IDEAS home Printed from https://ideas.repec.org/p/auu/dpaper/471.html
   My bibliography  Save this paper

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

Author

Listed:
  • 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
    as

    Download full text from publisher

    File URL: https://www.cbe.anu.edu.au/researchpapers/CEPR/DP471.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Paul Frijters & Michael A. Shields & Stephen Wheatley Price, 2004. "To Teach or not to Teach? Panel Data Evidence on the Quitting Decision," Department of Economics - Working Papers Series 916, The University of Melbourne.
    2. Askildsen, Jan Erik & Baltagi, Badi H. & Holmås, Tor Helge, 2002. "Will Increased Wages Reduce Shortage of Nurses? A Panel Data Analysis of Nurses’ Labour Supply," Working Papers in Economics 21/02, University of Bergen, Department of Economics.
    3. Michael A. Shields & Stephen Wheatley Price, "undated". "Racial Harassment, Job Satisfaction and Intentions to Quit: Evidence from the British Nursing Profession," Discussion Papers in Public Sector Economics 01/2, Division of Economics, School of Business, University of Leicester.
    4. Shields, Michael A. & Ward, Melanie, 2001. "Improving nurse retention in the National Health Service in England: the impact of job satisfaction on intentions to quit," Journal of Health Economics, Elsevier, vol. 20(5), pages 677-701, September.
    5. Emanuela Antonazzo & Anthony Scott & Diane Skatun & Robert. F. Elliott, 2003. "The labour market for nursing: a review of the labour supply literature," Health Economics, John Wiley & Sons, Ltd., vol. 12(6), pages 465-478, June.
    6. Stephen Pudney & Michael Shields, 2000. "Gender, race, pay and promotion in the British nursing profession: estimation of a generalized ordered probit model," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 15(4), pages 367-399.
    7. Irene Hardill & Sandra Macdonald, 2000. "Skilled International Migration: The Experience of Nurses in the UK," Regional Studies, Taylor & Francis Journals, vol. 34(7), pages 681-692, October.
    8. Frank A. Sloan & Somchai Richupan, 1975. "Short-Run Supply Responses of Professional Nurses: A Microanalysis," Journal of Human Resources, University of Wisconsin Press, vol. 10(2), pages 241-257.
    9. Blundell, Richard & Macurdy, Thomas, 1999. "Labor supply: A review of alternative approaches," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 27, pages 1559-1695, Elsevier.
    10. Gray, Alastair M. & Phillips, V. L., 1996. "Labour turnover in the British National Health Service: a local labour market analysis," Health Policy, Elsevier, vol. 36(3), pages 273-289, June.
    11. Phillips, V. L., 1995. "Nurses' labor supply: Participation, hours of work, and discontinuities in the supply function," Journal of Health Economics, Elsevier, vol. 14(5), pages 567-582, December.
    12. Stephen Morris & Alistair McGuire, 2002. "The private net present value and private internal rate of return to becoming a nurse in Great Britain," Applied Economics, Taylor & Francis Journals, vol. 34(17), pages 2189-2200.
    13. Dennis A. Ahlburg & Christine Brown Mahoney, 1996. "The Effect of Wages on the Retention of Nurses," Canadian Journal of Economics, Canadian Economics Association, vol. 29(s1), pages 126-129, April.
    14. Van den Berg, Gerard J., 2001. "Duration models: specification, identification and multiple durations," Handbook of Econometrics, in: J.J. Heckman & E.E. Leamer (ed.), Handbook of Econometrics, edition 1, volume 5, chapter 55, pages 3381-3460, Elsevier.
    15. Jan Erik Askildsen & Badi H. Baltagi & Tor Helge Holmås, 2003. "Wage policy in the health care sector: a panel data analysis of nurses' labour supply," Health Economics, John Wiley & Sons, Ltd., vol. 12(9), pages 705-719, September.
    16. Baker, Michael & Melino, Angelo, 2000. "Duration dependence and nonparametric heterogeneity: A Monte Carlo study," Journal of Econometrics, Elsevier, vol. 96(2), pages 357-393, June.
    17. Tor Helge Holmås, 2002. "Keeping nurses at work: a duration analysis," Health Economics, John Wiley & Sons, Ltd., vol. 11(6), pages 493-503, September.
    18. Paul Frijters & Michael A. Shields & Stephen Wheatley Price, 2004. "To Teach or not to Teach? Panel Data Evidence on the Quitting Decision," Department of Economics - Working Papers Series 916, The University of Melbourne.
    19. Gray, Alastair M. & Phillips, V. L. & Normand, Charles, 1996. "The costs of nursing turnover: evidence from the British National Health Service," Health Policy, Elsevier, vol. 38(2), pages 117-128, November.
    20. Pudney, Stephen & Shields, Michael A, 2000. "Gender and Racial Discrimination in Pay and Promotion for NHS Nurses," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 62(0), pages 801-835, Special I.
    21. Shields, Michael A & Price, Stephen Wheatley, 2002. "Racial Harassment, Job Satisfaction and Intentions to Quit: Evidence from the British Nursing Profession," Economica, London School of Economics and Political Science, vol. 69(274), pages 295-226, May.
    22. M. F. Bognanno & J. S. Hixson & J. R. Jeffers, 1974. "The Short-Run Supply of Nurse's Time," Journal of Human Resources, University of Wisconsin Press, vol. 9(1), pages 80-94.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    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. 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.
