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Discussion

Applying talent management to nursing

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Talent management can be used to identify, recruit and develop individuals with leadership qualities in order to fill essential leadership roles

Abstract

To deliver the chief nursing officer for England’s vision for compassionate care and embed the 6Cs effectively, the NHS must attract, develop and retain talented nurses with a diverse range of skills. This is particularly important given the predicted shortage of nurses and evidence that NHS providers need to increase skill mix ratios to deliver safe patient care.

“Talent management” is increasingly discussed within the health service; we recently asked nurses and student nurses to identify their priorities for talent development. They highlighted the importance of strong ward leadership, effective personal appraisal, clearer career pathways, increased staff engagement and involvement in decision making, as well as a need for greater emphasis on the recognition and reward of nursing achievements.

We concluded that these factors are crucial to attracting, retaining and developing talent in nursing. Nurse leaders can learn approaches to developing talent from business and wider healthcare settings.

Citation: Haines S (2013) Applying talent management to nursing. Nursing Times; 109: 47, 12-15.

Author: Sue Haines is assistant director of nursing, nursing development, Nottingham University Hospitals Trust

Introduction

The NHS Leadership Academy recently launched its national leadership development programmes, in addition to two national nursing and midwifery leadership programmes (NHS Leadership Academy, 2013a).

The importance of talent management in nursing to develop the profession’s future leaders has been recognised for some time (Department of Health, 1999); maximising the potential of nurses’ roles to support innovation and change is a key driver in the NHS and the importance of ward leadership skills is recognised throughout the literature (Royal College of Nursing, 2009; NHS Institute for Innovation and Improvement, 2008; Burdett Trust for Nursing, 2006).

The Francis report (2013) identified the need for effective nursing leadership at all levels of the health service and highlighted the importance of the ward sister role for enhancing patient safety. People with the right skills and attributes need to be recruited in to these key clinical leadership roles (Francis, 2013).

The NHS Leadership Academy is undertaking a review and developing a new leadership model for the health service. The new model aims to respond to changes in healthcare delivery and to focus on the core values of the NHS constitution, including care and compassion (NHS Leadership Academy, 2013b).

The chief nursing officer for England and Department of Health nursing director have outlined a vision for nursing, describing a need for “the right staff, with the right skills, in the right place” (Cummings and Bennett, 2012).

However, it is important to also consider:

  • How talent management can help to achieve this vision by increasing the quality of clinical leadership at all levels, across all nursing career pathways;
  • What talent management means for nursing.

Talent management

Talent management has been defined as the process of attracting, developing and retaining high-potential and high-performing people (Blass, 2007). Despite some variations on this definition, its core components (Fig 1) and the need to directly align it with the organisation’s performance and ambitions are generally agreed on.

Within the NHS, talent management has mainly been focused at executive and senior management level (NHS Employers, 2010). However, current national healthcare strategies highlight a need to develop and maximise the workforce as a whole (NHS Leadership Academy, 2013a). There is evidence within the nursing literature of some components of talent management being used specifically in recruitment, retention, leadership development and succession planning (Brown et al, 2012; RCN, 2009; DH, 2008; Burdett Trust for Nursing, 2006).

As many nurse managers are reaching retirement age, there is a need to formally prepare future nurses leaders (Sverdlik, 2012), and identifying these leaders is an international workforce priority (Griffith, 2012). Some have criticised traditional models of “succession planning”, preparing for the replacement of individuals in key leadership roles over a period of time (Rothwell and Poduch, 2004). It has been suggested that in fast-paced work environments, roles change may not be part of longer-term business plans, or people may leave an organisation before benefits are realised. The literature suggests a more flexible approach to staff development using transferable skills, rather than the more traditional method

of succession planning (Heinen and O’Neill, 2004). Tansley et al (2007) point out that “talent management is a more dynamic process than succession planning, which makes it better suited to the uncertain environment facing today’s organisations”.

It is important to develop both leadership talent and “technical” or specialist talent, particularly when looking at nursing career pathways that include clinical academic careers, nurse education and advanced nursing practice roles (NHS Employers, 2011). It has been suggested that the culture of the organisation will affect how it approaches talent management (Tansley et al, 2007). For example, a highly exclusive approach, in which staff are selected into a top “talent pool” within an organisation, may not be suitable for a public sector service such as the NHS where there is a culture of equality (Fig 2).

