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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.

The past two years have seen considerable changes in the organisation of the Industrial Relations Research Unit (IRRU) at the University of Warwick as well as its personnel. It is now a Designated Research Centre (DRC) for which the university is responsible, as opposed to the Economic and Social Research Council (ESRC). The unit now comprises members of the DRC and of the industrial relations teaching staff of the school. An overview of the main research projects being undertaken during the first phase of the eight‐year term of the DRC is given. These can be divided into three broad areas: those concerned with managing industrial relations; trade unions and collective bargaining; and the law and industrial relations. Some of the thinking behind these projects is given. It is argued that continuity is as important as change in the work of the unit, in particular in the value placed on theoretical developments and interdisciplinary research. There is no reason why new areas of investigation cannot be accommodated within additional definitions of industrial relations

This study sought to address one of the most critical issues that mental health professionals endure in modern health care, namely stress at work. Though it has been discussed for some time in the literature relating to mental health services, it still remains one of the biggest impediments to the provision of high quality care. In this study, two groups of mental health nurses were compared: forensic and acute mental health nurses. Stress levels were ascertained using a standardised assessment tool, the Mental Health Professional Stress Scale (MHPSS). Though both groups reported high levels of stress, no significant differences were found between them. Though both groups perceived certain aspects of their work as being stressful, each group identified different causes for stress within their respective work environments. This paper discusses some of the implications of these findings and highlights the importance of protecting staff from unpropitious work environments and burn‐out.

Trade unions have featured prominently in explanations of Britain′s relative industrial decline. Indeed, for at least a century, unions and their members have been accused of damaging productivity, increasing labour costs and destroying jobs. These claims are evaluated to see whether they are the product of systematic research evidence or mere prejudice. Focusing on the unions‐productivity link, looks at the most recent research evidence for Britain, situates it in a theoretical context, including recent American controversies, and then discusses the consequences of diminishing union membership and influence for the structure, performance and future prospects of the British economy.

This paper reports on a study undertaken in one mental health NHS foundation trust in the UK, which sought to examine to what extent advanced practice nursing could contribute to advancing new ways of working in the future. The literature on advanced nursing in the UK is critically discussed and where availability permits, reference is made to international literature. The findings of a survey of nurses with a Masters degree or acting at advanced level are reported and discussed. Though the data reported here are largely confirmed by similar studies, nevertheless the insights provided should alert organisations to the complexity of introducing new roles during a time of radical change in the health care system. Despite the efforts of a highly motivated trust, respondents identified barriers and obstacles that were of such significance that some were forced to rethink their readiness to embrace the role. It is hoped that the recommendations derived from this study may assist other organisations at a similar stage of implementing advanced nursing practice roles.

A survey of the views of members of a forensic mental health team on the post of forensic nurse consultant was carried out by means of a questionnaire. All respondents were supportive of the development of the post and hoped that the consultant would be the ‘voice’ of nursing, a strong individual with the confidence and competence to challenge traditional interprofessional boundaries and to raise the profile of mental health nurses within the clinical team. Concerns, however, were expressed that the post might have too many facets and that the consultant could become a victim of elevated expectations, unable to meet all the demands. Respondents advised that in order to avoid consultant burnout, the role needs to be clearly defined, to retain a clinical focus and to provide time for continuing professional development. For postholders to be effective, it is essential that they are supported at all levels of the organisations in which they work.

As the beliefs people hold exert more influence over their behaviour than any other single factor, the purpose of this paper is to elicit those held by service users about being cared for in acute mental health settings.

Data were collected by means of a semi‐structured, non‐standardised, 17‐item interview schedule from an opportunistic sample of 44 respondents (18 men and 26 women) following their admission over a nine‐month period.

Findings suggest that those admitted to acute care settings harbour very different beliefs about what to expect, what is being offered and how it will affect them. While some respondents saw admission as an event simply to be endured, others saw it as a means of gaining relief, accessing better care and treatment as well as providing respite for their families. Whereas previous knowledge and experience of acute care did influence their beliefs, this was largely due to how they interpreted experiences rather than the experiences themselves. The data also suggest that service users can be assisted to reframe their beliefs by means of genuine, consistent and empathic relationships, thus putting services users in a position to derive maximum benefit from being admitted.

Relatively little attention has been paid to the beliefs that service users have on entry to mental health services, in comparison to that paid to problem‐identification, care planning and intervention regimens. A starting point for any health care intervention, especially mental health care, should be the identification of the beliefs held by those about to embark on treatment programmes. This area deserves much more attention than it has been given hitherto.

Conventional theories of market entry assume choice availability. This investment assumption is subject to challenges in the power generation market of an emerging economy where the host government controls most key resources and market entry choices. With such constraints, entrants become heavily dependent on their host country partners. This study investigates how the resource dependency frameworks explain better in respect of some US power generation firms that manage to operate electricity facilities in China whereas some have to abort. Using cross‐case analysis, patterns emerged illustrate how two groups of entrants manage key resources differently.

The aim of this paper is to ascertain the attitudes and experiences of psychiatrists, nurse prescribers, and service users with regard to the prescription of antipsychotic medication, the route of administration, and the extent of service users' involvement.

A total of 26 psychiatrists and 12 nurses agreed to be interviewed in phase one of this study, concerning general aspects of prescribing. In phase two, 11 of the psychiatrists and five nurses from the first cohort took part in follow‐up interviews that focused specifically on their most recent prescribing experiences. In phase 3 of the study, 18 service users (14 male and 4 female) were recruited, during which their experiences of having medication prescribed was explored.

This interview‐based survey found that though there was some agreement between the attitudes and perceptions of prescribers and service users, there were also some important differences including differences with respect to the purposes of prescribed medication, when to prescribe, and under what conditions depot medication produces optimal results. It is not always clear to service users as to why certain medicines were prescribed nor is the information provided always understood. A considerable amount of prescribing practice is based on assumptions.

Even though medication (both oral and depot) has been shown to be useful in certain situations, nevertheless, the type of medication, dose and mode of administration continues to be idiosyncratic and inconsistent. This paper seeks to contribute to the debate by identifying in which pharmacological interventions for people with severe mental health problems could be improved.