Mortimer: Waterproofing the NHS workforce

With the NHS facing worker shortages, tight budgets and major recruitment issues, Danny Mortimer, chief executive of NHS Employers, explains how organisations can go about retaining talented staff.

Workforce shortages within the NHS have long dominated the headlines, as concerns over pay and conditions, increasing service requirements and longer working hours continue to be reported.

Recent analysis from the King’s Fund has also shown that the number of nurses employed by the NHS has fallen for the first time on a year-on-year basis since 2013.

While reduced levels of international recruitment are an important supply side factor, the NHS needs to work harder than ever to make sure it is able to retain a talented workforce in the immediate term, as a stable workforce is associated with better patient outcomes, and recruitment and training of new domestically sourced staff will naturally take time.

There have been some significant national steps to support retention with moves to improve the availability of affordable accommodation for NHS staff, and we have been given real hope for an easing of pay restraint following an announcement from Jeremy Hunt in October.

But other national workforce challenges remain – not least the need to reverse the disinvestment we have seen in continuing professional development (CPD) funding.

Our members are clear, however, that while this national support is very welcome, they need to deliver action in their organisations to reduce rates of staff leaving the NHS. With this in mind, NHS Employers recently published a guide to staff retention, aimed at providing clear and succinct information to help trusts to take rapid action.

Knowing your organisation inside out

The guide is the result of work with 92 NHS organisations over the course of 2016 and 2017, and the overarching message is that there is no one-off action that will solve all retention issues; rather, it is a question of finding the right balance from a bundle of best practice for an individual trust.

At the heart of the advice NHS Employers has given is the need to know properly the ins and outs of your own organisation. What is your workforce data telling you? For example, what do staff surveys or appraisals reveal? What needs to be discussed with staff and managers? Is there higher or lower turnover in certain areas? It’s essential to be able to drill down into this information as far as department or staff group.

Having an open dialogue with the workforce and regularly engaging with staff is also extremely important, as it helps employers understand why people choose to remain with an organisation and how they can become an ‘employer of choice.’ Our focus on the importance of CPD funding stems directly from the feedback given to employers by their people and teams.

Of course, some turnover is indeed beneficial, and can help to make organisations more dynamic and better able to support career progression for individuals. The key is in making sure turnover rates do not become unmanageably high, which can in turn affect continuity of care.

It’s not about reinventing the wheel; it’s about making good use of the solutions and supporting resources and best practice that are already available.

For example, when considering the ‘lifecycle’ of an employee, it’s important to start at the very beginning with robust recruitment and induction practices, making sure staff feel supported and secure from the outset so that they are more likely to remain with the organisation for a longer period of time.

Creating a positive environment

The retention guide looks at the work East Kent Hospitals University NHS FT has done in this area. In 2015-16, the trust identified a major issue: a high number of staff were leaving in their first year of employment.

It therefore began work to improve the experience of staff in their first year, including values-based recruitment, increasing focus on attracting the right staff, creating an online portal for new starters to engage with them before they joined, and building a strong local induction programme.

As staff move through their careers, providing solid pathways for development is another way of making them feel valued, supported and professionally fulfilled, alongside good relationships with management, with regular appraisals and one-to-one meetings.

Organisations could follow the example of Buckinghamshire Healthcare NHS Trust, whose work on using data to improve nurse retention saw the creation of a series of 12 focus groups with existing nurses to identify the reasons they were leaving. These included poor line management, poor work/life balance, lack of professional development, and lack of appreciation.

As a result of this work, the trust also created an ‘itchy feet’ programme, making it easier for staff to move around the organisation internally before it advertised a role externally.

Retirement support

There is also a need to support staff at the other end of their employment journey, including the use of flexible retirement options to retain staff and their skills for as long as possible in the final years of their working lives.

Flexible retirement options can support overall workforce planning. Initiatives incorporating these options into flexible working procedures, providing staff with enough information, encouraging them to attend pre-retirement workshops and ensuring line managers are aware of the options can all contribute to strong staff retention.

Another cohort of 30 organisations are receiving more targeted support from NHS Improvement, and their analysis reinforces the importance of the actions identified above.

Fundamentally, of course, strong staff retention comes about as a consequence of creating a positive workplace environment where staff feel appreciated and supported, and where values are well-understood and shared across the organisation.

The upshot is that while the challenges facing employers are numerous and difficult, with the right approach and with some national support too, especially in funding for CPD, the outlook can be improved.




There are no comments. Why not be the first?

Add your comment


national health executive tv

more videos >

latest healthcare news

First patient receives blood plasma treatment at Guy’s and St Thomas’ NHS FT

06/07/2020First patient receives blood plasma treatment at Guy’s and St Thomas’ NHS FT

As part of a major ongoing coronavirus clinical trial, Guy’s and St Thomas’ NHS Foundation Trust has given its first patient an ... more >
NHS to launch online coronavirus rehabilitation service

06/07/2020NHS to launch online coronavirus rehabilitation service

Sir Simon Stevens has announced the launch of a new on-demand recovery service to support the tens of thousands of people who are suffering long-... more >
NHS and St John Ambulance to recruit thousands of ‘NHS Cadets’

06/07/2020NHS and St John Ambulance to recruit thousands of ‘NHS Cadets’

As the NHS celebrated its 72nd birthday, the NHS and St John Ambulance are joining forces to recruit and train thousands of ‘NHS cadets&rsq... more >

the scalpel's daily blog

NHS at 72: Managing mental health services going forward

03/07/2020NHS at 72: Managing mental health services going forward

Sean Duggan, Chief Executive of the Mental Health Network Let’s take this opportunity to reflect on the amazing achievements of our health system over the past few months. But as we recognise the best of the NHS and its response to the Covid-19 crisis we must not forget that for mental health the peak has yet to come. Covid-19 has placed enormous pressure on the entire health and care system. Despite the very real hardships f... more >
read more blog posts from 'the scalpel' >


Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

24/10/2019Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

Today, speaking at the Royal College of General Practitioners (RCGP) annual conference, Matt Hancock highlighted what he believes to be the three... more >
NHS dreams come true for Teesside domestic

17/09/2019NHS dreams come true for Teesside domestic

Over 20 years ago, a Teesside hospital cleaner put down her mop and took steps towards her midwifery dreams. Lisa Payne has been delivering ... more >
How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us th... more > more last word articles >

editor's comment

26/06/2020Adapting and Innovating

Matt Roberts, National Health Executive Editorial Lead. NHE May/June 2020 Edition We’ve been through so much as a health sector and a society in recent months with coronavirus and nothing can take away from the loss and difficulties that we’ve faced but it vital we also don’t disregard the amazing efforts we’v... read more >

health service focus

How NHS Property Services adapted to a new way of working

01/07/2020How NHS Property Services adapted to a new way of working

From May/June 2020 edition Trish Stephen... more >
Cleaner, greener, safer media: Increased ROI, decreased carbon

12/06/2020Cleaner, greener, safer media: Increased ROI, decreased carbon

Evolution is crucial in any business and Nati... more >