Exploring the Impact of Leadership Styles on Nurse Retention and Job Satisfaction: A Narrative Review of Qualitative Evidence in UK Healthcare

Abstract

Abstract Background: Nurse retention and job satisfaction continue to present significant challenges for the UK healthcare system, especially within the NHS, where staffing pressures and rising patient demand place ongoing strain on the workforce. Effective leadership has been widely recognised as a crucial factor influencing whether nurses are motivated to remain in their roles or consider leaving. Understanding how different leadership styles shape retention and satisfaction is vital for developing a stable, engaged nursing workforce. Aim: This narrative review set out to identify, appraise, and synthesise recent qualitative evidence on the connection between leadership styles and nurse retention and job satisfaction in UK healthcare contexts, drawing out key themes to guide practice and policy. Methods, Results, and Conclusion: A focused search of four major databases retrieved twelve peer-reviewed studies published between 2019 and 2025 that met clear inclusion criteria, covering a mix of qualitative and mixed-methods research. Critical appraisal was carried out via the CASP Qualitative Checklist, and thematic synthesis was used to develop key findings. The review highlights six main themes: the positive impact of transformational leadership on staff well-being; the importance of relational and authentic leadership in building trust; the value of distributed leadership and shared decision-making; the influence of supportive organisational culture; the role of visible leader support and staff voice in daily practice; and the need for consistent leadership development. Taken together, the findings confirm that supportive, inclusive leadership is strongly linked to improved job satisfaction and greater retention intentions among nurses. However, structural barriers such as workload pressures and unsupportive cultures can limit the positive effects of good leadership. Addressing these barriers through investment in leadership development and organisational support will be essential for strengthening the sustainability of the nursing workforce in the UK.