Work package 2: Routine Data Analysis

Work package 2 will investigate data collected as a matter of routine (by Trusts and NHS England) to look at the relationships between staff experiences at work, retention and service user outcomes in different Trusts.

Specific research questions for this work package will be:

• What are the reasons for variation in retention rate in different NHS Trusts?
• What is the relationship between staff experience, retention and service user outcomes?

We plan to combine data from the NHS staff survey and numbers of staff leaving and joining each Mental Health NHS Trust in England to investigate correlations and predictors of leaving rates with other data sets containing service user outcome measures (including readmission rates, ‘did not attend’ (DNA) rates and patient satisfaction surveys). No individuals will be identifiable in the data we collect or report.

Staff outcomes, will examine all key findings measured within the staff survey, particularly focusing on the questions and data that are most likely to be related to retention (such as staff engagement, work pressure, experience of bullying, harassment or abuse, and measures of job design). Although early versions of the staff survey included a measure of intention to leave, this has not been included since 2012.

The findings from the Realist Review will be used to identify particular factors that can be targeted in the data analysis such as the type of Trust or mechanisms such as numbers of staff receiving appraisals.

Service user outcomes (also known as patient outcomes) in mental health research are not straight forward to measure. Different illnesses have different outcomes and many are not routinely measured.

• We will use mental health specific outcomes such as ‘did not attend’ (DNA) rates. Engagement and collaboration between staff and service users are essential for successful mental health treatment. A high DNA rate indicates a lack of engagement and is an indicator for poorer outcomes.
• Other service user outcomes focus on satisfaction. The patient experience survey indicates how highly service users rate their care .
• The Realist Review may highlight other key patient outcomes that we can seek to incorporate into the analysis.

Analysis in this work package will investigate if there are any relationships between these specific data sets which could be the focus of recommendations to improve retention.

Analysis will also identify areas where Trusts with high retention rates have high areas of staff satisfaction (and vice versa) which will be used as target areas for the Organisational case studies.