ObjectivesA systematic review was undertaken to understand the nature of the relationship between the UK National Health Service (NHS) labour force and satisfaction, retention and wages.DesignNarrative systematic review.Data sourcesThe literature was searched using seven databases in January 2020: MEDLINE (1996–present), the Cumulative Index to Nursing and Allied Health Literature (CINAHL via EBSCO) (1984–present), Embase (1996–present), PsycINFO (1987–present), ProQuest (1996–present), Scopus (all years) and Cochrane library (all years). We used medical subject headings and key words relating to ‘retention’, ‘satisfaction’ and ‘wages’.Eligibility criteria for selecting studiesPrimary research studies or reviews that focused on the following relationships within the NHS workforce: wages and job satisfaction, job satisfaction and retention or wages and retention.Data extraction and synthesisTwo independent reviewers screened all titles, abstracts and full texts, with arbitration by a third reviewer.Results27 803 articles were identified and after removing duplicates (n=17 156), articles were removed at the title (n=10 421), abstract (n=150) and full-text (n=45) stages. A total of 31 full-text articles were included. They identified three broad themes, low job satisfaction impacting negatively on job retention, poor pay impacting negatively on staff satisfaction and the limitations of increasing pay as a means of improving staff retention. Several factors affected these relationships, including the environment, discrimination, flexibility, autonomy, training and staffing levels.ConclusionsThis review highlighted how multiple factors influence NHS labour force retention. Pay was found to influence satisfaction, which in turn affected retention. An increase in wages alone is unlikely to be sufficient to ameliorate the concerns of NHS workers. More research is needed to identify the role of autonomy on retention. A system leadership approach underpinned by data is required to implement bespoke job satisfaction improvement strategies to improve retention and achieve the goals of the NHS Long Term Plan.

Background Integrated curricula is being adopted within healthcare programmes with a growing number of curriculum evaluations being undertaken and reported. A framework exists to guide educationalists in the planning, design and implementation of integrated curricula. It is unknown how widely utilised this framework has been to inform curricula development. This study presents a systematic appraisal of the evidence on how healthcare students experience and perform within integrated interventions and aims to assess how the context of the curriculum has influenced these outcomes. Methods Six electronic databases: Medline, Embase, Scopus, Psych-INFO, CINHAL and ProQuest were systematically searched in September 2018. Studies reporting on undergraduate healthcare students providing feedback, or performing at terminal assessment after experiencing integrated curricula were included. The assessments were categorised by the learning domain they aimed to test. Studies were assessed for methodological quality and risk of bias using a critical appraisal checklist. Studies were appraised against the implementation framework to facilitate contextual understanding of the intervention and findings. Results Forty studies from programmes in medicine, pharmacy and dentistry met the inclusion criteria and were included. Interdisciplinary level integration was most widely adopted, with a wide range of teaching and learning strategies employed in the delivery. Assessments testing higher learning domains, e.g. application and analysis of knowledge, were more commonly reported. Students appear to perform similarly or conservatively better after experiencing integrated education, however adopted study designs preclude the deduction of a direct causal relationship. Students report generally positive feedback on their integrated experiences, claiming the development of a wide range of skills. However, authors provide insufficient detail about the integrated educational developments to best inform future educationalists on the best systems for curriculum integration. Conclusions There is an impetus in research purporting best practices in curriculum integration, however, more standardised, evidence-informed design and reporting of interventions and outcomes are required to strengthen evidence in this area.