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Abstract
Should I stay or should I go?NHS staff retention in a post-COVID-19 world….
Background
The COVID -19 pandemic has imposed unprecedented demands on NHS staff and resources. This study explores the impact of prevailing conditions on NHS staff experiences, future employment intentions and key factors in decisions to leave or remain in NHS employment.
Methods
Over 6,500 NHS employees participated in an online UK-wide survey in two waves (winter 2020/21 – N = 1962) and summer of 2021 (N = 2217) that aimed to capture staff experiences of working since the emergence of the COVID-19 pandemic in March 2020. The survey was complemented by interviews (June 2021 – February 2022) with a cross-sectional sample of NHS staff (N = 60+) working in acute, ambulance, mental health and community settings. Data analyses focused on comparing and contrasting the experiences of different staff demographics, with respect to their experiences, impacts, and orientation to leave / continue in NHS employment, including change between the two sampling periods. Quantitative analyses employed SPSS and qualitative data analysed thematically.
Results
Surveys:
The most widely cited very important reasons for leaving (push effects) NHS employment were: Work-related stress; Unsupportive managers; Staff shortages. Globally, the top three strongest ‘pull’ influences that keep staff working in the NHS were Job security, To make a difference and Job satisfaction from caring for patients.
‘High-risk’ of exit populations included: ambulance service; staff redeployed to COVID care; those aged Headline sources of concern for all NHS staff included: staff shortages; time to do my job properly; impact on my mental health and making mistakes due to workload, a high proportion of which were not reported to line managers. Staffing levels, morale, stress and workload were rated as much worse than pre March 2020.
Anxiety over mandatory vaccination (~ 10% of staff) was more apparent amount BAME staff and those aged 13% of respondents at Wave 2 reported having applied for a non-NHS job in the preceding 6 months; a rise from 10% at Wave 1. Approximately 33% reported aspire to exit NHS employment within 5years, the highest proportion being nurses & paramedics. 56% (61% W1) would recommend working for the NHS to others
Interviews:
The pandemic was identified as magnifying pre-existing issues, in particular, job-demands and staffing. A primary focus on personal COVID risk in the early phase of the pandemic, shifted to concerns about work demands and resources. Involuntary redeployment and working with COVID patients was experienced as traumatic by some. Accounts of relentless and stressful experiences with mental health impacts and limited resources were widespread. There was increased need for staff to apply non-technical skills, providing emotional support to patients and relatives, as well managing patient/public expectations, combined with ‘moral injury’ and frustration due to not being able to provide the standard of care they would like.
Fear of what the future might bring was widely encountered, with respect to the profile of the pandemic, the growing backlog and further depletion of staff resource. Staff spoke of re-adjusting their work-life balance by reducing hours, avoiding over-time and doing bank nursing. Suggested changes to support retention included greater flexibility of hours/shifts/days, more opportunity for development and progression, and greater attention to staff concerns. The issue of pay was perceived as one of lack of appreciation and recognition.
Implications
The COVID-19 pandemic continues to have a detrimental effect on workload, morale and both mental and physical health, with implications for staff retention and NHS care delivery. Insights provided by this study are relevant to NHS strategy and policy for addressing staff retention.
Background
The COVID -19 pandemic has imposed unprecedented demands on NHS staff and resources. This study explores the impact of prevailing conditions on NHS staff experiences, future employment intentions and key factors in decisions to leave or remain in NHS employment.
Methods
Over 6,500 NHS employees participated in an online UK-wide survey in two waves (winter 2020/21 – N = 1962) and summer of 2021 (N = 2217) that aimed to capture staff experiences of working since the emergence of the COVID-19 pandemic in March 2020. The survey was complemented by interviews (June 2021 – February 2022) with a cross-sectional sample of NHS staff (N = 60+) working in acute, ambulance, mental health and community settings. Data analyses focused on comparing and contrasting the experiences of different staff demographics, with respect to their experiences, impacts, and orientation to leave / continue in NHS employment, including change between the two sampling periods. Quantitative analyses employed SPSS and qualitative data analysed thematically.
Results
Surveys:
The most widely cited very important reasons for leaving (push effects) NHS employment were: Work-related stress; Unsupportive managers; Staff shortages. Globally, the top three strongest ‘pull’ influences that keep staff working in the NHS were Job security, To make a difference and Job satisfaction from caring for patients.
‘High-risk’ of exit populations included: ambulance service; staff redeployed to COVID care; those aged Headline sources of concern for all NHS staff included: staff shortages; time to do my job properly; impact on my mental health and making mistakes due to workload, a high proportion of which were not reported to line managers. Staffing levels, morale, stress and workload were rated as much worse than pre March 2020.
Anxiety over mandatory vaccination (~ 10% of staff) was more apparent amount BAME staff and those aged 13% of respondents at Wave 2 reported having applied for a non-NHS job in the preceding 6 months; a rise from 10% at Wave 1. Approximately 33% reported aspire to exit NHS employment within 5years, the highest proportion being nurses & paramedics. 56% (61% W1) would recommend working for the NHS to others
Interviews:
The pandemic was identified as magnifying pre-existing issues, in particular, job-demands and staffing. A primary focus on personal COVID risk in the early phase of the pandemic, shifted to concerns about work demands and resources. Involuntary redeployment and working with COVID patients was experienced as traumatic by some. Accounts of relentless and stressful experiences with mental health impacts and limited resources were widespread. There was increased need for staff to apply non-technical skills, providing emotional support to patients and relatives, as well managing patient/public expectations, combined with ‘moral injury’ and frustration due to not being able to provide the standard of care they would like.
Fear of what the future might bring was widely encountered, with respect to the profile of the pandemic, the growing backlog and further depletion of staff resource. Staff spoke of re-adjusting their work-life balance by reducing hours, avoiding over-time and doing bank nursing. Suggested changes to support retention included greater flexibility of hours/shifts/days, more opportunity for development and progression, and greater attention to staff concerns. The issue of pay was perceived as one of lack of appreciation and recognition.
Implications
The COVID-19 pandemic continues to have a detrimental effect on workload, morale and both mental and physical health, with implications for staff retention and NHS care delivery. Insights provided by this study are relevant to NHS strategy and policy for addressing staff retention.
Original language | English |
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Publication status | Published - Jul 2022 |
Event | HSR Conference 15th 2022 Shefffield - Sheffield, UK United Kingdom Duration: 5 Jul 2022 → 7 Jul 2022 Conference number: 15 https://www.eventsforce.net/eventage/frontend/reg/thome.csp?pageID=95260&eventID=186&traceRedir=2 |
Conference
Conference | HSR Conference 15th 2022 Shefffield |
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Abbreviated title | HSR 15 2022 |
Country/Territory | UK United Kingdom |
City | Sheffield |
Period | 5/07/22 → 7/07/22 |
Internet address |
Keywords
- NHS Staff Employe Retention COVID-19
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Should I stay or should I go? - NHS staff retention in a post COVID19 world, challenges and prospects
Weyman, A. (PI)
Economic and Social Research Council
30/11/20 → 1/03/22
Project: Research council