Push and pull: why allied health professionals stay in, leave or return to the NHS

336 Pages·2017·0.93 MB·English

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Push and pull: why allied
health professionals stay in,
leave or return to the NHS -
views of professionals inside
and outside the NHS
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Business School

Push and Pull
Why Allied Health Professionals Stay In, Leave or Return to the NHS
Views of Professionals Inside and Outside the NHS

Final Report
A Report Prepared for the Department of Health

John Arnold
John Loan-Clarke
Crispin Coombs
Sara Bosley
Caroline Martin

Disclaimer
The views expressed in this report are not necessarily those of the Department of
Health or any other government department.

Acknowledgements
The authors would like to thank all those who have provided information for this
report. We thank the four professional bodies for assisting us in contacting their
members, and the Department of Health for financial and other support. Thanks also
to our colleague Tracey Preston for her help with compiling this report.

Enquiries
Enquiries concerning this report should be addressed to:
John Arnold
Professor of Organisational Behaviour
Business School
Loughborough University
Loughborough
LE11 3TU
UK.

Email: [email protected]
Tel: [phone]

March 2006

Why AHPs Stay In, Leave or Return to the NHS Table of Contents

Table of Contents
Executive Summary.................................................................................................xv
1 Introduction........................................................................................................1
1.1 Background to the Research..........................................................................1
1.1.1 AHP Vacancy Rates, Retention and Return.........................................2
1.1.2 Existing Research on AHPs’ Reasons for Leaving and Returning.......3
1.2 Research Aim and Objectives.........................................................................4
1.3 Significance of this Study...............................................................................6
1.4 Context of the Study........................................................................................8
1.5 Organisation of the Report..............................................................................8
2 Literature Review.............................................................................................11
2.1 Introduction....................................................................................................11
2.2 Retention Issues in the Public Sector and the NHS....................................11
2.3 Allied Health Profession Literature..............................................................13
2.3.1 Retention issues in the Allied Health Professions..............................13
2.3.2 Views of AHPs on Working for the NHS.............................................14
2.3.3 Diversity and Retention......................................................................15
2.3.4 Career Development and Retention...................................................16
2.3.5 Summary of the AHP Literature..........................................................16
2.4 Occupational Therapy Literature..................................................................17
2.4.1 Background........................................................................................17
2.4.2 Size and Profile of the Profession......................................................19
2.4.2.1 Diversity..........................................................................................19
2.4.3 Retention of Occupational Therapists in Post....................................22
2.4.4 Retention of Occupational Therapists in the Profession.....................24
2.4.5 Returning to Occupational Therapy in the NHS.................................26
2.4.6 Summary of the Occupational Therapy Literature..............................27
2.5 Physiotherapy Literature...............................................................................28
2.5.1 Introduction.........................................................................................28
2.5.2 Background........................................................................................28
2.5.3 Size and Profile of the Profession......................................................29
2.5.3.1 Diversity..........................................................................................29
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Why AHPs Stay In, Leave or Return to the NHS Table of Contents

2.5.4 Recruitment and Retention of Physiotherapists.................................30
2.5.5 Returning to Physiotherapy in the NHS..............................................31
2.5.6 Summary of the Physiotherapy Literature..........................................32
2.6 Radiography Literature..................................................................................32
2.6.1 Introduction.........................................................................................32
2.6.2 Background........................................................................................32
2.6.3 Size and Profile of the Profession......................................................34
2.6.3.1 Diversity..........................................................................................34
2.6.4 Recruitment and Retention of Radiographers....................................35
2.6.4.1 Reasons for Leaving Radiography and the NHS............................36
2.6.5 Returning to Radiography in the NHS................................................37
2.6.6 Summary of the Radiography Literature.............................................38
2.7 Speech and Language Therapy Literature...................................................38
2.7.1 Introduction.........................................................................................38
2.7.2 Background........................................................................................39
2.7.3 Size and Profile of the Profession......................................................39
2.7.3.1 Diversity..........................................................................................39
2.7.4 Recruitment and Retention of Speech and Language Therapists......41
2.7.5 Leaving the Speech and Language Therapy Profession....................42
2.7.6 Returning to Speech and Language Therapy.....................................43
2.7.7 Summary of the Speech and Language Literature.............................43
2.8 General Turnover Literature..........................................................................44
2.8.1 Limitations and Implications of the Wider Turnover Literature...........47
2.9 Theoretical Underpinning of the Study........................................................48
2.10 Summary.......................................................................................................49
3 Conducting the Research and Description of Respondents.......................52
3.1 Introduction....................................................................................................52
3.2 Research Aims...............................................................................................52
3.3 Choice of Research Strategy........................................................................53
3.3.1 Ethical Clearance...............................................................................53
3.4 Stage One - The Questionnaire Survey........................................................54
3.4.1 Development of Questionnaire...........................................................54
3.4.2 Incentive for Questionnaire Completion and Return...........................55
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Why AHPs Stay In, Leave or Return to the NHS Table of Contents

