Framing effects in factors influencing health professional staff decisions to leave or stay working in the UK National Health Service

Purpose - In common with other health care providers internationally, health professional retention represents a key challenge for the UK National Health Service. This study set out to quantify secondary care health professionals ratings of the relative importance of widely cited influences on staff retention. The method of paired comparisons was used to determine whether ratings vary between the principal job families (doctors, allied health professionals, nurses/midwives, paramedics, and nursing support) and to test whether reasons for leaving fully explain what needs to change to retain staff.
Design/methodology/approach - Independent samples of National Health Service staff (N=1958; N=1994) completed one of two paired comparisons tasks, framed as reasons why staff in their job-family leave or what needs to change to encourage staff in their job-family to stay, referenced to eight variables: working hours, pay, workload, staffing levels, mental health/stress, work-homelife balance, time pressure and recognition of contribution.
Findings - Across all job-families and both frames, staffing levels and mental health/stress emerged as top priorities. However, priorities showed variability by profession and by framing.
Practical implications - A comprehensive perspective on retention requires consideration of both why staff leave and what needs to change to encourage them to stay. Evidence of job-family differences in priorities for attention suggests the need for a segmented approach to intervention.
Originality/value - This study is believed to be the first large sample comparison of secondary care job family perspectives on why staff leave the NHS and what needs to change to encourage them to stay.