Nurse Retention Program in England’s National Health Service

The paper includes the direct cost of the program as well as the reduced costs of hiring due to the policy’s effect on nurse retention. As the program did not induce any transfers, the paper calculates the direct cost of the program as the opportunity costs of the labor needed to implement it. The authors were informed by NHS Improvement officers that approximately one full work day was spent per treated health organization. In addition, the paper makes some assumptions about the time spent by managers at the hospital organization level to implement the program. Using these time estimates and publicly available salary data, the authors estimate that 24,277.6 pounds were spent in labor costs per treated hospital organization.

In addition to the direct costs of implementing the program, the paper also includes the savings induced from increased nurse retention. The paper finds that the program causes an additional 1,697 nurses to stay at their hospital organizations. NHS Improvement estimates that it costs £11,400 to replace a nurse. Thus, the total savings of the program is £11,400*1,697 = £19,345,800 assuming that all unretained nurses would be replaced. As there were 132 treated hospital organizations, the savings per organization is £141,500.

Overall, the net cost per organization was £24,277.6 – £141,500 = -£117,222.4.

The paper finds that RDSP has a net cost of – £117,224 and finds a positive willingness-to-pay of £686,460,000. Thus, they find the policy has an infinite MVPF.