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Staff shortage in the UK National Health Service has a long history, but is widely predicted to become acute over the next decade. Falling enrolment rates in health professional training and restrictions to migrant labour recruitment have brought the, traditionally neglected, issue of staff retention into sharp relief. The purpose of this paper is to represent the first large scale systematic appraisal of the relative salience of recognised headline drivers of employee exodus from the NHS.

The data were collected from an opportunity sample of 1,594 health professionals, managers and administrators employed by the NHS. Participants completed a paired ranking task (Case V method of paired comparisons, Thurston, 1927) to determine the relative importance of eight widely cited reasons for exit. The item set was derived from focus groups conducted as a component of the wider study.

Findings revealed almost universal consensus regarding the primacy of shortage of resources, job demands and time pressure. Pay was ranked lower than predicted. Flexible working arrangements do not presented as a key solution, and there is no support for claims of generational differences.

Survivor population effects could constitute a source of sample bias, i.e. all participants were current NHS employees. It is possible that those who remain may be more resilient or hold different dispositions to leavers. Thus, comparisons by age and grade may not be comparing like with like. Tapping respondent beliefs about the actions of peers can embody some degree of inaccuracy and attribution bias. However, effects can be considered to operate as a source of common, rather than systematic, error across the demographics compared. The medical and dental sample was too small to give confidence in detected differences.

Findings challenge the claim that wider availability of flexible working hours will significantly reduce exit rates. Pay, being a source of dissatisfaction, does not constitute a key push variable in itself, rather its salience reflects the effort reward-imbalance produced by rises in job demands.

Staff shortages in the NHS represent a threat to: public well-being – waiting lists and demand for care; the well-being of who continue to work in the NHS – job demands and resources; the employment prospects of staff who leave involuntarily, e.g. on grounds of incapacity and threats to health and well-being – extending to impacts on their dependents.

Issues of staff retention within the NHS are topical and under researched. The findings provide an up to date picture of the relative influence of headline drivers of early exit from the NHS. The study draws upon a more diverse and comprehensive sample of NHS employees that any other known previous studies of early exit. Findings are of potential international relevance to other State health systems. The authors believe this to be the largest (sample) known application of the method of paired comparisons.

We discuss workforce management, related to those aged 50+ , in the United Kingdom and the Republic of Korea. With international competitiveness becoming increasingly crucial, retaining the ‘right’ mix of employees to achieve strategic organisational goals is likely to determine organisational success. However, we argue that workforce management is not only influenced by organisational-level strategy but also by national institutional and sectoral policies. Decisions on whether and how to retain older workers are therefore (co-)determined by institutional incentives and barriers to doing so.

We find that British and Korean governments have legislated in favour of extended working lives and, hence, the retention of ageing workforces. In the United Kingdom, pension eligibility ages are being increased and in Korea mandatory retirement age has been raised to age 60. While changes to the UK pension systems leave individuals with the (financial) risks associated with extended working lives, the Korean government tries to protect individuals from financial hardship by enabling them to remain longer in their primary career. However, whether and how government regulation plays out depends on how organisations react to it. The Korean discussion, in fact, shows that there might be leeway: organisations might continue to externalise their employees early framed as honourable, or voluntary, early retirement, which might not be in the interest of the individual but very much in the interest of the organisation. It therefore appears as if the retention of ageing staff is not (yet) considered to be of strategic importance by many organisations in these countries.

In 1967 Aslib Research and Development Department published a note describing experimental work on computer‐aided typesetting, and announcing that further research was planned. The proposed programme of work was carried out by the authors of the present paper, during their sojourns as members of the Department. The results are here reported.

In 1966, the Government's Office for Scientific and Technical Information offered to increase its support for Aslib specifically to encourage it to build up a viable research department, to undertake systematic programmes of research into scientific and technical information systems, and to provide consultancy services in this field. In response to an appeal from Lord Kings Norton, then President of Aslib, some twenty member organizations agreed to share with OSTI the cost of this new development during its first three years. The three‐year development period ended in December 1969, and an account of the progress made during this period was published in Aslib Proceedings for May 1970.

The purpose of this paper is to discuss contemporary approaches to workplace health and well‐being, articulating key differences in the intervention architecture between public and workplace health contexts and implications for intervention design.

Contemporary practice is discussed in light of calls for a paradigm shift in occupational health from a treatment orientation to an holistic approach focused on mitigation of the causes of ill health and the promotion of well‐being. In practice, relatively few organizations have or seem able to engage with a broader perspective that encompasses challenges to health and well‐being associated with contextual organizational drivers, e.g. job design/role, workload, systems of reward, leadership style and the underpinning climate. Drawing upon insights from public health and the workplace safety tradition, the scope for broadening the perspective on intervention (in terms of vectors of harm addressed, theory of change and intervention logic) is discussed.

There are important differences in scope and options for intervention between public health and workplace health contexts. While there is scope to emulate public health practice, this should not constrain thinking over intervention opinions. Increased awareness of these key differences within work organizations, and an evidence‐based epidemiological approach to learning has the potential to strengthen and broaden the approach to workplace health and well‐being management.

The authors argue that approaches to workplace well‐being interventions that selectively cross‐fertilise and adapt elements of public health interventions offer promise for realising a broader change agenda and for building inherently healthy workplaces.

