Literature review (3.3) This literature review will look at publications that surround the topic of our research question and begin to narrow down on to publications that are very close to our research question itself. Due to the fact that we are looking at pay and working hours, we will and focusing our review towards literature that looks specifically at pay and working hours and how this affects employees and potential employees. At first, for research these question, we wanted to find some professional literature or articles to support our views. After searching in google scholar and primo, there were many different articles and journals we found. We found lots of news articles related to our questions, which is related to current events. According to the articles, we mainly separated them into two parts: nurses and junior doctors. Finlayson et al. (2002) summarised that there are four factors that cause recruitment and retention problems. Among them, pay and working hours are the topics relating to our question. Though the government has tried to improve salary, comparing with other public workers, it still remains at a low level and is hard to meet the cost of living (Finlayson et al., 2002). Hopson (Triggle, N, 2017) pointed out that pay restraint and stressful workload led to recruitment and retention problems. Poor pay leads to less competitive edge in terms of employability as employees may resign rather than bear high pressure and low paid work (Triggle, N, 2017). Williams et al. (1998) stated that high absence rates in the NHS were caused from the pressure of overwork. Reported by Whitehead (2016), with the increasing amounts of patients, workload for nurses increased as well. Due to the long working hours, some of the nurses could not burden the stress and choose to leave, which continued rising the workload and cutting down labour force. Meanwhile, Forster (2017) reported that the staff vacancies have gone up more than 10%, 40% of it was the vacancies of NHS nursing and midwifery positions. The figures released by Healthy Foundation showed nurse registrants in the UK showed a large proportion not being from the UK between 1990 and 2016, with a large share of EU nurses (The Healthy Foundation, 2017). After Brexit, the number of nurse registrants from the EU decreased by 96% between January 2016 and April 2017, which influences the numbers of nurses in the workforce. However, without considering brexit, low pay can be a main reason as well as long working hours for the lack of nurses. Moore (2017) supports that the financial shortage of NHS and the pay cup restriction decrease their salaries. It is hard to attract new potential employees and retain the experienced employees who have left. Moore (2017) gives evidence that the amount of students applying for degree courses has fallen by 23% while the average turnover rate of the NHS nurses work in England up to 8% based on the information from Health and Social Care Information Centre (Merrifield, 2015). In other words, if the government doesn’t improve the salary, labour is likely to decrease further due to the fact that for the work itself, the salary to justify the work isn’t substantial enough to meet employee’s needs or expectations. A nurse who was interviewed by Forster (2017) also claimed that low pay, relentless pressure and new training costs had great impact on their works. In fact, the recruitment of nurses is being weakened due to the limited pay rise and inflation (Campbell, 2017). The literature is outlining that low salary will drop the morale of staff. More and more nurses are leaving in search of companies that pay higher. The lack of labour force increases the workload for remaining nurses and doctors. According to Doward’s report (2015), more and more junior doctors choose to work overseas because the wage they earn in another country, such as Australia, is double than they get in the UK. Doctor in Australia can enjoy tax breaks if he has a meal outside, rent or mortgage (Briggs, 2015). In addition, the medical indemnity insurance GPs pay in Australia is much cheaper than UK’s as well as the insurance policy in Austrilia covers much more services than UK’s (Doward, 2017). These benefits mentioned above are more attractive than UK’s. Basically, junior doctors get a pay around £23,000 in the first year and about £28,000 in the next year (Briggs, 2015). To get more extra reward, junior doctors will work during unsocial hours, outside 07:00 to 19:00 Monday to Friday (Briggs, 2015). However, the contract was changed in 2015. Unsocial hours were changed into outside 07:00 to 22:00 Monday to Saturday and the pay for overtime was cut down, affecting junior doctors’ extra income (Briggs, 2015; BBC NEWS, 2016). As a result, they will have to face with increasing tuition fees and student loans, together with the drop of the wages and longer fixed time to work (Toynbee et al., 2016). Moreover, junior doctor doesn’t only mean the new doctor, which also includes the GP trainee and hospital speciality trainee. And the former lasted five years, the latter lasted nine years. (BBC NEWS, 2016). The new contract will limit their salary for a long time. Although the news reported that government believe that the new contract is a good for junior doctors, it cannot be avoided that a amont of junior doctors have decided to leave due to the contract (Sini, 2016). It was reported that the doctors applied for abroad work increased by 1000% rapidly (Stone, 2016). The news (Campbell, 2015) indicated that after fundation training, nearly half of the junior doctors refuse to work in NHS, because they worried about the extra stress and the effect of new contract. It is a huge loss to lose these well-trained young work labour. For GPs, with the growing number of patients and declining budget, the pressure increased day by day, leading fewer new medical students would like to attend (Boffey, 2014). To summarise, for junior doctors, they are willing to work for a longer hour if they can get the reward worth it. Otherwise, they would leave and find another way to get a higher pay job. Therefore, the main factor influence can be thought as pay. As Australia is one of the countries where NHS employees tend to go, it is valuable to compare some of the terms and conditions between the two countries, helping to find out which aspects attract them. One way it differentiates from the UK is the fact Australia pays attention to the working hours of junior doctors, with the purpose of improving safety in health care, which benefits both patients and staff (Glasgow, J N., 2014). There is no detailed data to show how long junior doctors work per week in the article, but the working hours of other staff within the NHS, is less than the hours of doctors. The introduction of GP salary in Australia displays a big gap as well. The basic salary of GP in Australia is $150,000 – 350,000 (Aster medical, n.d.) while the pay in UK is arround £55,000 – 86,000 (BMA, 2017). Converting into the same currency, the former nearly is more than twice as much as the latter. It is obvious that medicare in Australia have good models to care for staffs. In turn, employees with high morale will give good contribution on work. With the end of the literature review, we have given evidences to indicate how pay and working hours affect employability. Analysing the resources, we choose two characters, nurses and junior doctors to support our research. With the comparison between the pay and working hours, we found that pay is a more important element influencing the employability. Besides, we cite some commens from NHS staffs and compare UK with Australian in some aspects, showing NHS terms and conditions need to improve to retain staffs.