Background: Research into recruitment, retention and return of speech and language therapists in the National Health Service (NHS) is relatively limited, particularly in respect of understanding the factors that drive employment choice decisions. Aims: To identify what factors influence speech and language therapists working in the NHS to stay, and consider leaving, but not do so. To identify what features of the NHS and alternative employers influence speech and language therapists to leave the NHS. To identify why some speech and language therapists return to the NHS after working elsewhere. Methods & Procedures: A total of 516 male and female speech and language therapists, in three distinct groups (NHS stayers, leavers and returners) completed a questionnaire and gave responses to open-ended questions regarding their perceptions of the NHS and other employers. Qualitative data analysis identified reasons why individuals stayed in, left or returned to the NHS employment, and what actions could be taken by management to facilitate retention and return. Outcomes & Results: Stayers value job and pension security; professional development opportunities; the work itself; and professional support. Leavers not involved in childcare left because of workload/pressure/stress; poor pay; and not being able to give good patient care. Returners returned because of flexible hours; work location; professional development; and pension provision. Stayers and returners primarily wish to see more staff in the NHS, whereas leavers would return if there were more flexibility in work arrangements. Returners were particularly hostile towards Agenda for Change. Conclusions & Implications: Whilst some preferences appear to require increased resources, others such as reducing bureaucracy and valuing professionals do not. The full impact of Agenda for Change has yet to be established. Predicted excess labour supply of allied health professionals and future structural changes present pressures but also possible opportunities for speech and language therapists. (Contains 10 tables and 1 note.)