keeps your skills current and your registration meaningful, and it makes the whole move reversible. That last one matters most. Reversibility lowers the stakes on a decision that feels enormous at midnight.

Keep it light, but check the numbers before you decide how light. Nurses and midwives need 450 practice hours over three years to revalidate, which one twelve-hour shift a month does not quite reach. Two a month clears it comfortably. Worth knowing too: the NMC counts non-clinical work that uses your registered-nurse skills, so a clinical safety or implementation role may count towards those hours by itself. Other regulators set their own requirements, so check yours rather than copying a colleague. A bridge needs a far bank, so keep half an eye on live roles as you shift across. Plenty of people run this arrangement for a year. For how the early stretch tends to go, read the first ninety days out.

Line up your references early

Ask while you are still there. A manager who sees you every week writes a warmer reference than one reconstructing you from memory six months on.

Your line manager is the obvious first ask, so have that conversation early, while they still see your work up close. Do it before you resign. Line up two or three people who have watched your actual work. Tell each of them what the new role needs, so they can speak to it. A reference that describes judgement and ownership carries more weight than one that lists your rota. That is the same translation your CV needs, covered in turning a clinical CV into an industry CV.

Clear the exit admin

The unglamorous list. Miss these and they follow you.

• Annual leave: check what you have accrued and book it, or confirm what they owe you in lieu.
• Final pay: confirm your last pay date and check the figure, including any outstanding leave.
• Equipment and access: hand back badges, keys, devices, and locker contents. Return anything with a trust asset tag.
• Systems: your smartcard and logins close when you go. Download nothing patient-related, ever. Save only your own records, like appraisals and payslips.
• Honorary contracts: if you hold one, tell that organisation too. It does not lapse just because your main post ends.

The part that is not on any form

Telling your team is harder than any of the above. Expect guilt. It does not mean you are wrong.

You are not abandoning anyone. The rota was short before you gave notice, and it stays short after. That is the system's problem to solve, and it predates you by years. Tell your closest colleagues in person, before the news travels. Thank the people who taught you. Then let yourself feel the odd grief of leaving something that mattered, even when leaving is the right call. If you are still unsure it is right, is leaving the NHS worth it is the honest version of that question.

FAQ

Can I keep my NMC or GMC registration after I leave?

Yes. Registration is not tied to an NHS post. Keep paying the annual fee and meeting your own regulator's requirements and you stay on the register as normal. Those requirements differ. The NMC and GMC both run revalidation. The GPhC runs its own annual revalidation, built on CPD records, a peer discussion and a reflective account. The HCPC uses two-yearly renewal with CPD audit, and has a firmer rule about coming back: if you have been out of practice for two years or more you must complete a period of updating, thirty days or sixty depending on how long you were away. Doctors have an extra choice worth knowing about. You can give up your licence to practise while keeping registration, which removes the need to revalidate, though you then cannot do bank or locum work, and keeping the licence requires a designated body and responsible officer that an industry employer may not provide.

What happens to my NHS pension when I leave?

The benefits you have built do not vanish. You can defer them in the scheme, look at a transfer, or with under two years of qualifying membership claim a refund of contributions. Watch the five-year rule: a longer break can sever the final salary link on 1995 or 2008 benefits, which is expensive. A defined-benefit pension is valuable, so get regulated advice from a financial adviser and confirm your own record with NHS Pensions before you decide anything.

Can I do bank shifts while working in industry?

Usually, yes, as long as your registration is live and you respect working-time limits and any conflict rules in your new contract. Two shifts a month is the useful figure for nurses, since revalidation needs 450 practice hours over three years and one shift a month falls just short. Read your industry contract for restrictions first.

How much notice do I have to give?

Whatever your contract says. Notice differs by band and grade, so read the document rather than trusting a colleague's memory. Count back from your start date, and give yourself a buffer for the new employer to move.

One last thing

Leaving well is a gift to the you of two years from now, the one who might want a reference, a shift, or a route back. Do the boring parts properly, and every door stays open.