It’s people that are at the heart of the NHS

Our NHS is about people – patients, their families and loved ones and of course, the people who work in it.

When I speak to colleagues who have chosen to work in the NHS, whatever challenges they face, they always put their patients at the centre of everything they do. In return, we must put them at the centre of everything we do.

Creating environments where colleagues feel valued and respected, work in ways that support them and help them understand what benefits their workplace has to offer, is key to improving culture, leadership and wellbeing. It will also help ensure fewer staff leave the NHS over the next 15 years, as set out in the NHS Long Term Workforce Plan.

It is therefore important we make the People Promise – which was created by thousands of staff who were asked what they felt would make the NHS feel like a great place to work – a reality for everyone.

2023 National Staff survey results

This year over 700,000 people completed the staff survey – more than ever before. This is the third year the results have been aligned with the People Promise and as such the survey provides invaluable insight into our colleagues’ experiences across the NHS.

It is really encouraging that all People Promise elements that can be reported on have improved for 2023 with four of the six People Promise elements showing notable improvements compared with 2022.

Whilst great work is happening, there is always room to do more and make staff experience the best it can be for all of us, regardless of where we work.

People Promise exemplars

Significant progress has been made in the People Promise exemplar programme.

The People Promise exemplars are 23 organisations NHS England is working intensely with to deliver a bundle of interventions, influenced by their staff, set out in the People Promise, to respond to feedback, improve outcomes and achieve optimum staff satisfaction and therefore retention.

In this year’s survey, our exemplar organisations saw their staff engagement and morale scores improve at an increased rate compared to other organisations in the benchmark group and the NHS average. In 2023, 16 exemplars saw improvement across all of the People Promise elements, an improvement from six exemplars in 2022.

The leaver rate has also improved faster across the exemplar organisations participating in the programme over the past year. Collectively we estimate an additional 2,000 FTE colleagues were retained over the 12 month period.

To help accelerate the spread of best practice, a second cohort of exemplars; over 100 organisations including primary care and ambulance trusts, were enrolled onto the Exemplar Programme so we can retain more of our skilled, talented and experienced people.

They will implement interventions aligned to the People Promise, to help support staff in ways such as the following examples:

Lancashire and South Cumbria NHS Trust has been urging staff considering leaving the trust to have confidential catchups with ‘Stay Advocates’, who help identify ways to improve their working life and prevent them from leaving being the only option. The informal chats lead to, for example, staff being offered training for new skills and changes to working hours. They have seen reductions in both their leaver and turnover rates.

Buckinghamshire Healthcare NHS Trust has implemented a suite of interventions centred around elements of the People Promise, aimed at improving overall experience, engagement and retention rates. To support flexible working, jobs are now advertised with flexible working opportunities and prospective employees are now encouraged to request this at interview stage. The trust has also provided a cost-of-living support package which includes a brochure sent to every employee’s home detailing support available locally and nationally, webinars and details of a hardship fund.

At United Lincolnshire Hospitals NHS Trust improving flexibility has helped staff stay and stay well, reduce turnover and agency spend. The trust advertises flexibility in all their roles and includes flexible working within their recruitment training for managers. Thanks to new functionality within the electronic staff record to simplify their flexible working requests, they received triple the number of requests, over 600 in the first year, with a 98% approval rate. They have also saved over £9 million in agency spending in the current financial year in correlation with improvements in retention.

Taking a focused approach through the People Promise Exemplar Programme means we can put our staff at the centre of everything we do, and ultimately, provide better care for our patients. Please don’t think that if you aren’t in the Exemplar Programme cohorts, you must wait, there are plenty of resources available on NHS England’s retention hub. The smallest of changes can have the biggest of impacts if we really listen and respond to what colleagues need.

Photograph of Professor Em Wilkinson-Brice

Em Wilkinson-Brice is the Director of Staff Experience and Leadership Development at NHS England. Em qualified as a nurse in 1992 in Exeter. She was appointed to NHS England in September 2019 following roles spanning over 30 years in the NHS bringing clinical operational experience, working at executive level as Director of Nursing and Facilities at Derby Hospitals NHS Foundation Trust.

Em returned to Exeter in July 2010 where she undertook various executive roles alongside the Chief Nurse role, including Chief Operating Officer, Deputy Chief Executive and lead for integration across Devon. In recognition of the close working partnership between the Trust and two local universities, Em was awarded Associate Professor Faculty of Health and Human Sciences at both Exeter and Plymouth Universities.

Em has a keen interest in people and workforce, health and wellbeing, staff experience and organisational culture. She led on responding to the national workforce challenges of Covid-19. Em remains a practicing nurse and has a Master’s Degree in healthcare management and became a Chartered Fellow of the Chartered Institute of Personnel Development (CIPD) in 2022.