NEW: we need to talk about NHS staff retention.

At a time when Britain’s healthcare system is acutely short of workers, *1 in 7* UK-trained doctors are practising overseas. No other developed country is like this, which immediately tells you there’s a problem.

Let’s dig deeper:

First, let’s address some common pushback.

Some argue that there can’t really be a staffing crisis if the NHS can consistently recruit from overseas to make up for these departures. But there are two problems with this view.

The first is that international flows of staff are imbalanced.

Most staff recruited from overseas return to work in their origin countries (or leave for a third country), and a significant portion of UK-trained staff leave.

Outflows exceed inflows: it’s a leaky pipe.

The second is that even if recruitment keeps pace with departures, the churn rate itself is a problem.

As of last December, one in eight NHS staff had been in their current role for less than a year, the highest figure since this series was first recorded in 2009.

This means more work is carried out by agency staff or less experienced team members, which has been shown by Ben Zaranko and co to increase the risk of harm to patients qualitysafety.bmj.com/content/32/5/2…

So what can be done to plug the leak? As nurses prepare for another strike on Sunday and talks between the government and junior doctors remain stalled, the most obvious and frequently mentioned solution is pay.

Critics of striking medics argue that everyone is suffering at the moment. But doctors & nurses have had it worse.

Recent inflation has taken the average UK worker’s real wages 2.5% below their 2009 level, but earnings are down 13% for nurses and 24% (!) for junior doctors.

For some groups in particular, the numbers are eye-watering.

Specialty registrars — junior doctors about 5-10 years into their professional career — would be earning *£20,000* more per year today if pay had kept up with inflation.