Loss of staff through medical retirement has significant cost implications for annual police budgets. Research on medical retirements was combined with work on the management of sickness absence because the two are closely related. This study comprised four main components: a literature review and secondary data analysis; postal survey to all forces; telephone interviews with personnel and occupational staff; and focus group discussions about local initiatives. Force responses indicated that there were 20 forces undertaking specific initiatives to reduce medical retirement costs. Techniques included greater use of restricted duties, development of leaving schemes, and more stringent controls on the medical retirement process as a whole. The issues to consider when determining the benefits of retaining any individual in a restricted post are priorities, equality issues, cost implications, reviews, managing staff wishes and needs, and changes in sickness absence levels. One of the leaving schemes is the “Leaving with Dignity” scheme which provides career counseling and outplacement services to officers wishing to leave due to lack of motivation with their job. Many forces revised their policy documents to define stricter criteria for medical retirement and speed up the retirement process for those officers who remained on long-term sick leave. The Force Medical Officer (FMO) is responsible for providing medical advice on management decisions, and is therefore vital to maintaining tight control of the retirement process. The main legal issue surrounding the eligibility for medical retirement revolves around the definition of “permanent disablement” and “ordinary duties.” Actions to reduce costs should include: exploring options for restricted duties prior to considering medical retirement; actively using sickness monitoring groups; claiming back the cost of the referee’s fee where an individual loses the appeal; and implementing a structured process of review following retirement. 8 references