To deliver the best care for patients, current workforce issues need to be addressed – the NHS needs more people, with the right skill sets, in good physical and mental health. Recent analysis by the Health Foundation suggests a 7 per cent workforce supply‐demand gap in England. Whilst training more staff is critical, if the NHS does not embed the right culture and improve staff retention, NHS workforce shortfalls will persist. Applied correctly, workforce research and data can help us to better understand some of the workforce challenges, and in turn support the development of evidence-based interventions to tackle them.
Throughout 2024, the Shelford Group and HSR UK will be co-hosting a series of webinars aimed at bringing together health and care service leaders with workforce researchers. The series has been developed to bridge the gap between healthcare workforce research and practice, and to promote an exchange of insights between the two communities. The series builds on the foundations of the first ever UK forum on healthcare workforce evidence, hosted by Health Service Research (HSR) UK in March 2023 and is framed around the three themes of the NHS Long Term Workforce Plan – Train, Retain and Reform.
In this blog, Shelford Group's Senior Policy Fellow Ellie Carter shares insights from the first webinar on the theme of retention.
Retention
Held on 6 February 2024, this webinar was an opportunity for healthcare service leaders to hear directly from workforce researchers about their latest insights into retention of staff in the NHS. Colleagues from across the Shelford Group and beyond were joined by Dr Billy Palmer - Senior Fellow in Health Policy at the Nuffield Trust, Professor Jane Ball - Professor of Nursing Workforce Policy at the University of Southampton, and Dr Ourega-Zoé Ejebu - Research Fellow at the University of Southampton.
Research
Dr Billy Palmer (co-author of ‘Waste not, want not: Strategies to improve the supply of clinical staff to the NHS’) presented data highlighting the significant challenge around retention of staff, particularly in the first few years of employment. The data shows that around one in five radiographers, nurses, occupational therapists and physiotherapists have left NHS hospital and community settings within two years, with similar trends being seen for doctors in training. Retention rates appear to improve after five years of service. There are particular challenges within the domestic clinical training pipeline with the number of nurses joining the NHS from universities falling by a third between 2019-20 and 2021-22.
Based on his research, Dr Palmer and his team have drawn up a 10-point plan to help address some of the challenges identified. This includes a call to analyse the competitiveness of NHS (and other public sector) starting and early career salaries, to look at inequalities in career advancement opportunities between professions, and to consider a student loans forgiveness scheme for nurses, midwives and allied health professionals and to consider the same, or an interest-free ‘repayment holiday’, for doctors.
Professor Jane Ball and Dr Ourega-Zoé Ejebu (co-authors of Retention of NHS nurses: A scoping review) focussed specifically on the nursing workforce, sharing their research into the different job factors that can impact an individual’s decision to leave or stay in the nursing profession. The data shows that these factors differ depending on the stage someone is at in their career - for student nurses, financial challenges or quality of mentorship available play a part, whereas for those in their mid-careers, opportunities for career progression, and access to adequate staffing and equipment may be more important. Following a survey of over 3,000 registered nurses in England across all career stages, Professor Ball and Dr Ejebu went on to share some preliminary findings, looking at the top five reasons given for leaving the NHS and the top five factors that would motivate a possible return. Other than salary, the factors influencing nurses’ choices to stay or return are within the control of employers, pointing to the potential scope for improving the attractiveness of nursing posts for current and prospective employees.
Connecting research and practice
Following the presentations, attendees had the opportunity to explore whether the research resonated with practitioner’s experience on the ground, and to share reflections that built on the collective knowledge of the two communities.
Specific areas of focus included:
- Opportunities to apply workforce retention research in practice: As well as broadening practitioners’ knowledge of some of the latest workforce research, colleagues were able to identify tangible ways in which this research can, and should, be incorporated into their future practice. This included recognition of the need to personalise our approaches in working to retain staff.
- Potential to co-create future research priorities: The session generated a series of priorities and questions for researchers to consider in their future work. There was a clear call for more research into the impact of specific interventions intended to improve retention – both within and outside England, such as ‘tie-ins’ in Wales and financial incentives for healthcare employees in New Zealand. If academics can use their research to identify the interventions that have the biggest impact, this will provide an invaluable evidence base for practitioners.
- The importance of ongoing dialogue between research and practitioner communities: The webinar reiterated the value of connecting research and practice communities – service leaders are eager to hear more about the research available and to broaden their understanding of that data to inform their everyday practice. Simultaneously, researchers want to utilise this relationship with frontline professionals to help prioritise their research and ensure it adds value to the profession.
This webinar is the first in a series of events intended to provide a platform for continued dialogue between academics and practitioners, bridging the gap between research, policy and practitioner communities. For more information please contact [email protected].