In an era of persistent healthcare workforce challenges, particularly in socioeconomically deprived regions, understanding why doctors choose to remain in their roles is as crucial as understanding why they leave. A new qualitative study, titled “Retaining doctors in organisations in socioeconomically deprived areas in England: a qualitative study,” sheds vital light on this often-overlooked aspect of workforce sustainability.
The Challenge: The UK, like many countries, faces a significant healthcare workforce crisis, characterized by high vacancy rates and fewer doctors per capita than comparable nations. This shortfall is particularly acute in socioeconomically deprived areas, which struggle to recruit and retain medical professionals, directly impacting patient care and health outcomes. While much existing research focuses on factors leading to attrition and burnout, this study strategically shifts focus to the positive organisational factors that foster retention.
About the Study: Conducted by researchers from Lancaster Medical School, this qualitative study involved semi-structured interviews with 100 NHS-employed doctors across four purposefully sampled geographic case study sites in England. Three of these sites were areas known to struggle with doctor recruitment and retention, while one was consistently oversubscribed. The diverse participant group included general practitioners, consultant specialists, resident doctors, and other medical professionals. The research specifically aimed to identify work-related organisational factors that positively influence doctors’ decisions to stay in their current roles and organisations.
Key Findings: Two Organisational Levers for Retention
The study identified two core “organisational levers” that influence doctors’ decisions to remain in an organisation:
- Feeling Valued by the Organisation:
- This extends beyond mere financial compensation to a “deeper and more meaningful commitment from an employer”.
- Material Support: Practical aspects such as accessible car parks and 24/7 canteens were highlighted as important, as were small bonuses or “added extras” that significantly boost morale and counter the feeling of being “just one of the numbers”.
- Relational Support: Feeling supported by colleagues and having a clear commitment to training, including dedicated time for tutorials and support for managing complex patients, were highly valued. One GP even reframed retention as “nurture and sustain,” emphasizing ongoing support.
- Autonomy and Opportunity:
- Doctors are more likely to stay if they have the autonomy to craft their own job design and pursue their interests.
- The perception of future opportunities and potential career pathways within the organisation is a strong driver for retention, especially for younger doctors seeking career growth.
- Making a Difference: In smaller, less prestigious areas, doctors often found greater control over their work and perceived a higher ability to make a bigger difference to patient care and outcomes. This often led to higher job satisfaction, allowing them to “find a nice niche” for themselves.
Implications for Policy and Practice: The findings underscore that healthcare organisations have the potential to drive change by focusing on these modifiable “organisational levers”. Prioritizing how doctors feel valued (through resources, remuneration, and both material and relational support) and providing genuine autonomy and opportunities for career growth are crucial for improving doctors’ working lives and enhancing staff retention. This study provides practical recommendations for healthcare managers and policymakers to improve future healthcare service provision and ensure a more stable and satisfied medical workforce.
This research contributes significantly to the understanding of medical workforce retention by focusing on what makes doctors stay, providing high-quality evidence that can inform meaningful interventions and improvements in healthcare.
Reference: Brewster, L., Mumford, C., Patel, T., Chekar, C. K., Lambert, M., Shelton, C., & Lawson, E. (2025). Retaining doctors in organisations in socioeconomically deprived areas in England: a qualitative study. BMJ Open, 15, e100694. https://doi.org/10.1136/bmjopen-2025-100694
