A study published by The BMJ suggests that efforts to reduce staff turnover may improve patient care and hospital quality.

The findings are based on yearly records for 236,000 nurses; 41,800 senior doctors and 8.1 million patients admitted to 148 NHS acute hospital trusts in England from 1 April 2010 to 30 March 2019.

The main outcomes of interest were risk of death from any cause within 30 days of hospital admission, and risk of unplanned readmission within 30 days of discharge after elective hospital treatment.

After accounting for patient age, sex, and pre-existing conditions, the researchers found that a one standard deviation increase in the monthly turnover rate for nurses – equivalent to about 20 nurses quitting the hospital trust – was associated with 35 additional deaths per 100,000 admissions in a given month, equivalent to an extra 239 deaths per month across the 148 hospital trusts.

For senior doctors, a one standard deviation increase in the monthly turnover rate – equivalent to about seven senior doctors quitting the hospital trust – was associated with 14 additional deaths per 100,000 admissions in a given month, equivalent to an extra 96 deaths per month across the 148 hospital trusts.

Higher nurse turnover was linked to increased deaths for patients on surgical and general medicine wards, while higher turnover among senior doctors was linked to increased deaths in patients with infectious diseases and mental health disorders.

No statistically significant association was seen between staff turnover rates and deaths for non-emergency care patients, likely due to the higher risk of death in patients requiring emergency admission, note the researchers.

They acknowledge that these are observational findings, so no firm conclusions can be drawn about causality, and they can't rule out the possibility that other unmeasured factors may have affected their results.

The researchers concluded: ‘High turnover of nurses and doctors suggests a potential risk for patients. Therefore, retention of healthcare staff should be a priority to improve continuity and quality of care for patients.'

In response, Rachel Harrison, GMB National Secretary, said: ‘For 14 long years, NHS workers have suffered real terms pay cuts, under-funding and, devastating under-staffing. It's no surprise health workers are leaving in droves.

‘Poor pay and conditions are bad for staff, for the health service and - as this report shows - deadly for patients.

‘Labour appears to grasp the scale of the problem and what it will take to get the health service off life support, but there's a long way to go.'