Improving nurse retention in the National Health Service in England: the impact of job satisfaction on intentions to quit

Michael A. Shields, Melanie Ward

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299 Citations (Scopus)


In recent years the British National Health Service (NHS) has experienced an acute shortage of qualified nurses. This has placed issues of recruitment and retention in the profession high on the political agenda. In this paper, we investigate the determinants of job satisfaction for nurses and establish the importance of job satisfaction in determining nurses' intentions to quit the NHS. We find that nurses who report overall dissatisfaction with their jobs have a 65% higher probability of intending to quit than those reporting to be satisfied. However, dissatisfaction with promotion and training opportunities are found to have a stronger impact than workload or pay. Recent policies, which focus heavily on improving the pay of all NHS nurses, will have only limited success unless they are accompanied by improved promotion and training opportunities. Better retention will, in turn, lead to reduced workload.

Original languageEnglish
Pages (from-to)677-701
Number of pages25
JournalJournal of Health Economics
Issue number5
Publication statusPublished - 2001
Externally publishedYes


  • Job satisfaction
  • Nurses
  • Principal component analysis
  • Quitting intentions

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