An open and inclusive organisational approach is needed to release the full potential of the workforce (Clutterbuck, 2012) and a recent study showed NHS managers prefer an inclusive approach to talent management (Powell et al, 2012). There continues to be evidence of discrimination against black and minority ethnic staff in the NHS during recruitment, selection and promotion processes, with few represented in senior leadership roles. As Kline (2013) points out: “more of the same will not be good enough. There is a cost to the NHS in terms of talent not appointed and to patients deprived of care by that talent”. Talent management provides opportunities for organisations to address this.

Talent management in the NHS

The current NHS Leadership Academy’s approach to talent management focuses on inclusivity (Box 1).

Box 1. NHS leadership academy approach

“Talent management should consider all individuals in an organisation. It should cover the development they require, the value they bring, and the position(s) that best suit their skills currently and into the future within an organisation and/or elsewhere in their career journey. Talent and career development is necessary for the retention of employees no matter what their seniority and position within the organisation”

NHS Leadership Academy (2013d) 

The academy states: “Talent Management is all about nurturing our future and being the custodians of our NHS” (NHS Leadership Academy, 2013c). All staff and students in the NHS have an important role to play in delivering compassionate, high-quality, safe patient care and this needs to be recognised by investments in development and support.

Managers and employees are encouraged to have supportive conversations about continuing professional development within their current role and about maximising future potential (NHS Leadership Academy, 2013d). New development programmes include the Edward Jenner Programme, an open-access online leadership development learning package; this is designed for newly qualified staff but is open to everyone and focuses on essential leadership skills.

Case study - clinical nurses’ perspectives

As part of a research study, we set out to gather the views of nursing staff from all levels on what they define as nursing talent and what they feel is important to developing strategies to recruit, develop and retain nursing talent. The study included focus groups of band 5-7 nurses and revealed significant interest in talent management within the profession.

We found that ward sisters or immediate line managers play a key role in coaching, developing and enabling or blocking talent development, while more junior nurses recognised the importance of a meaningful and effective appraisal for personal and professional development.

Initial findings also support previous national work that shows many junior nurses are deterred from applying for ward sister posts by administrative pressures and a belief that they will have less patient contact (RCN, 2009). When analysing leadership roles, the potential benefits of a supervisory ward sister role must be considered, and the role definition, responsibilities and support systems must be clarified. There are also opportunities for exploring further support for nurses in career pathway planning and careers guidance, earlier identification of leadership potential, skills development and preparation for clinical leadership roles.

In acute trusts, it is an essential workforce priority to recruit and develop nurses who have the skills and potential to become leaders. Ensuring early “talent spotting” and encouraging ambition in students and newly qualified nurses is an important part of this and will also help with retention (Bulmer, 2013). There are further research opportunities to evaluate the processes used to recruit and develop employees to fill ward leadership roles and the impact this has on patient care.

Nursing talent

The nurses participating in the study found it difficult to describe what was meant by “talent” in the context of nursing. Their levels of awareness and understanding of nursing roles and career pathways varied considerably; the diversity of career pathways open to nurses results in a wide range of skills and abilities that many participants had not previously considered as “talents”.

The recruitment of caremakers - students and newly qualified nurses who act as champions and ambassadors for the core nursing talents defined in the 6Cs -identifies nurses with a passion for clinical leadership. There is an opportunity to involve more of the existing nursing workforce in such innovations to further enhance and identify clinical leadership talent in practice.

Our ongoing study is also showing a need for staff nurses to be more involved in decision making within the ward team. Developing an inclusive ward culture gives staff the opportunity to influence and pursue their specific interests and talents with recognition and support.

There is a need for greater emphasis on reward and recognition of nursing achievements and talents both nationally and locally, and a more positive media image of nursing to be promoted to attract and retain nurses.

Learning from other health systems

Inclusive approaches to staff development and retention are already being used in international healthcare settings.

The American Nurses’ Credentialing Centre Magnet Recognition Programme has made several changes throughout hospitals with the aim of developing, retaining and engaging direct care nursing staff (staff nurses) (ANCC, 2011). The programme includes implementing “shared governance councils”, a management approach that allows staff nurses to self-nominate to take responsibility for evidence-based practice, aspects of decision making and leading improvement. There is also significant investment in education, professional development and support for the nursing workforce, with staff nurses actively involved in decision making through staff-led councils (Luzinski, 2011).

