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NHS nursing labour supply decisions and the cost of living


Pay in the NHS is highly regulated and relatively flat across the country. How pay compares to cost of living is likely to be a determinant of recruitment and retention. This study examined nurse reactions to cost of living changes that affect the relative generosity of NHS pay.


2019 – 2021


NIHR Policy Research Programme


The study used NHS payroll data from the Electronic Staff Record (ESR) combined with house price data and Hospital Episode Statistics to examine nurse labour supply decisions and patient outcomes.


In parts of England where house prices – a proxy of cost of living – have increased rapidly, the relative earnings of nurses in these areas have decreased compared to nurses living and working in areas with slower growth in living costs. This has translated into increased movement of staff between hospitals, and more exits from the hospital sector entirely among frontline nurses.

Details are contained in the study reports (see under Outputs below).


Reports for DHSC on labour supply were discussed with DHSC policy colleagues and arm’s length bodies to inform pay review considerations.

Project status: Completed