3.4.3 Structure and Content of the Questionnaire.......................................55
Question 1 – Occupation................................................................................56
Question 2 – Professional Experience...........................................................56
Question 3 – Working Life..............................................................................56
Question 4 – Working for NHS.......................................................................56
Question 5 – Respondents’ Opinions about the NHS....................................56
Question 6 – Views of Working for the NHS..................................................57
Question 7 – Attitudes to Working for the NHS as an Allied Health
Professional....................................................................................................58
Question 8 – Career Pattern..........................................................................58
Questions 9, 10 and 11..................................................................................58
Question 9 – for Stayers and Joiners.............................................................58
Question 10 – for Returners...........................................................................59
Question 11 – for Leavers, Nevers and Others.............................................59
Question 12 – Salary, Grade and Post...........................................................59
Question 13 – Further Background Information.............................................59
Question 14 – Further Comments..................................................................60
3.4.4 The Sampling Strategy and the Sample.............................................60
3.4.4.1 Occupational Therapists.................................................................61
3.4.4.2 Radiographers................................................................................62
3.4.4.3 Speech and Language Therapists..................................................62
3.4.4.4 Physiotherapists.............................................................................63
3.4.5 Distribution of the Questionnaire........................................................63
3.4.6 Data Analysis......................................................................................64
3.4.6.1 Quantitative and Structured Data...................................................64
3.4.6.2 Qualitative Data..............................................................................65
3.4.7 Description of the Questionnaire Respondents..................................67
3.4.8 Building Variables for Statistical Analysis...........................................72
3.4.8.1 Intention to Work for the NHS as an AHP.......................................73
3.4.8.2 Attitude Towards Working for the NHS as an AHP.........................73
3.4.8.3 Perceived NHS Work Characteristics.............................................73
3.4.8.4 Opinions About the NHS.................................................................75
3.5 Stage Two – The Interviews..........................................................................75
3.5.1 Conducting the Interviews..................................................................76
3.5.2 Analysing the Interview Data..............................................................77
3.6 Limitations and Problems Encountered......................................................77
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Why AHPs Stay In, Leave or Return to the NHS Table of Contents

4 Quantitative Findings from the Questionnaire..............................................82
4.1 Introduction....................................................................................................82
4.2 The Key Variables Broken Down by Group and Profession......................83
4.2.1 Mean Scores by Profession and Group for: Intention to Work as an
AHP for the NHS................................................................................................83
4.2.2 Mean Scores by Profession and Group for: Attitude towards Working
as an AHP for the NHS......................................................................................85
4.2.3 Mean Scores by Profession and Group for: Perceptions of
Professional Development in NHS Work............................................................86
4.2.4 Mean Scores by Profession and Group for: Perceptions of Negative
Pressure in NHS Work.......................................................................................88
4.2.5 Mean Scores by Profession and Group for: Perceptions of Patient
Care in NHS Work..............................................................................................89
4.2.6 Mean Scores by Profession and Group for: Perceptions of NHS Work
as Supporting Lifestyle.......................................................................................91
4.2.7 Mean Scores by Profession and Group for: Perceptions of
Convenience of NHS Work................................................................................92
4.2.8 Mean Scores by Profession and Group for: Perceptions of Social
Contact in NHS Work.........................................................................................94
4.2.9 Mean Scores by Profession and Group for: Perceptions of NHS Work
as being Low Paid..............................................................................................95
4.2.10 Mean Scores by Profession and Group for: Perceptions of NHS Work
as a Secure Job.................................................................................................96
4.2.11 Mean Scores by Profession and Group for: NHS Work as Offering the
Opportunity to be in a Good Pension Scheme...................................................97
4.2.12 Mean Scores by Profession and Group for: Perceptions of “Subjective
Norm” ............................................................................................................98
4.2.13 Mean Scores by Profession and Group for: Sense of Moral Obligation
to Work for the NHS.........................................................................................100
4.2.14 Mean Scores by Profession and Group for: Belief in the Principles of
the NHS ..........................................................................................................101
4.2.15 Mean Scores by Profession and Group for: Confidence That One
Could Get an NHS Job.....................................................................................102
4.2.16 Mean Scores by Profession and Group for: ‘I have plenty of options
other than being employed by the NHS in my Allied Health Profession’..........103

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