Should I stay or should I go?NHS staff retention in a post-COVID-19 world….

Rachel O'Hara, Andrew Weyman, Richard Glendinning, Deborah Roy, Joanne Coster, Peter Nolan

Research output: Contribution to conferencePaperpeer-review


Should I stay or should I go?NHS staff retention in a post-COVID-19 world….

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.
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.
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
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.
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 languageEnglish
Publication statusPublished - Jul 2022
EventHSR Conference 15th 2022 Shefffield - Sheffield, UK United Kingdom
Duration: 5 Jul 20227 Jul 2022
Conference number: 15


ConferenceHSR Conference 15th 2022 Shefffield
Abbreviated titleHSR 15 2022
Country/TerritoryUK United Kingdom
Internet address


  • NHS Staff Employe Retention COVID-19


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