IFS - Which staff members leave the NHS acute sector? (23 August 2022)

Summary

This report by the Institute for Fiscal Studies (IFS) looks at which staff are more likely to leave the NHS acute sector. There is still little analysis available on the reasons why staff leave the NHS, but increasing our understanding of the complex factors that cause people to leave the health service would allow the NHS to develop more effective retention strategies.

The report uses the Electronic Staff Record, the monthly payroll of directly employed NHS staff, to analyse the leaving rates of consultants, nurses and midwives, and health-care assistants (HCAs) between 2012 and 2021.

The authors highlight that many other factors that influence retention remain unknown, and much more research is needed in this area.

Content

Key findings:

• Differences in leaving rates between men and women in the same staff group are larger than the differences between those in different job roles of the same gender.
• Male consultants and nurses and midwives had almost the same leaving rate up to the age of 55, before rising substantially for those over 55. Male HCAs, unlike their female counterparts, also had very high leaving rates in their 20s.
• There were large differences in leaving rates by nationality, holding all other factors, including age, gender and tenure, constant.
• For consultants, non-British consultants were substantially more likely to leave the acute sector than their British counterparts. 
• For nurses and midwives, the pattern is more complicated. EU staff were 43% more likely to leave than their British counterparts, while non-EU nurses and midwives were 28% less likely to leave.
• Previous sickness absences are strongly correlated with future exits from the NHS acute sector for both consultants and nurses and midwives.
• Regions with higher unemployment rates have lower leaving rates of nurses and midwives and HCAs.
• Better reported ‘staff engagement’ for nurses and midwives is associated with lower leaving rates.