The pressurised leaky funnel: rethinking recruitment, selection and retention in the UK psychiatry workforce

Recent years have seen record numbers of applications to UK psychiatry training, yet consultant vacancies remain high and substantial workforce gaps persist. This contradiction reflects a growing recruitment-retention paradox: increasing pressure at the point of entry has not translated into sustainable workforce capacity. This feature introduces the pressurised leaky funnel, a systems-based conceptual model that reframes the psychiatry workforce as a pathway shaped by upstream recruitment pressures and downstream attrition across five stages: exposure and intent, application, selection, training environment and career outcomes. Drawing on established workforce models and educational psychology theory, the model explains how application volume can expand while misalignment, motivational erosion and identity strain drive cumulative workforce loss across the pipeline. We argue that recruitment, selection and retention should not be treated as separate policy domains but understood as interacting components of a single system. By linking where doctors enter psychiatry with how commitment is sustained or eroded, the model offers a framework for moving beyond short-term recruitment metrics towards progression, retention and long-term workforce sustainability, while highlighting new opportunities for selection reform, training environment redesign and retention-focused workforce planning.

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Publication Details

Journal
The British Journal of Psychiatry
Published
2026-06-29
DOI
https://doi.org/10.1192/bjp.2026.10715
Primary Topic
Medical Education and Admissions
Type
article
Field-Weighted Citation Impact
0.00

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article

The pressurised leaky funnel: rethinking recruitment, selection and retention in the UK psychiatry workforce

Hugh Alberti, Adrian Lloyd, A A Dave, Jun Jie Lim et al.
The British Journal of Psychiatry
Medical Education and Admissions
article

The pressurised leaky funnel: rethinking recruitment, selection and retention in the UK psychiatry workforce

Hugh Alberti, Adrian Lloyd, A A Dave, Jun Jie Lim, Bryan Burford, Gill Vance
article en

Abstract

Recent years have seen record numbers of applications to UK psychiatry training, yet consultant vacancies remain high and substantial workforce gaps persist. This contradiction reflects a growing recruitment-retention paradox: increasing pressure at the point of entry has not translated into sustainable workforce capacity. This feature introduces the pressurised leaky funnel, a systems-based conceptual model that reframes the psychiatry workforce as a pathway shaped by upstream recruitment pressures and downstream attrition across five stages: exposure and intent, application, selection, training environment and career outcomes. Drawing on established workforce models and educational psychology theory, the model explains how application volume can expand while misalignment, motivational erosion and identity strain drive cumulative workforce loss across the pipeline. We argue that recruitment, selection and retention should not be treated as separate policy domains but understood as interacting components of a single system. By linking where doctors enter psychiatry with how commitment is sustained or eroded, the model offers a framework for moving beyond short-term recruitment metrics towards progression, retention and long-term workforce sustainability, while highlighting new opportunities for selection reform, training environment redesign and retention-focused workforce planning.

The British Journal of Psychiatry
Cumbria Northumberland Tyne and Wear NHS Foundation Trust (GB), Health Education England (GB), Black Country Partnership NHS Foundation Trust (GB), Newcastle University (GB)
National Institute for Health and Care Research, University of Exeter, Newcastle University, Fakultet Medicinskih Nauka, Univerziteta U Kragujevcu, Faculty of Medical Sciences, Newcastle University, NIHR Newcastle Biomedical Research Centre
Openalex Percentile: Top 7%
Medical Education and Admissions
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