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Trusts urged to ‘think imaginatively’ to retain nursing staff


Nursing directors and their trusts have been urged to think about whether they can do more to improve clinical staff retention rates, especially for nurses and mental health workers, with the launch of a new tool.

NHS Improvement has today launched a new guide designed to boost staff retention within the health service, which forms the latest part of its work in supporting trusts to cut workforce turnover.

“Clinical workers are the NHS’s greatest asset”

Ruth May

It said, as well as improving care quality and outcomes from workforce stability, keeping hold of staff would also help trusts reduce their vacancy rates and lower their need to use costly agency workers.

To “help the NHS get better at keeping” its workers, it has created a new “improvement resource” that outlines seven essential steps every organisation should take to improve its staff retention.

Issues covered by the resource include advice on reducing variation in working environments, empowering staff, and tailoring roles to match the different stages of worker’s career.

The guidance – titled Retaining your clinical staff: a practical improvement resource – also features “innovative and proven” approaches to improving staff retention being used by NHS organisations.

For example, Buckinghamshire Healthcare NHS Trust reduced turnover by 2% in the past 12 months by introducing targeted “itchy feet” programmes and discussing development options with staff aged over 50.

Meanwhile, Sandwell and West Birmingham Hospitals NHS Trust has reduced nursing turnover by 3% in the past 12 months, with more effective staff engagement, an “exciting” career development offer and an “innovative” offer on staff benefits.

“We have distilled our advice from interviews with trust HR directors, directors of nursing and medical directors”

NHS Improvement

A further case study highlighted in the guide was Wrightington, Wigan and Leigh NHS Foundation Trust, which uses an online survey to capture real-time feedback on how staff are feeling about their work and “provide timely insight on the drivers for turnover”.

These examples reinforce the anecdotal evidence that it has seen during its work on improving staff retention at trusts in the first two cohorts of its Direct Support Programme, said the regulator.

For example, the organisations with the lowest staff turnover rates are those that have developed ways of promoting positive physical and emotional wellbeing for their staff.

NHS Improvement said it was now calling on all trusts to “think imaginatively” on what they can do encourage their staff to stay with them, and then “take action” where necessary to make it happen.

The guidance stated: “This improvement resource outlines key steps to improving retention of clinical staff. We have distilled our advice from interviews with trust HR directors, directors of nursing and medical directors.

“We recognise that no one action will boost retention on its own – sustained action in several areas is needed. We also know that external factors like private sector wage growth, the strength of the pound and the increasing demands of a clinical role in the NHS all make it difficult to retain staff,” it said.

“But there are factors in trusts’ control and trusts are exploiting these in their efforts to improve retention. These factors are covered in this resource,” said the document.

Such factors included enabling flexible working, providing clear career progression and the ability to adapt roles as staff get older, noted the regulator.

NHS Improvement

Nurse staffing shortage is ‘top priority’ for regulator

Source: Kate Stanworth

Ruth May

In her introduction to the guide, Ruth May, executive director of nursing at NHS Improvement, urged all trusts to “think about how you can further play your part in helping the NHS retain our staff”.

She suggested that trusts should begin by asking themselves three questions – including did they know why their staff left and stayed, what mechanisms were in place to engage and empower staff and how could they be sure that staff were aware of retention initiatives?

She added: “Patients’ deserve good quality, reliable care that meets their needs from the NHS, and the best way of achieving this is via the service’s talented and dedicated staff.

“But, we, local and nationally have to make it easier for our staff to want to do this for the long-term,” she said.

“Clinical workers are the NHS’s greatest asset which is why we’ve developed an intensive support package and resources for organisations, so they can take the steps needed to keep our valued staff,” she said.

The guidance forms part of NHS Improvement’s towards trying to achieve an improvement in the number of nurses and other NHS clinical staff leaving the health service in England by 2020.

It warned that staff retention was becoming “harder than ever” across the NHS and was seen by some nurse leaders as more challenging than getting students onto undergraduate nursing courses.

The regulator highlighted that the latest operating plans submitted by both NHS trust and foundation trusts showed there were around 36,000 registered nursing and midwifery vacancies.

In response, NHS Improvement has created a major three-year programme to support improvement in clinical staff retention within trusts in England.

The initial focus of the Direct Support Programme has been nurses and mental health staff, which have some of the highest leaver rates across the NHS, noted the regulator.

It has been working directly with all mental health trusts and also with acute trusts and community trusts with the “biggest challenge around nursing retention to see where it can bring this down”.