    3. 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.
    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. 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.
    6. 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.
    7. Budría, Santiago, 2012. "The shadow value of employer-provided training," Journal of Economic Psychology, Elsevier, vol. 33(3), pages 494-514.
    8. 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).
    9. Martin Kroczek & Philipp Kugler & Anne Zühlke, 2022. "Erwerbsverläufe und Einkommensentwicklung in der Pflege," IAW Discussion Papers 137, Institut für Angewandte Wirtschaftsforschung (IAW).
    10. Martin Kroczek, 2021. "Analyzing Nurses‘ Decisions to Leave Their Profession – a Duration Analysis," IAW Discussion Papers 136, Institut für Angewandte Wirtschaftsforschung (IAW).
    11. 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.
    12. 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.
    13. 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.
    14. 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.
    15. Claude Montmarquette & Laure Thomas, 2005. "La pénurie de travailleurs qualifiés," CIRANO Project Reports 2005rp-03, CIRANO.
    16. 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.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Shields, Michael A. & Ward, Melanie, 2001. "Improving nurse retention in the National Health Service in England: the impact of job satisfaction on intentions to quit," Journal of Health Economics, Elsevier, vol. 20(5), pages 677-701, September.
    2. Hanel, Barbara & Kalb, Guyonne & Scott, Anthony, 2014. "Nurses’ labour supply elasticities: The importance of accounting for extensive margins," Journal of Health Economics, Elsevier, vol. 33(C), pages 94-112.
    3. T. Kankaanranta & P. Rissanen, 2008. "Nurses’ intentions to leave nursing in Finland," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 9(4), pages 333-342, November.
    4. Emanuela Antonazzo & Anthony Scott & Diane Skatun & Robert. F. Elliott, 2003. "The labour market for nursing: a review of the labour supply literature," Health Economics, John Wiley & Sons, Ltd., vol. 12(6), pages 465-478, June.
    5. Denise Doiron & Glenn Jones, 2004. "Nurses' retention and hospital characteristics in New South Wales, CHERE Discussion Paper No 52," Discussion Papers 52, CHERE, University of Technology, Sydney.
    6. Frijters, Paul & Shields, Michael A. & Theodoropoulos, Nikolaos & Wheatley Price, Stephen, 2003. "Testing for Employee Discrimination Using Matched Employer-Employee Data: Theory and Evidence," IZA Discussion Papers 807, Institute of Labor Economics (IZA).
    7. 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.
    8. 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.
    9. 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.
    10. Di Tommaso, M.L. & Strøm, S. & Sæther, E.M., 2009. "Nurses wanted: Is the job too harsh or is the wage too low?," Journal of Health Economics, Elsevier, vol. 28(3), pages 748-757, May.
    11. Paul Frijters & Michael A. Shields & Stephen Wheatley Price & Nikolaos Theodoropoulos, 2006. "Testing for Employee Discrimination in Britain using Matched Employer-Employee Data," University of Cyprus Working Papers in Economics 8-2006, University of Cyprus Department of Economics.
    12. 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).
    13. Qin, Xuezheng & Li, Lixing & Hsieh, Chee-Ruey, 2013. "Too few doctors or too low wages? Labor supply of health care professionals in China," China Economic Review, Elsevier, vol. 24(C), pages 150-164.
    14. Dolado, Juan J & Felgueroso, Florentino, 2008. "Occupational Mismatch and Moonlighting Among Spanish Physicians: Do Couples Matter?," CEPR Discussion Papers 6803, C.E.P.R. Discussion Papers.
    15. 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.
    16. Barbara Eberth & Robert F. Elliott & Diane Skåtun, 2016. "Pay or conditions? The role of workplace characteristics in nurses’ labor supply," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(6), pages 771-785, July.
    17. Paul Frijters, 2003. "Testing for Employee Discrimination using Matched Employer-Employee Data: Theory and Evidence," Paul Frijters Discussion Papers 2003-1, School of Economics and Finance, Queensland University of Technology.
    18. Damien Échevin & Bernard Fortin, 2011. "Physician Payment Mechanisms, Hospital Length of Stay and Risk of Readmission: a Natural Experiment," CIRANO Working Papers 2011s-44, CIRANO.
    19. Antecol, Heather & Cobb-Clark, Deborah, 2006. "The sexual harassment of female active-duty personnel: Effects on job satisfaction and intentions to remain in the military," Journal of Economic Behavior & Organization, Elsevier, vol. 61(1), pages 55-80, September.
    20. Sæther, Erik Magnus, 2009. "Nurses’ labor supply with endogenous choice of care level and shift type A nested discrete choice model with nonlinear income," HERO Online Working Paper Series 2004:9, University of Oslo, Health Economics Research Programme.

    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

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:auu:dpaper:471. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/cpanuau.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.