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This article reports empirical evidence on the costs of nursing and other staff turnover in the National Health Service. It begins by considering the possible costs and benefits associated with turnover. It then examines current turnover rates in the NHS and existing estimates of the direct administrative costs and the short-term productivity losses associated with turnover. Using these estimates, it compares the cost-effectiveness of a policy which uses across-the-board pay increases to reduce turnover with one which targets pay rises to certain groups only. Next, possible indirect costs of turnover are evaluated using data collected from a large cross-section of providers and other sources. No relationship is found between turnover rates and crude measures of patient service or staff morale measures. The paper concludes with a brief discussion of the main findings and some suggestions for future research.


Journal article


Health Policy

Publication Date





117 - 128


Cost-Benefit Analysis, Data Collection, Employee Incentive Plans, Health Services Research, Nursing Staff, Personnel Turnover, Salaries and Fringe Benefits, State Medicine, United Kingdom, Women, Working