Retention Charter action 3.4
Action 3.4: Have enabling conversations with Psychiatrists considering leaving or who have decided to leave the organisation/profession before retirement age, ensuring that they feel supported, and their decision is a considered, positive choice..
Action 3.4 is part of Domain 3 of the RCPsych's Retention Charter for employers - which relates to creating a culture of belonging.
What stage is your organisation at?
Use this maturity matrix to assess what stage your organisation is at, in terms of Action 3.4.
- ‘Retention conversations’ routinely take place with staff considering leaving the organisation to understand factors influencing their decision-making.
- The organisation is responsive to the needs of staff who are considering leaving due to feeling unsupported or other workplace issues (e.g. bullying, harassment, discrimination, workplace stress). This involves working with such staff members to identify and implement solutions and supporting them to continue in their roles, if this is appropriate and desired.
- Voluntary exit interviews are routinely offered to all staff leaving the organisation and conducted sensitively.
- The effects of Psychiatrists leaving the organisation on those who remain are actively and routinely considered, with appropriate review of workload and resources occurring to avoid them becoming overstretched.
- Processes are in place to identify early indicators of staff having negative experiences at work and/or considering leaving the organisation through various feedback mechanisms and data.
- The organisation demonstrates awareness of key themes arising from exit interviews and retention conversations, and action plans are in place to address common reasons for psychiatrists leaving.
- Processes exist to support effective handover between staff leaving the organisation and those continuing working, ensuring that key knowledge, resources, and skills are passed on.
- There is evidence of an organisational culture where staff feel able to come forward and discuss thoughts of leaving the organisation at an early stage.
- The organisation demonstrates effective learning with measurable improvements being demonstrated in priority areas identified from exit interviews and retention conversations.
- Systems are in place to capture Psychiatrists leaving the organisation due to feeling unsupported as incidents and indicators of risk to the quality of care delivered.
Advice and recommendations
- Offer training for supervisors/managers to have effective retention conversations with psychiatrists.
- Offer drop-in sessions for psychiatrists who are considering leaving the organisation or who wish to discuss their career options with senior leaders.
- Deliver training in how to conduct sensitive and effective exit interviews when psychiatrists leave the organisation.
- Work with colleagues in human resources (HR) and organisational development (OD) to identify themes from exit interviews and retention conversations, and implement improvement plans to address these.
- Ensure that information collated from exit interviews and retention conversations related to staff feeling unsupported or unable to deliver quality care is recorded using incident management systems and/or flagged at the appropriate safety and quality forums.
- Proactively fill gaps left by psychiatrists exiting the organisation through advance
planning, recruitment to substantive roles, and appropriate allocation of resources.
Encourage continued membership of the organisation so that psychiatrists who
leave can continue to feel connected and benefit from opportunities featured in
communications.
Links and resources
- NHS Employers have produced a practical guide to having discussions with staff that
improve retention, including ‘retention conversations’.
- NHS England have a webpage titled ‘Understanding your data’ which provides information about various types of workforce data available to help inform the development of retention strategies.
- The RCPsych conducts a workforce census every two years.
- The RCPsych published a ‘State of the nation report’ in October 2023 exploring the psychiatric workforce in Scotland.
- The BMA recently published a report titled ‘When a doctor leaves: Tackling the cost of attrition in the UK’s health services.
- The GMC have published findings from a survey of over 3000 doctors focused on identifying groups of migrating doctors.
- Voices of Experience (VOX) Scotland recently collated the views of adults with recent experience of care by a psychiatrist in Scotland and published a report, which highlights the importance of retaining psychiatrists in long-term employment.
Examples of good practice
Solent NHS Trust worked with NHS Shared Business Services (SBS) to offer comprehensive telephone interviews with an independent HR specialist for those leaving the organisation.
This resulted in significantly increased engagement in exit interviews and the collation of detailed data which enabled the organisation to identify priority areas for improvement and take positive action.
They subsequently achieved reductions in employee turnover and 94% of leavers who completed exit interviews with NHS SBS rated them positively.