Why hospital staff leave and how to understand why
Nurses, doctors, technicians and support staff leave hospitals for different reasons. How to run a respectful exit conversation, spot patterns and act.
7 min readRead articleA private practice is often one doctor or a small group with a handful of staff, where the doctor is also the employer. When the doctor is also the employer, people matters tend to wait behind patients, so small routines made early save the most time.

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Share your requirementsA private medical practice is usually a general practitioner or specialist working alone or with a few partners, supported by a nurse or assistant, a receptionist and perhaps a compounder or pharmacy attendant. The doctor is the clinician, the owner and the employer, and has little time for staffing matters between patients. Staff are few, so each role carries wide duties: the receptionist books, bills and answers the phone, and the assistant handles dressings, injections and tidying. Hours run in a morning session and an evening session, and a doctor's absence closes the practice. Pay, leave and notice tend to be agreed by word, and staff move on when a better offer appears. See also HR for healthcare.
Who does the work
The doctor is also the HR department
Hiring, pay and complaints are handled between patients, with no time or system.
Everyone does everything
Roles are not defined, so tasks are missed or duplicated, and nobody can say who owns which duty.
Terms are verbal
Pay, leave and notice are agreed by word and remembered differently, which leads to disputes at exit.
Split shifts wear people down
Morning and evening sessions with a gap between make the day long, with little recognition.
Locum cover is arranged at the last minute
When the doctor is away, the practice closes or a locum arrives with no briefing.
Write the roles on one page each
A short description of duties for the receptionist, assistant and compounder. See role design and job descriptions.
Issue a simple appointment letter
Pay, hours, leave and notice in writing, signed by both sides. The HR documentation process shows what to include.
Make the split shift fair
A clear schedule, a weekly off that is honoured and extra pay or time off for the long days.
Prepare a locum brief
A one-page note on routines, records and contacts so cover is ready on short notice.
Set a monthly people routine
One hour a month to check attendance, pay and complaints, so issues do not pile up. See fractional HR management.
Confirm with a qualified professional. What applies to you depends on your business, your state and your arrangements, and it changes. This page describes practice. It does not state a legal position.
Appointment letters and written terms for every staff member, so pay, leave and notice are on record.
One-page role descriptions that make clear who does what at the desk and in the consulting room.
A fair split-shift schedule with weekly offs and a simple leave record.
A route for finding and checking receptionists and assistants, and a locum bench for cover.
Every engagement starts by recording where you stand, and every later report compares against that. We do not promise outcomes. Start with a free conversation, or see the paid HR Diagnostic.
From the GullyHR blog: one on HR in healthcare, and one on each of the topics this page points to.

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Yes. A short appointment letter with pay, hours, leave and notice protects both sides and costs very little.
Write down who handles booking, billing, records, injections and cleaning, and review it after a month.
Give a clear schedule, honour weekly offs and recognise the long day with pay or time off.
A one-page note on routines, records, contacts and any local practices, and a short chat before the first session.
Pay on time, define the role, offer a small step up in duties and pay, and treat the person as part of the team.
Quite practical. We would ask you to describe each person's duties, check whether everyone has terms in writing, and look at how often the practice closed because nobody could cover. A first piece of work might be one-page role descriptions and a simple appointment letter. Nothing starts until the scope is agreed with you in writing.
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