City Research Online

Abstract

The English National Health Service (NHS) is one of the largest employers in the world. It is currently suffering from high employee turnover and rising numbers of job vacancies. This article uses five waves of NHS Staff Survey data (2018–2022) to try to understand the relationship between line manager quality and staff intention to quit. It estimates pooled cross-sections with data on close to 400,000 individuals and approximately 130 NHS Trusts. The analysis adjusts for a wide variety of confounding variables, including hospital trust fixed effects. We also check for omitted variables and potential endogeneity. Our econometric estimates point to the important influence that line manager quality has on employees’ intentions to quit or stay. This study's novel results suggest that an increase in line manager quality by one unit (on a scale from 1 to 5) is associated with a substantial decrease in NHS employee quit intentions of 17 percentage points.

Publication Type:	Article
Additional Information:	© 2025 The Author(s). British Journal of Industrial Relations published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords:	line managers, National Health Service, quit intentions, senior management
Subjects:	H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management R Medicine > R Medicine (General)
Departments:	School of Policy & Global Affairs School of Policy & Global Affairs > Department of Economics
SWORD Depositor:	Symplectic Administrator

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