Managing to Stay: Does Line-Manager Quality Affect Employees’ Intention to Quit in the NHS?

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.