registered nurses. 13 Outer city trusts have difficulty recruiting nurses in the lowest grades but experience lower turnover in higher grades, such as F and G.If turnover rates are high (particularly in London), should we be worried? Clearly high turnover has a knock-on effect on staff morale, 9 14 organisational finances, 15 16 and perhaps patient care.
18Little consensus exists over whether there is an appropriate level of turnover that can be applied to all trusts since different, and at times uncontrollable, factors operate in different places and to varying degrees. Consensus is firm, however, among acute trusts in London that turnover rates are too high.
ConclusionThe serious problems facing acute trusts in England in retaining and recruiting nurses result in high financial costs and low morale and may affect patient care. These staffing problems are most stark in inner city and teaching trusts-particularly in London, where they will need to be tackled if the government's modernisation agenda for the NHS is to be realised.
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