A large-scale international collaborative research study identified Magnet Recognition as successful in transforming the organisation, improving the quality of patient care, patient and nurse satisfaction and nurse retention rates (Aiken et al, 2012). This evidence shows potential for similar programmes to be implemented elsewhere.

We have learnt from the Magnet hospitals’ example and piloted a shared governance council called a “unit practice council” in an acute admissions ward. The UPC is chaired by a newly qualified staff nurse and provides opportunity for leadership development and for staff to be more involved in decision making. This is the focus of a practice-based development and research programme supported by the Foundation of Nursing Studies and the General Nursing Council for England and Wales Trust (Dinning et al, 2012). We plan to roll out further UPCs across two clinical directorates.

Relevance to nursing

The CNO for England has set national nursing leadership priorities, which include:

  • Providing effective clinical leadership,
  • Establishing the evidence base for practice
  • Developing clear nursing career pathways to maximise strengths in clinical practice, research, education and nursing management, supported with preceptorship and education (Cummings and Bennett, 2012).

There is also recognition of the importance of improving public perceptions of nursing, both to increase public confidence and enhance understanding of the role nurses play in modern healthcare settings. With predicted shortages of nurses, students with the right values and behaviours to complete their nurse training successfully must be recruited, and newly qualified nurses need to be offered opportunities to develop in an increasingly competitive and global market (Centre for Workforce Intelligence, 2013; RCN, 2013).

Reviewing talent management processes within nursing is a good opportunity to analyse how we define “talent”, recognise how organisational cultures affect talent development, and understand and address discrimination. Talent development is often seen as part of separate management practices, such as recruitment and selection and leadership development, and not necessarily part of overall organisational strategic objectives (Heinen and O’Neill, 2004).

Conclusion

Talent management describes a complex range of processes that aim to place the right people in the right positions within an organisation. There is a lack of research and no internationally agreed definition or approach to this; a recent US study identified that the best healthcare systems invest in talent management to meet business objectives (Groves, 2011).

The NHS Leadership Academy aims to use talent management to maximise the potential of all NHS staff and offers a selection of leadership development programmes. All nurse leaders have a role to play in identifying, coaching and developing nursing talent from students, healthcare assistants and staff nurses to senior nurses.

New approaches to developing staff potential could be identified through further research of more devolved approaches to nursing management and through shared decision making. Shared governance models provide one approach to increasing frontline staff engagement and involvement, changing leadership culture and valuing each individual’s potential and strengths for the benefit of patient care. Talent management provides exciting opportunities for nurses to innovate, influence and learn from wider healthcare and business settings.

Key points

  • “Talent management” us a range of processes to attract, develop and retain staff
  • Effective leadership is needed at all levels of healthcare delivery
  • There is a predicted nursing shortage and attracting, developing and retaining nursing leadership talent is a priority
  • Talent management is not widely researched in nursing and there is opportunity for further study
  • Shared governance councils offer a way to involve and engage more junior nursing staff in leadership development and decision making
  • 3 Comments

Readers' comments (3)

  • I can see a lot of positive points in this article . I often feel the culture in nursing , certainly what I have witnessed, is a culture in which nurses are expected by Managers to 'shut up and put up 'with the situations in the work place as they are. On the surface manager appear to be encouraging professional devopment as a box ticking excersice but I feel they avoid the enouragment of feedback , innovative thinking or dicussions of staffs concerns and issues for the fear of loss of control . The managers need to have the confidence , skills and genuine commitment to the place of work to be able to allow staff to act autonomously and give them the oppotuity to become leaders. Instead it feels as though they need to keep at tight hold on staff an keep them in their places instead of allowing some talent to flow .

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  • A grade 8 nurse I come from a wider 'healthcare and business setting with skills in 'leadership, effective personal appraisal, clearer career pathways, increased staff engagement and involvement in decision making, as well recognition and reward of nursing achievements' . I was prepared to take a major salary cut to get back to a teaching/nurse role. I was offered a job with a salary significantly lower than many of the nurses for whom I would be responsible. I politely said no thank you much to the managers annoyance. I value myself and was pleased to see that my colleagues admired me for 'standing up for myself'. The little extra money that would have tempted me into the role has been spent 10 times over through re-advertising and delayed service launch. How short sighted?

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  • makes sense

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