Why are so many medics quitting Blackpool Victoria Hospital?
That's the question bosses there want answered, though only a fraction of workers complete exit interviews.
Only 40 out of 540 exit interviews were done, NHS documents showed, with the Vic overspending on agency staff to such an extent its finance boss Tim Bennett warned a recent meeting it was "unsustainable" and would breach a government cap.
Chairman Pearse Butler said "workforce was a significant challenge" and "emphasised the need to increase staffing and to engage with existing staff", the papers said.
One Vic director, Mark Beaton, called for more urgency - with plans now in place to hold talks with disgruntled medics to try and stop them from leaving as part of the NHS's retention programme.
That was rolled out earlier this year after, the health service claimed, it kept more than 1,000 nurses, midwives, and other clinicians in the NHS.
Rewards from local firms, like discount gym memberships, were among the incentives used to keep them, while a 'transfer window' allowed staff to move between areas to develop their skills.
Trusts were also offering 'itchy feet' interviews, where staff get the chance to talk to bosses about why they might leave.
Simon Stevens, the NHS's chief executive, said "it's right that local NHS employers are now themselves increasingly taking common sense action to support, develop, and retain their staff".
And Prerana Issar, the NHS's chief people officer, said: "The national retention programme has had a promising start and we are now looking to roll out this scheme to other trusts and into general practice.
"Getting the right workforce is not just about the number of people we bring in, but keeping and rewarding the team we have."
In September, The Gazette reported a staff shortage of 440 at Blackpool Teaching Hospitals NHS Foundation Trust, which runs the Victoria Hospital, in Whinney Heys Road, and Clifton Hospital, in St Annes, and employs around 6,725 people.
Some 540 left in 12 months, with the situation putting pressure on finances. Spending on agency staff was double the expected £1 million.
A hospital report said: "The trust is at a significant risk due to the inability to attract, recruit, and retain a high calibre and skilled workforce in areas which are hard to recruit, eg nursing and midwifery, medical and dental, and allied health professionals," such as therapists and dietitians.
A new retention and recruitment strategy aimed to offer more flexible working arrangements, support those deemed to be under-performing, and intervening early if people are unhappy in their roles.
Mr Butler said: "We have to retain our existing staff. We have to treat them better and make them think this is a great place to work. We are looking fundamentally at changing the culture of this organisation."
More than 100,000 days were lost due to illness last year, with a third relating to anxiety, stress, depression, and other mental health conditions, leading to concern from unions about the pressure being put on medics.
And "high sickness levels" were highlighted again in August, which was "possibly due to staff being under pressure, which highlighted the need to show compassion", Vic documents added.
The trust has been recruiting in the Philippines, with one recent trip seeing 103 offers made.