In beginning its work at the end of the 1950s, the Aslib Research and Development Department inevitably faced the task of identifying the most significant problems for investigation, at the same time having the need to establish appropriate experimental techniques. Most of the projects undertaken since that time have dealt with current problems, and to an extent the advent of new technologies and techniques to the information world (mechanization in the 'sixties, management studies in the early 'seventies, on‐line working and publication problems in more recent years) is reflected in the work reported below. What follows is a complete bibliography of publications by members of the Department from its formation up to the end of 1977.

There is a growing academic interest in the examination and exploration of work intensification in a wide range of healthcare settings. The purpose of this paper is to explore the differing staff perceptions in emergency ambulance services in the UK. It provides evidence on the challenges for the paramedic professionalisation agenda and managing operational demands and work intensity in emotionally challenging circumstances, with significant implications for patient safety.

Drawing on the evidence from an empirical study in a large National Health Service ambulance trust in England, this paper examines the challenges and differing staff perceptions of the changing scope and practice of ambulance personnel in the UK. Amidst the progress on the professionalisation of the paramedic agenda, individual trusts are facing challenges in form of staff attitudes towards meeting performance targets, coupled with rising demand, fear of loss of contracts and private competition.

Research findings highlight differing perceptions from various sub-cultural groups and lack of clarity over the core values which are reinforced by cultural and management differences. Need for greater management to explore the relationship between high sickness levels and implications for patient safety including the need for policy and research attention follows from this study. The implications of work intensity on gender equality within the ambulance settings are also discussed.

Ambulance services around the world are witnessing a strain on their operational budgets with increasing demand for their services. Study evidence support inconclusive evidence for patent safety despite the growing specialist paramedic roles. Organisational implications of high staff sickness rates have been largely overlooked in the management literature. This study makes an original contribution while building upon the earlier conceptions of work intensification.

The study findings have significant implications for the ambulance services for better understanding of the staff perceptions on work intensity and implications for patient safety, high sickness absence rates amidst increasing ambulance demand. Study findings will help prepare the organisational policies and design appropriate response.

Societal understanding about the organisational implications of the work intensity in an important emergency response service will encourage further debate and discussion.

This study makes an original contribution by providing insights into the intra-organisational dynamics in an unusual organisational setting of the emergency ambulance services. Study findings have implications for further research inquiry into staff illness, patient safety and gender issues in ambulance services. Evidence cited in the paper has further relevance to ambulance services globally.

Previous research has shown that paramedics form intuitive impressions based on limited “pre-arrival” dispatch information and this subsequently affects their diagnosis. However, this observation has never been experimentally studied.

This was an experimental study of 83 Australian undergraduate paramedics and 65 Australian paramedics with median 14 years' experience (Range: 1–32 years). Participants responded to written vignettes in two parts that aimed to induce an intuitive impression by placing participants under time pressure and with a secondary task, followed by a diagnosis made without distraction or time pressure. The vignettes varied the likelihood of Acute Coronary Syndrome (ACS) and measured self-reports of typicality and confidence. Answer fluency, which is the ease with which the answer comes to mind, was also measured.

More participants exposed to the likely pre-arrival vignette recorded a final diagnosis of ACS, than those exposed to unlikely pre-arrival information (0.85 [95%CI: 0.78, 0.90] vs 0.74 [95%CI: 0.66, 0.81]; p = 0.03). This effect was greater in paramedics with more than 14 years' experience (0.94 [95%CI: 0.78, 0.99] vs 0.67 [95%CI: 0.48, 0.81]; p = 0.01). Answer fluency and confidence were associated with the impression, while the impression and confidence were associated with final diagnosis.

The authors have experimentally shown that pre-arrival information can affect subsequent diagnosis. The most experienced paramedics were more likely to be affected.

This is the first experimental study of diagnostic decision-making in paramedics and paramedic students.

The primary aim of this systematic review is to identify, describe and synthesise the published literature on the types and effects of feedback received by emergency ambulance staff. The secondary aim will be to describe the mechanisms and moderators of the effects of prehospital feedback in an organisational context.

The application and effects of feedback for healthcare professionals, to support improved practice, is well researched within the wider healthcare domain. Within a prehospital context, research into feedback has been developing in specific areas such as automated feedback from defibrillators and debrief after simulation. However, to date there has been no systematic review published on the types and effects of feedback available to emergency ambulance staff.

This study will be a systematic mixed studies review including empirical primary research of qualitative, quantitative and mixed methods methodology published in peer-reviewed journals in English. Studies will be included if they explore the concept of feedback as defined in this review, i.e. the systematised provision of information to emergency ambulance staff regarding their performance within prehospital practice and/or patient outcomes. The search strategy will consist of three facets: ambulance staff synonyms, feedback synonyms and feedback content. The databases to be searched from inception are MEDLINE, Embase, AMED, PsycINFO, HMIC, CINAHL and Web of Science. Study quality will be appraised using the mixed methods appraisal tool (MMAT) developed by Hong et al. (2018). Data analysis will consist of narrative synthesis guided by Popay et al. (2006) following a parallel-results convergent synthesis design.

Registration: PROSPERO (CRD42020162600)