The first cohort taking part in the programme, comprising 35 trusts, has now completed its work and a second is underway involving a further 40 trusts.

Trusts receiving the targeted support are expected to assess their situation, identify where they can they make changes and implement sustainable benefits for staff.

Among the organisations receiving targeted support are over 50 mental health trusts. The regulator is aiming to keep 6,000 clinical staff currently working in mental health in the NHS by March 2021.

Similar but separate work is also being carried out by the organisation NHS Employers. As reported by Nursing Times, during the autumn it published a new guide about how organisations can reduce staff their turnover, which particularly highlighted the need to offer training as a way of improving nurse retention.


Readers' comments (8)

  • My ex trust would know a good idea if it smashed them in the face. Elimination of parking charges and responding to staffing concerns would be a start. Rather than robbing staff especially in areas known for non existent transport and non clinical bedmanagers berating staff to clear beds. In effect expecting staff to treat patients no better than bags of spuds!

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  • As a nurse just about to retire, I can honestly say I would think twice about choosing the same career again today. Internal rotation is so un-family friendly and the rotation is often within the same week! Nursing has never been family friendly but is worse now than when I was a young woman.

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  • Agree with both the above comments.

    A letter has just appeared on our staff room wall saying that if we need paracetamol or brufen we have to go and buy them from the pharmacy. Absolutely right if you are at home but if you get a headache, back ache sore throat whatever whilst at work where is the harm in treating with a painkiller and soldiering on.

    Is there any wonder nurses are leaving what was once a proud profession.

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  • Returning to practice after a break I am wondering what has happened to nursing. In the community it is culturally acceptable not to have a break and to take paperwork home and to finish late. There may be regional differences but certainly in the north this is the case. I hoped community nursing would be more family friendly, but unfortunately I have resigned after a short time and feel very dissapointed as hoped returning to practice would be fulfilling and enjoyable.

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  • Nursing is this country is about belonging to a group be it from this country or from abroad. If you do not fit in any of them, you will have no opportunities for anything in this job other than to be seen as a pair of hands. I went to an interview for a higher band (6) and during the interview, I told the panel that all the courses of CPD that I have done were self-funded. I do not think Managers in the NHS like people who take their own initiative to study, they feel them as threats rather than an asset to patients care. I was shocked when one member of the panel told me that the courses or CPD are meant for revalidation only and nothing else. I have been 23 years in this profession and I still go to college to do my courses every year. When I hear lecturers and students talk about old nurses who are trapped with revalidation and having to take courses, this makes me wonder that in such a country as UK, there is age discrimination. I see so many of the nurses after a year of qualification taking managerial posts, may be they have the merits, however seeing the chaos of how situations are managed, may be we should look into thinking of other people who have the skills but because of group appartenance does not get anywhere.

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  • One Trust which constantly advertises on the NHS Website for nurses in one particular department. Having worked in that department, staff do not stay long because of the attitude of the Manager. Top management knows about it but they still tolerate the unethical behaviour of this manager. Recently, I noticed that they have advertised for a retention manager paying a starting salary of £50K. I want to know, instead of wasting this money or may be they are creating job for somebody that they want to give such a salary, if they had looked into the style of management of certain people, it would have been more beneficial. Nurses go to work and have to bear with many difficult situations and the culture in nursing is that managers must make some nurses lives unbearable. Many times while on duty, the team leaders and the Manager will go on break but do not even care to relieve the band 5. I went without a drop of water from 8 am to 15h 30 while they have been on two breaks. Is it because of short of staff, so how come some can have breaks and others not? Will the retention Manager be able to deal with such issues? He/She will be sitting comfortably with a cup of tea/coffee/green tea and then write policies about staff well being to be filed nicely on the shelves or advertised on the intranet. On top of that, one of those mangers has just been nominated to be among the panel for staff retention!

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  • Well they could think imaginatively about cutting down hours. I have just packed in my job at the age of 63 because I cannot work 10+ hour shifts anymore. By the end of the day I can hardly walk because my legs have swollen and I am starting to fall asleep. It's even worse on the wards where they are expected to work over 12 hours at a time - how can anyone function efficiently by the end of such a long day/night? I seem to recall some years ago the government saying that flexible part-time working hours should be encouraged in order to get more women with families back into the work force, instead of which things have just got worse.

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  • Some of the management couldn't imagine their way out of a wet paper bag. I would imagine.

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