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Retention, retention, retention

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Jess Henry, Head of Leadership, Learning and Development at Somerset Partnership NHS Foundation Trust, talks about the workforce challenge of the moment, and how her organisation is using the Questback feedback platform to help.

jess henry

Workforce has become one of the big issues facing the NHS. Over the last six months, we have seen national figures worrying about the outflow of EU workers, the ageing workforce, the linked potential loss of experienced staff, and the number of people who leave early in their careers.

Professor Ian Cumming, the Chief Executive of Health Education England, told the NHS Confederation’s last annual conference that there are partial solutions to these problems, starting with an increase in training places.

But they will not work unless we keep the people we have got. Suddenly, the mantra is: “retention, retention, retention.” Except that retention is not suddenly an issue for us; it’s one that has been with us for a long time.

National and local challenges

We are a community and mental health trust, and we have some of the challenges that are being seen nationally.

For example, we have some specific issues around the mental health nursing workforce. There are significantly fewer mental health nurses than there were five or six years ago, and you cannot just go and recruit them from abroad.

We have also got some local, geographical issues. There is no university in Somerset, so people leave for further education and they don’t come back again. We attract psychiatry trainees – we have got one of the best ratings in the country for our training provision – but our conversion rate, the number of trainees who take up opportunities for posts, is low.

People move on to Bristol or Birmingham or London to further their careers. We are part of the South West Peninsula, so people have to make a conscious decision to move here or stay here.

Even then, the road system isn’t great. It’s not too bad going north to south on the motorway, but it’s very difficult to travel east to west. In some parts of the country, people can be based in one area but choose to work for a variety of trusts. That’s just not the case here in Somerset. ~

Engaging with staff across more than 80 sites

One of the reasons we wanted to work with Questback was to use its online community feedback platform to find out from our staff what is unique about us. What is it that we can do that nobody else can do?

We also wanted to show them that we are committed to their health and wellbeing, and to encourage them to feel that we are all part of one organisation.

I also work in the district general hospital sector, doing so in a large hospital setting means you can walk around or put up a few signs or organise a meeting, and people will see you. Somerset Partnership has more than 80 sites. Thirteen are community hospitals, but even some of these are not that big.

So, you can’t engage with people in the same way; if I tried, I’d spend my whole-time driving. We felt Questback could help us by enabling us to share information with people and by encouraging them to respond to that.

One platform, many engagement opportunities

Questback is going to deliver our patient Friends and Family test, a national patient experience survey, and we are already using the platform to do our staff Friends and Family Test. We will also use it for the NHS staff survey.

One of the good things about the Questback solution is that it links into the NHS Electronic Staff Record, so you can run analysis by staff group or geographical area. So, the next time we do the staff survey, we won’t just produce a trust action plan; we’ll be able to draw up a series of action plans that address specific issues for specific staff.

We hope that will help people to feel that they are working for an organisation that understands what their problems are. If we can’t address them immediately, at least we will be able to show that we know they exist and that our plans will take them into account.

We also want to use Questback for exit interviews and for what Questback calls ‘onboarding’ – that’s contacting people a month after they join, to say: ‘why did you choose us’, and ‘have you had your induction’ and ‘how useful was it’?

Then you can follow-up in three months or six months, to say ‘are you getting what you hoped from the job’ and ‘how useful did you find the training’ and ‘how have you settled in’? We want to spot where there are tensions in the system.

Exit interviews can help, but by then, people have already decided to leave. We want to know if there are problems brewing. We also want to set up staff discussion groups.

Northern Devon Healthcare NHS Trust, which also uses the system, has done a lot in this area. It has discussion groups for specific teams, such as community nurses, and for specific processes. But it also has more social groups on surfing, or cycling, or whatever. We don’t have them yet, but it’s something we think we could really build on.

Action needed at every level: national to local

Of course, it’s only part of the solution. We need to look again at pay. But that’s only part of the picture.

We have never had an issue recruiting nursing assistants, but recently a couple of supermarkets have opened in our area, and people have gone to work there. Our nursing colleagues are disgruntled and you can understand it, because when you look at a band 5 nurse, and what they do, and the level of responsibility that they have, they just don’t earn enough.

That’s a national, strategic issue. Locally, we are working with our partners to try and address our shared recruitment challenges for example joining forces to try and bring a university offer to Somerset.

Within Somerset’s Sustainability and Transformation Plan, we are also working collaboratively with our county council and district general hospital colleagues to explore whether we can create rotational opportunities for colleagues to work between organisations. For example, someone might come to work in a community hospital, but get the chance to work on a district hospital site, to gain some additional experience or do a more varied job.

As an organisation, we are very committed to development; not just Masters courses but ongoing supervision and appraisal. We know that, at the moment, senior people are so busy that they end up doing shifts, and then supervision goes out of the window. We want to put resources into making sure that it happens, so we can say to people ‘we are committed to you’.

Many parts, one whole

Having said that, we think Questback will be an important part of the picture. Our geography and our roads make it so hard for the people who work for us to feel like they are working for one organisation.

We think Questback’s digital solution will help us to promote the idea that while we are lots of individual units, we are also parts of one organisation. And that we will be able to look at the staff survey, and the friends and family test, and spot surveys, and see if there are challenges or things that need improving.

The platform should give us data that will point us in the right direction, in a way that is just not possible at the moment.

About Jess Henry: Jess Henry has more than 20 years’ experience of working in mental health services, most of it in the South West. She joined Somerset Partnership NHS Foundation Trust in June 2006, working in Learning and Development and Organisational Development and is responsible for the roll out of the Questback system.

About Somerset Partnership NHS Foundation Trust: Somerset Partnership NHS Foundation Trust employs c4000 staff and has a turnover of £169 million. It runs 13 community hospitals, nine inpatient mental health wards, seven minor injuries units, four dental access services, and a wide variety of services from GP practices, clinics – and people’s homes. The trust makes 1.1 million patient contacts a year.

About Questback: Questback is a global leader in staff and patient feedback technology, helping organisations to improve staff engagement and retention, thereby reducing workforce costs, increasing productivity and improving patient experience. Our technology is used in applications such as Freedom to Speak Up, Staff Friends and Family Test, Patient Friends and Family Test, Annual NHS Staff Survey and more. We work with companies like John Lewis Partnership, Swiss, Lufthansa, across the globe to support them to change their cultures, increase engagement, improve outcomes and meet challenging corporate objectives.


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