Relationship between labour force satisfaction, wages and retention within the UK National Health Service: a systematic review of the literature

Summary

The systematic review by Bimpong, Khan, Slight, Tolley, and Slight (2020) investigated the intricate relationship between labour force satisfaction, wages, and retention within the UK National Health Service (NHS). The study, a narrative systematic review, involved searching seven databases in January 2020 to synthesize existing literature on this critical issue. The authors defined 'retention' as the ability to retain staff in NHS employment and 'wages' as the regular payment of staff. The methodology focused on understanding the nature of these relationships across various studies. The findings underscore that NHS labour force retention is a multifaceted issue, influenced by numerous interacting elements. A significant conclusion drawn is the strong link between staff satisfaction and retention; poor job satisfaction directly correlates with an increased probability of employees leaving the NHS. While an increase in wages was found to positively influence satisfaction, and consequently retention, the review highlights that relying solely on pay increases is unlikely to resolve the concerns of NHS workers. The cost-benefit effectiveness of such an approach is also considered questionable. Crucially, non-monetary factors were identified as powerful drivers of staff's intentions to leave, including issues such as lack of recognition, experiences of discrimination, and high workload pressures. The review also points out the need for further research to fully understand the impact of autonomy on staff retention. The implications of these findings suggest that comprehensive strategies are required to improve NHS retention. A key recommendation is the necessity for a cultural shift within the NHS to enhance equality and prioritize staff well-being. The authors advocate for a data-driven, system leadership approach to develop and implement bespoke job satisfaction improvement strategies. Practical solutions proposed include creating tailored Continuing Professional Development (CPD) regimes, offering greater flexibility in working arrangements, and empowering employees with the resources to provide high-quality care, all of which could contribute to improved retention.