Evidence map›Paper›PMID 40233962›Full record

Observational studyBMJ open2025

AmReS: an observational retrospective time-to-event analysis of staff voluntary turnover in an English ambulance trust.

Robert M Cook, Zillur Rahman Shabuz, Matthew Bennett, Josh Miller, Abigail East, Alisen Dube, Gina Varnals, Md Asaduzzaman, Mark Radford, Alison Leary and 1 more

Abstract readObservational Study
In one paragraph

Observational study in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Robert M CookSchool of Health and Social Care, University of Staffordshire, Stafford Campus, Stafford, UK robert.cook@staffs.ac.uk.ORCID http://orcid.org/0000-0003-3343-8271
Zillur Rahman ShabuzLancaster University, Lancaster, UK.
Matthew BennettLondon Ambulance Service NHS Trust, London, UK.
Josh MillerWest Midlands Ambulance Service NHS Foundation Trust, Brierley Hill, UK.
Abigail EastNorth West London Cancer Network, London, UK.
Alisen DubeSchool of Health and Social Care, University of Staffordshire, Stafford Campus, Stafford, UK.
Gina VarnalsSchool of Health and Social Care, University of Staffordshire, Stafford Campus, Stafford, UK.
Md AsaduzzamanDepartment of Engineering, University of Staffordshire, Stoke on Trent, UK.
Mark RadfordNHS England, Redditch, UK.
Alison LearyLondon South Bank University, London, UK.ORCID http://orcid.org/0000-0001-7846-5658
Sarahjane JonesSchool of Health and Social Care, University of Staffordshire, Stafford Campus, Stafford, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe purpose of this study was to identify which, and to what extent, demographic and operational factors are indicative of likelihood for a new call handler or paramedic to remain in role within the first two years of employment at an ambulance trust using data held in the trust's bespoke data warehouse.

designThe study uses a retrospective observational cohort design using routinely collected data.

settingOne ambulance trust focused on a large, predominantly urban area in the UK.

participantsThe study used the data of all employees of the trust who started employment as call handlers (869) or paramedics (1672) between 1 January 2018 and 31 July 2023. PRIMARY AND SECONDARY OUTCOME MEASURES: 'Time-to-event' analysis of 'likelihood to remain in post within the first two years of employment' as call handlers or paramedics via accelerated failure time regression.

resultsSeveral factors showed a significant contribution to the likelihood of remaining in post within an ambulance National Health Service Trust. Among the findings, short-term sick leave in the first two years of employment was associated with increased retention for paramedics (0.040, 95% CI 0.030, 0.060). In addition, female call handlers were found to have increased retention (0.29, 95% CI 0.043, 0.54), and paramedic retention increased with time outside of 'job cycle time' (JCT) activities (ie, activities other than responding to calls) (0.097, 95% CI 0.057, 0.14).

conclusionsThis study presents a method for extracting new insights from routinely collected operational data, identifying common drivers and specific predictors for retention among the ambulance NHS workforce. It emphasises the importance of workforce-centred retention strategies, highlighting the need for non-JCT time, which in turn would allow paramedics to have time to reflect and recuperate to avoid burnout and attrition. The study also suggests that a lack of sick leave might indicate a lack of trust and self-care culture, potentially leading to paramedic staff attrition. Our approach to retention analytics provides a new mechanism for trusts to monitor and respond to their attrition risks in a timely, proactive fashion.

Indexed as

Allied Health PersonnelAmbulancesEmergency Medical TechniciansPersonnel TurnoverAdultEnglandFemaleHumansMaleMiddle AgedRetrospective StudiesSick LeaveState MedicineUnited KingdomACCIDENT & EMERGENCY MEDICINEBurnoutHealth ServicesHealth Workforce

Identifiers

PMID40233962
PMCPMC12001345

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.