ABSTRACT
For most of its existence, the National Health Service (NHS), Britain’s largest employer, has managed its human resources centrally with pay and conditions of employment determined at a national level. Under this system periodic concern has arisen in relation to the rate of staff turnover and to sustained recruitment and retention difficulties relative to particular skill groups or in specific geographical areas. Discussions have focused on factors likely to influence turnover, such as pay, management practices, age and gender of the workforce, and aspects of the wider labour market (King’s Fund Institute 1990; National Audit Office 1991; Review Body 1992). Although the absence of empirical information in this area is striking, recent reforms to the NHS have clearly underlined the Government’s belief that local labour market conditions affect staff behaviour.
