Retaining of nurses in the NHS is growing concern in the United Kingdom’s health sector following the increasing turnover rates attributable to a wide range of factors (Department of Health 2015). Some of the prominent pull or positive factors influencing nurse turnover include nurses’ desire to increase their skills and knowledge of other specialties, seeking opportunities for training and progressing in their career, potential for a grade 6 career pathway, better work and life balance, promotion, better financial reward for a similar post in the NHS that is graded differently elsewhere, and higher pay rates for similar post working as a temporary staffing agency nurse. On the other hand, negative reasons of nurse turnover include renumerations and cost of living, attitude of patients and their relatives, management practices, the effect of nurse vacancies, and working patterns, staffing, and patient acuity. Ongori (2007) simplified the negative reasons for turnover as job- related stress, lack of commitment in the organization, and job dissatisfaction. Besides, Ongori (2007) asserted that personal factors such as locus of control, sense of powerlessness, and personal control influence substantially influence turnover.
According to Buchan et al. (2017) the problems facing the NHS are not isolated but rather symptoms of a lack of clear and comprehensive workforce strategy. The Covid-19 pandemic exposed most of the underlying challenges facing the NHS, including underfunding, workforce pressure, and increased demand on staff to deal with increasing infection rates (Bakerjian et al. 2021; Buchan et al. 2017; Lasater et al. 2021; NHS Providers 2020). Before, the first wave of the COVID-19, hospital nurses were experiencing burnout and worked in understaffed conditions and therefore, posing risks to patients (Lasater et al. 2021). In April 2020, the Center for Medicare and Medicaid Services launched the Coronavirus Commission for Safety and Quality in NHs to address the pressure that the staff endured in providing healthcare services aimed at improving safety procedures, infection prevention and control, and quality of life of people in nursing homes (Bakerjian et al. 2021). The dedication of NHS staff has been outstanding throughout the pandemic but there has been increasing reports of burnout which has alarmed 99% of trust leaders who are extremely or moderately worried that the staff overstretched beyond reasonable limits (NHS Providers 2020).
There has been a decline in the number of nurses in the NHS, particularly mental health and community health nurses (Marangozov, Williams, & Buchan 2016). For instance, in 2016, the NHS in England registered a shortage of 29, 000 FTE (full-time equivalent) staff, where 1 out of 10 represented nursing vacancies (Buchan et al.2017). One of the predominant factors of declining number of nurses in the NHS is the increasing number of nurses leaving their jobs before retirement age. Buchan projected that approximately 84, 000 nurses were expected to leave their job by 2022. However, in July 2017, the NHS England rolled out the National Retention programme across 145 Trusts and general practices to retain approximately 290, 000 hospital staff (Ely 2019). The scheme included motivational features, for instance, a transfer window to give staff opportunities of moving to different areas in the NHS to improve and diversify their skills, mentoring programs for new recruits, and incentives like gym memberships. The scheme resulted in 800 fewer nurses leaving their jobs and reduced nurse turnover to 12%.
Besides, the NHS is increasing its intrinsic motivation strategy by reducing bureaucracy and simplifying of regulations so that staff can exercise autonomy in working flexibly and developing new skills in new areas (NHS Providers 2020), which could be significant in achieving job satisfaction (Hayes et al. 2006). Besides, some of the recommendation likely to decrease turnover intentions include supporting newly qualified nurses through supportive transition or development programs, enhancing team cohesion, and adopting team-based intentions (Halter et al. 2017)
Some of the recommendation on how to address the increasing nurse turnover in the NHS include the adoption of effective and coordinated workforce policy based on training and motivational factors to retain the current nurses (Buchan et al. 2019). Rightly so, the NHS has welcomed the help of fast-tracked students besides the returning of NHS staff who had previously left the health organization (NHS Providers 2020). Moreover, provision of flexible working hours, new pay systems, restricting the pay system and career structure besides access to education could help improve nurse rentention (Marangozov et al. 2016). Also, Bakerjian et al. (2021) recommended that the NHS should consider 24/7 registered nurses coverage and competitive compensation to increase motivation of nurses, ensure registered nurses have geriatric nursing and leadership skills, and increase effort towards recruiting and training more registered nurses. The NHS has been prompted to adopt international recruitment to address nurse shortage but this strategy is constrained by uncertainties of Brexit and broader immigration policies (Buchan et al. 2019). Besides, The NHS has adopted a new policy of nurse recruitment that includes nurse associates, Nurse First scheme, and nursing degree apprenticeship (Jones-Berry 2018). Further research on potential initiatives to minimize turnover show that nurse turnover can benefit organizations in cost-saving but also offer nurses opportunity of matching their skills with jobs where they can efficiently contribute to the labor market, hence increasing productivity (Hayes et al. 2006).
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