The Truth Behind the Murmurs: Exploring Wellbeing and Employment Decisions Within the NHS Psychological Professions Workforce

Harding, Annabel (2025) The Truth Behind the Murmurs: Exploring Wellbeing and Employment Decisions Within the NHS Psychological Professions Workforce. Doctoral thesis, University of East Anglia.

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Abstract

The National Health Service (NHS) is the UK’s national health provider and is known as such across the world. However, more recently it has become known as a service of disillusion within, and for, its workforce. With demand continuing to outstrip supply, the wellbeing of staff is being sacrificed and their desire to continue their NHS employment is being weakened. By virtue of the emotionally-taxing work that psychological professionals do, this NHS workforce is one that continues to be affected by poor wellbeing and retention challenges. With retention being a key part of the NHS Long Term Plan, and significant investments being made into the expansion of the psychological workforce, the need to understand the wellbeing and employment decisions of the psychological professionals is underscored. This thesis therefore aims to complete this exploration in order to provide insight into the sustainability of the NHS psychological workforce and guide targeted strategies to ensure its longevity.

The primary exploration into the wellbeing of the NHS psychological professions workforce was conducted through a systematic review and narrative synthesis. This explored levels of stress and burnout within trainee and qualified NHS psychological professions, as identified within nine identified peer-reviewed empirical papers. The findings revealed stress and burnout to be key challenges for the select psychological professions that were explored. Differences in stress and burnout levels were found between professions, with career stage, individual-related factors, and organisational-related factors noted to pose influence. Heterogeneity in measure use and data reporting limited the scope of the review; thus, future research must be conducted that utilises the recommendations provided.

The secondary exploration into the employment decisions of early-career Clinical Psychologists (CPs) within the NHS psychological professions workforce was conducted through a proceeding empirical paper. This explored the factors associated with early-career CPs thoughts and decisions to stay, work part-time, or leave their NHS employment. A total of 185 early-career CPs completed the online survey. Symmetries and asymmetries are found between the factors associated with early-career CPs thoughts and decisions regarding their NHS employment. Participants reported an effort/reward imbalance in their most recent NHS role, leading to most intending to reduce their contracted NHS hours over the next five years. Notably, this intention was for part-time NHS and part-time private work. The findings highlight the need for NHS organisations to be aware of the multiplicity of factors that influence early-career CPs thoughts and decisions regarding their NHS employment, from which targeted support that ensures the retention of this profession can be provided.

The findings of the review and empirical paper are discussed and critically evaluated, informing the final conclusions, clinical implications, and areas for future research, which are provided at the end of the portfolio.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	27 Oct 2025 12:03
Last Modified:	27 Oct 2025 12:03
URI:	https://ueaeprints.uea.ac.uk/id/eprint/100780
DOI:

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