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Delivering our promise to our staff - engage, empower and retain

A white paper on workforce retention

A framework for action

We are delighted to present our first white paper: Delivering on our promise to staff – engage, empower and retain.

As we emerge from a once-in-a-lifetime pandemic, the urgent crisis of workforce burnout and soaring vacancy rates becomes ever-more pressing.  The most recent national NHS staff survey demonstrates the growing disconnect in workforce morale: almost one third of respondents contemplate leaving their organisations, a mere half believe that they have the autonomy to decide how to do their work, and just one quarter feel staffing levels are sufficient to enable them to do their job properly. 

There is no single solution to improving workforce wellbeing and retention. However, the cost of inaction is more staff leaving; increasing pressure on the remaining workforce.

In creating this white paper, we have undertaken a detailed review of current evidence, statistics and commentary surrounding healthcare staff retention, and coupled this with our own data insights and qualitative analysis. The resulting paper presents the scale and nature of the retention challenge, its impact, a proposed "Framework for Workforce Retention”, and insights from third party and partner organisations.

Our hope is that leaders of all levels can take both reassurance and inspiration from this paper and the framework for retention presented within it. It is an opportunity to acknowledge and celebrate the strides already made while offering a road map for the future – a future where efforts can be focused where they are needed most.

Key findings

  • The NHS has seen a 22% year-on-year increase in vacancies in the last twelve months. Without concerted and immediate action, modelling of workforce supply and demand suggests that we will face a workforce gap of up to 360,000 staff by 2036/37.
  • High vacancy rates have a significant impact on staff experience and the quality and cost of patient care. As the workforce gap widens, increasing pressure is placed on an already overburdened workforce, leading to greater stress, burnout and sickness absence. The result is a troubling cycle, whereby even greater numbers of staff choose to leave.
  • The factors influencing individuals’ decision to remain with or leave an organisation are intricate and multifaceted. Pay and reward are often not the primary driver. Research suggests the more predominant factors relate to wider issues such as the capacity to deliver high quality patient care, work-life balance, having a sense of empowerment and feeling heard. In their 2021 Employment Survey, The Royal College of Nursing found the most cited reason for leaving was ‘feeling undervalued’ – surpassing concerns about pay by a substantial 17-percentage-point margin.
  • Following this desk-based evidence review, our Framework for Workforce Retention details eight key drivers that play a key role in impacting job satisfaction, staff morale and staff retention. These are levers that organisations should focus on in order to improve staff retention: (1) delivering high quality care; (2) staff wellbeing and resilience; (3) work-life balance; (4) engagement and empowerment; (5) reward and recognition; (6) sense of belonging; (7) bespoke career pathways; and (8) compassionate leadership.
  • New analysis of a sample of nearly 3,500 ideas revealed that 94% of ideas captured via the ImproveWell platform relate to at least one of the eight drivers in the Framework for Workforce Retention. Interestingly, over 80% of ideas relate to ‘delivering high quality care’ and ‘staff wellbeing and resilience’.
  • We outline how ImproveWell helps organisations proactively tackle retention; by transforming into listening organisations, fostering a culture of improvement, and enabling leaders to demonstrate their commitment to change by putting into the hands of every staff member, from ward to board.

Share the findings

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Engage to improve

Giving everyone a voice, ImproveWell makes it simple for organisations to capture continuous, real-time insight from the frontline to improve staff experience and the quality of patient care.


Track and boost workforce morale and wellbeing with real-time data, by asking your team how their workday is going.



Gather ideas for improvement, discuss or refine collaboratively, and keep everyone up to date with progress and implementation.


Understand what matters and see where improvements are needed with swift and straightforward survey creation. 


Capture real-time feedback from patients or partner organisations via customisable online portals.


Detect trends or pressure points;  enable data-driven decisions;  measure change; and publish reports to close the feedback loop. 


Creating the right environment for wellbeing at work and continuous improvement, ImproveWell delivers:

Improved staff experience

A happier, more motivated workforce reduces sickness absence and staff turnover.

Quality improvement

Frontline innovation and insight improve patient care and outcomes whilst also reducing errors.

Operational efficiences

Optimal use of scarce resources increases throughput; reduces duplication; and streamlines time per activity.

Cost improvements

Improved financial performance with less spend on agency staff; reduced costs; and cost avoidance.


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