EuHEA seminar: Marco Mello (University of Surrey)

Marco Mello

Abstract

In 2016 the UK government imposed a new national contract on NHS Junior Doc- tors, involving an increase in the basic salary but also more weekend working paid at the standard weekday rate. This paper studies how the introduction of the 2016 Junior Doctor Contract (JDC) affected the retention of Junior Doctors within the English NHS, by implementing a Difference-in-Difference (DiD) analysis with heterogeneous treatment intensity. We construct a predetermined and continuous measure of individual exposure to treatment, based on the remuneration for unsocial work earned by Trust-level Foundation Doctors. This approach identifies Junior Doctors that rotated across Trusts where unsocial work was more common and that reasonably felt more penalized by the new contractual terms. We find that a one-standard-deviation increase in the ratio between unsocial supplement pay and basic salary was associated with a 0.11% increase in the monthly probability of leaving the NHS, equivalently to about 8.8% of all Junior Doctors leaving the NHS over a year. Furthermore, we show that specialties in which weekend working is more frequent (e.g. A&E, Surgery) experienced a greater loss of trainees compared to those in which much of the work takes place over a 5-day week (e.g. Pathology, Psychiatry). These findings highlight the importance of working conditions and contractual agreements for the progression in the medical career and the retention of healthcare workers.

Speaker: Marco Mello (University of Surrey)

Discussant: Rita Santos (University of York)

Chair: Pedro Pita Barros (Universidade Nova de Lisboa)