One-way pendulum? – Staff retention in the NHS: Determining the relative salience of recognised drivers of early exit

Andrew Weyman, Deborah Roy, Peter Nolan

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Purpose - This paper presents the results of employee rankings of reasons why staff leave their employment in the UK National Health Service (NHS). It is based upon data gathered as a component of the Medical Research Council funded project Extending working life in the NHS Challenges and Prospects (2014-2018).

Design/methodology/approach – The data was collected from an opportunity sample of 1594 health professionals, managers and administrators employed by the NHS. Participants completed a paired ranking task (Case V method of paired comparisons, Thurston 1927) to determine the relative importance of eight widely cited reasons for exit. The item set was derived from focus groups conducted as a component of the wider study.

Findings – The analysis revealed that job demands, resources and time pressure were ranked as the strongest drivers of early-exit, and that the three lowest ranked elements were pay, working hours and flexible work. A high degree of consensus was apparent across the principal professional groupings, job grades and age cohorts. Findings raise important questions over the impact of the current NHS employer emphasis on flexible work and widespread calls for increased pay as solutions to the staff retention crisis.

Originality/value – Each of the drivers of exit had previously been identified in both NHS and international health sector research on staff retention. However, this is believed to be the first study that has attempted to determine the relative strength of recognised drivers of exit, and the degree to which their influence may vary between different segments of the NHS workforce. Findings are of relevance to NHS employers and trades unions with respect to the focus for future intervention activity aimed at maintaining and improving staff retention rates.
Original languageEnglish
JournalInternational Journal of Workplace Health Management
Publication statusPublished (in print/issue) - 11 Dec 2019


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