Staff retention in echocardiography: a formal exploration of workforce drivers

BACKGROUND: Retention of diagnostic imaging staff is a growing concern within the NHS, with echocardiography services facing particular pressure due to high demand, workforce shortages, and post-pandemic backlogs. While factors influencing NHS staff retention are well documented, limited research has focused specifically on echocardiography staff, a highly skilled and specialised workforce. AIM: This study aimed to explore intention to leave among NHS echocardiography staff and to identify factors that encourage retention, alongside perceived barriers to staying within the role or organisation. METHODS: As a part of business as usual, Trust staff support psychologists offered to meet with echocardiography colleagues for a general support session and to advertise the services they offer. The psychological support aspect of the team session has an evidence base in the Trust that was used to form the session content. All echocardiography staff were invited to attend a facilitated two-hour group or individual sessions combining survey completion, structured discussion, and psychological support. Quantitative data on job satisfaction and intention to leave were collected alongside qualitative discussion data, which were anonymised and analysed thematically. This mixed-methods service evaluation was conducted within a large acute NHS Trust. RESULTS: Forty-five staff participated, including Band 7 echocardiographers (n = 37) and Band 8 team leaders (n = 8). Retention intent differed by role: 88% of Band 8 leaders reported low intention to leave, compared with 39% of Band 7 staff indicating potential intention to leave within two years. Key retention factors included supportive management, positive team relationships, individualised flexibility, professional autonomy, and individualised plans around work-life balance. Barriers to retention centred on workload pressure, burnout (including musculoskeletal injury risk), limited career progression, and financial concerns. Younger staff were more likely to report thoughts of leaving. Participants highlighted meaningful relationships with patients and colleagues as protective against disengagement, alongside concerns regarding role narrowing and future AI integration. Impressions during the psychological support aspect involved the individualised understanding of flexibility, work-life balance and therefore a variety of potentially helpful solutions. The connection between colleagues generated in the group seemed of benefit. CONCLUSIONS: Retention among echocardiography staff is influenced by a complex interaction of organisational, professional, and wellbeing factors rather than pay alone. Multifaceted, individualised, targeted retention strategies focusing on workload management, career development, psychological support, and clear communication around service evolution are essential to sustaining this critical workforce.