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Investigating the Quitting Decision of Nurses: Panel Data Evidence from the British National Health Service

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  • Paul Frijters
  • Michael Shields
  • Stephen Wheatley Price

Abstract

There is currently a worldwide shortage of registered nurses, driven by large shifts in both the demand for and supply of nurses. Consequently, various policies to increase the recruitment and retention of nurses are under discussion, in particular, the role that wage increases might have in promoting nurse labour supply. In this paper we provide the first detailed empirical investigation into the quitting behaviour of nurses in the British National Health Service (NHS), using a newly constructed longitudinal survey. We fit both single and competing-risks duration models that enable us to establish the characteristics of those nurses who leave the NHS, distinguish the importance of pay in this decision and document the destinations that nurses move to. Contrary to expectations, we find that the hourly wage received by nurses outside of the NHS is around 20% lower than in the NHS, and that hours of work are about the same. However, there is a clear movement away from shift work. Age, seniority, job and employer characteristics are all found to be important predictors of nurses leaving the NHS. However, whilst the effect of wages is found to be statistically significant, the predicted impact of an increase in nurses' pay on retention rates is small. Our main conclusion, therefore, is that the current nurse shortages in the NHS will not be eliminated through substantially increased pay. Rather employers need to identify and address other aspects of the job which are driving nurses' decisions to quit the NHS.

Suggested Citation

  • Paul Frijters & Michael Shields & Stephen Wheatley Price, 2004. "Investigating the Quitting Decision of Nurses: Panel Data Evidence from the British National Health Service," CEPR Discussion Papers 471, Centre for Economic Policy Research, Research School of Economics, Australian National University.
    • Handle: RePEc:auu:dpaper:471
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    Cited by:

    1. Denise Doiron & Hong Il Yoo, 2020. "Stated preferences over job characteristics: A panel study," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 53(1), pages 43-82, February.
    2. Kroczek, Martin & Koch, Andreas, 2024. "The reaction of wages to skill shortage in nursing," VfS Annual Conference 2024 (Berlin): Upcoming Labor Market Challenges 302406, Verein für Socialpolitik / German Economic Association.
    3. Carol Propper & John Van Reenen, 2010. "Can Pay Regulation Kill? Panel Data Evidence on the Effect of Labor Markets on Hospital Performance," Journal of Political Economy, University of Chicago Press, vol. 118(2), pages 222-273, April.
    4. Serra-Sastre, Victoria, 2024. "Workplace violence and intention to quit in the English NHS," LSE Research Online Documents on Economics 121623, London School of Economics and Political Science, LSE Library.
    5. Daniels, Frieda & Laporte, Audrey & Lemieux-Charles, Louise & Baumann, Andrea & Onate, Kanecy & Deber, Raisa, 2012. "Retaining nurses: The impact of Ontario's “70% Full-Time Commitment”," Health Policy, Elsevier, vol. 107(1), pages 54-65.
    6. Budría, Santiago, 2012. "The shadow value of employer-provided training," Journal of Economic Psychology, Elsevier, vol. 33(3), pages 494-514.
    7. Frijters, Paul & Shields, Michael A. & Wheatley Price, Stephen, 2004. "To Teach or Not to Teach? Panel Data Evidence on the Quitting Decision," IZA Discussion Papers 1164, Institute of Labor Economics (IZA).
    8. Yaa Akosa Antwi & John R. Bowblis, 2018. "The Impact of Nurse Turnover on Quality of Care and Mortality in Nursing Homes: Evidence from the Great Recession," American Journal of Health Economics, University of Chicago Press, vol. 4(2), pages 131-163, Spring.
    9. Simon Condliffe & Charles R. Link & Sezin Zengin Farias Martinez, 2020. "Factors Affecting The Labor Supply Decisions Of Registered Nurses," Contemporary Economic Policy, Western Economic Association International, vol. 38(1), pages 127-138, January.
    10. Divine Ikenwilo & Anthony Scott, 2007. "The effects of pay and job satisfaction on the labour supply of hospital consultants," Health Economics, John Wiley & Sons, Ltd., vol. 16(12), pages 1303-1318, December.
    11. Serra-Sastre, Victoria, 2024. "Workplace violence and intention to quit in the English NHS," Social Science & Medicine, Elsevier, vol. 340(C).
    12. Michelle Cunich & Stephen Whelan, 2010. "Nurse Education and the Retention of Registered Nurses in New South Wales," The Economic Record, The Economic Society of Australia, vol. 86(274), pages 396-413, September.
    13. Martin Kroczek & Philipp Kugler & Anne Zühlke, 2022. "Erwerbsverläufe und Einkommensentwicklung in der Pflege," IAW Discussion Papers 137, Institut für Angewandte Wirtschaftsforschung (IAW).
    14. Martin Kroczek, 2021. "Analyzing Nurses‘ Decisions to Leave Their Profession – a Duration Analysis," IAW Discussion Papers 136, Institut für Angewandte Wirtschaftsforschung (IAW).
    15. Kenneth Snellman, 2007. "The determinants of nurses’ transitions into and out of health care," Working Papers 228, Työn ja talouden tutkimus LABORE, The Labour Institute for Economic Research LABORE.
    16. Divine Ikenwilo & Anthony Scott, 2007. "The effects of pay and job satisfaction on the labour supply of hospital consultants," Health Economics, John Wiley & Sons, Ltd., vol. 16(12), pages 1303-1318.
    17. Denise Doiron & Glenn Jones, 2006. "Nurses' Retention and Hospital Characteristics in New South Wales," The Economic Record, The Economic Society of Australia, vol. 82(256), pages 11-29, March.
    18. Claude Montmarquette & Laure Thomas, 2005. "La pénurie de travailleurs qualifiés," CIRANO Project Reports 2005rp-03, CIRANO.

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    More about this item

    Keywords

    nurses; panel data; wages; hours; quitting; NHS;
    All these keywords.

    JEL classification:

    • J45 - Labor and Demographic Economics - - Particular Labor Markets - - - Public Sector Labor Markets
    • J63 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Turnover; Vacancies; Layoffs
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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