Wage increases alone will not be enough to address NHS staff retention, finds study


  • Dawn O'Shea
  • UK Professional News
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An increase in wages alone is unlikely to be sufficient to ameliorate the concerns of NHS workers, concludes a systematic review published in BMJ Open.

The study, carried out by researchers at Newcastle University, examined published studies to understand the nature of the relationship between the NHS labour force and satisfaction, retention and wages.

The literature was identified using seven databases in January 2020: MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, Embase, PsycINFO, ProQuest, Scopus and the Cochrane library.

A total of 31 full-text articles were included in the final analysis.

Several studies reported how job satisfaction among NHS healthcare staff was negatively impacted on by low staff morale, inept management, an inability to partake in professional development or to provide patients with the desired level of care.

Three broad themes were identified: low job satisfaction impacting negatively on job retention; poor pay impacting negatively on staff satisfaction; and the limitations of increasing pay as a means of improving staff retention. Several factors affected these relationships, including the environment, discrimination, flexibility, autonomy, training and staffing levels.

The review showed a clear relationship between job satisfaction and the quality of care that they felt they provided.

The authors developed recommendations to improve wellbeing and retention:

  • Increase flexibility,       
  • Access to continuing professional development,
  • Discrimination prevention,         
  • Changing the negative narrative concerning the NHS through communication and engagement,
  • Establishing/improving staff banks to reduce the need for trusts to obtain temporary agency staff,
  • Valuing staff and ensuring they do not feel taken for granted,
  • Autonomy to provide high-quality patient care without being restricted unnecessarily,
  • Targeted wage increases to preventing the NHS from being out-competed in specific circumstances.