Work package 3: Organisational Case Studies

Work package 3 will involve organisational case studies of different NHS trusts to identify and learn from good practice and identify potential interventions or recommendations for practice. 

Specific research questions to be addressed by this work package will be :

Why do trusts retention rates vary? 

How are different trusts addressing retention?

What are Trusts with high retention rates doing differently?

The data analysis in work package 2 will identify Trusts with different rates of retention. The review in work package 1 will have identified some key contexts and mechanisms associated with retention/loss of staff. The organisational case studies in work package 3 will use these as the basis for key fieldwork decisions. As these have not yet taken place we cannot be sure of the most important factors for identification, but may include Trust size, locality, demographics, services provided etc.

Trusts will be deliberately chosen based on variation of these criteria and we will conduct organisational case studies of Trusts to identify and learn from good practice. 

Methods: We aim to compare 6-8 different Trusts with different retention rates using methods of qualitative semi-structured interviews with key stakeholders, ethnographic observations of identified processes, documentary analysis of key policies and procedures around key themes from the data and review. 

The theories from the review and key findings from the data analysis will be used to identify key practices and policies to investigate within these Trusts. If, for example, the data analysis finds that staff appraisals are correlated with high retention rates then we will investigate what these Trusts are doing around appraisal and if there are recommendations that can be made to allow other Trusts to replicate this good practice.

Finally we will combine the findings from all three work packages into a coherent set of findings and recommendations.

Listen to Emily on the Mental Elf https://twitter.com/Mental_Elf/status/1729764968831029621 

Open access published papers  

A realist evaluation of factors affecting the retention of the mental health workforce: building a realist programme theory.  https://bmjopen.bmj.com/content/15/8/e102161 

Factors affecting the retention of healthcare assistants in English mental health services: a qualitative interview study 

http://doi.org/10.1186/s12913-025-12665-1