Victoria Serra-Sastre is a Senior Lecturer in Economics in the City, University of London. PhD in Health Economics by the London School of Economics and Political Science, her main research interests are health economics and applied microeconometrics. Her research focuses on technology diffusion of health care technologies, in particular looking at the impact of technology on health outcomes, hospital performance and changes in workforce composition. She also works on issues related to staff retention in the NHS and efficiency, adaptation to health states and reporting of subjective health measures. 

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Abstract

NHS job vacancies remain at record levels and an increasing number of staff are leaving the NHS. Several factors have been identified as key determinants for improved retention rates of nurses and doctors, mostly related to job characteristics (such as flexibility, promotion, shift patterns and overtime) and a very limited role of wages influencing decisions to quit. Work-related violence is an aspect that has received little attention as a possible driving force in dropout rates among NHS workforce. Recent figures indicate that approximately 15% of NHS staff had experienced physical violence while at work (NHS Staff Survey, 2021). Given the prevalence of abuse and the consequences it may have on staff wellbeing, we examine the impact of workplace violence on intention to quit the organisation. We employ data from the NHS Staff Survey, a rich dataset that records the experience and views of staff working in the NHS. The survey collects information on staff working conditions, satisfaction, and respondent’s characteristics. We use data from 2018 to 2021 of NHS employees surveyed in all acute trusts. Our main dependent variables, all related to the respondent’s intention to quit, are indicator variables that reflect the intention to leave the organisation, intention to look for another job and job replacement. The explanatory variables of interest reflect a range of indicators that capture whether the respondent has experienced physical or verbal violence at work. We also examine whether the onset of the pandemic has aggravated this effect. The results suggest that experiencing violence from patients, managers or colleagues increases the likelihood of quitting their job. The pandemic only had a marginal contribution to these effects. Staff health, trust in management and quality of patient care are some of the possible mechanisms through which violence influences the intention to quit.