March 2025

IZA DP No. 17798: Employer Quality and Skilled Workers’ Mobility: Evidence from English NHS Hospital Doctors

We build a unique dataset by linking high-quality administrative data sources and model the mobility choices of tenured English National Health Service (NHS) hospital doctors across hospital organizations according to a random utility choice framework based on hospital quality, pay-for-performance incentives, local residential amenities and travel-to-work commuting distances. We account for the endogeneity of hospital quality through a control function approach. Doctors are willing to move 5.3 extra kilometers in order join a new hospital organization with a one-standard-deviation lower mortality rate, whereas they are willing to trade a standard deviation of the average monetary bonus received for their clinical excellence with the cost of moving 5 extra kilometers from their home. Primary school quality and low crime residential areas are only marginally salient in the choice of new employer. Counterfactual simulation estimates reveal that simultaneous improvements in hospital mortality and performance-related pay awards by one fourth of a standard deviation can lead to decreases in regional hospital doctor vacancy rates by 2% to 11%.