Meeting the staffing challenge

Director of Nursing (Improvement) for NHS Improvement explains the expanding support offered to Trusts in order to improve retention rates of the workforce and deliver the right care to patients:

As a hospital Chief Nurse, the role was dynamic and hugely rewarding. I loved it.

The staff, patients and what we did for our community was amazing. It was a huge privilege to lead this team.

I was often asked ‘what kept me awake at night’ and I always gave the same answer: staffing.

Keeping our patients safe was priority number one but key to this was having the right information and systems at my disposal to understand the problem and solutions. Even with a significant amount of information and innovation at our disposal, it still came down to practically having the numbers on the day to do the job.

The challenges on staffing are significant and I know that clinical and managerial colleagues move heaven and earth each day to ensure that they do the right thing for their service, be it a hospital, community service or a general practice. Many of our staff would step in to do extra and support colleagues, but we still had to make tough decisions. I would see tired and fed up colleagues, and as a leader you’re expected to know all the answers. It was only fair that I should take on some of their frustrations, but you do share their frustrations.

However, even in the toughest of times, I was always struck by the commitment and focus of the teams to get care right and support their colleagues. The sense of team was a powerful influence and one that I used to draw great energy from, and why nationally #teamCNO is about inclusion and recognising that, as a group, we have a greater chance of delivering change.

We take on leadership roles to make a difference and nationally that’s the same. Our new CNO, Ruth May, has made it a priority that staffing remains on the national agenda and through the NHS Long Term Plan we can deliver changes that are much needed on the frontline.

Every conversation we have with frontline staff and leaders centres on the challenges about workforce and it’s not just about nursing roles. One of the key areas we can all play a role in is the retention of our staff.

As part of our commitment to support providers with this critical challenge, we launched our Retention Programme in partnership with NHS Employers in June 2017, with the aim of developing and implementing improvement measures to drive the retention of our clinical workforce. In the last 20 months, the programme has created a platform for trusts to share ideas and resources to address the various drivers of retention. In addition to this, we have worked alongside 110 trusts to develop or refine local retention strategies through our Direct Support Programme.

The sector is addressing rising turnover rates and has reversed trends and delivered the lowest rates in the last four years. The commitment from senior nursing and workforce leaders has been remarkable and is evidenced through their achievements to date.

Within our first cohort of the Direct Support Programme (35 trusts), we have seen trusts achieve on average a 1% improvement in their turnover rates in the first eight months of the programme. This improvement has helped to drive a national improvement in nursing turnover rates of 0.5% in the first eight months of the programme

Based on the positive feedback we have received to date and in order to support trusts to go further on improving retention, we will be:

  • Extending our Direct Support Programme offer to all trusts to improve retention; we are currently working with a further 35 trusts to refine or develop retention strategies.
  • Providing regular data packs to trusts to show trends in turnover in comparison to peers, as well as how trust-level reasons for leaving and age profiles of leavers are changing over time.
  • Providing additional support within specialised areas where the need is greatest, including high secure hospitals and support to 15-20 emergency departments.
  • Continuing to facilitate better sharing of ideas and innovations via our masterclasses and our new Retention Improvement Hub. Both offer practical resources and case studies to help NHS organisations to improve turnover.
  • Including a major focus on workforce and retention at the 2019 CNO summit on 13-14 March.

We recognise that retention is a complex area and it will take some time to implement longer-term, sustainable improvements. However, these early gains represent a great start to this crucial challenge. There is still a long way to go, so your commitment to retaining the workforce within your organisation is paramount.

We look forward to welcoming you to the 2019 CNO summit where we value your thoughts and views on improving retention of our amazing NHS staff.

If you haven’t booked your place for the 2019 CNO Summit yet, please book now to guarantee your place.

Professor Mark Radford

Mark Radford is currently Chief Nurse of Health Education England and Deputy Chief Nursing Officer for England. Mark led the national NHS vaccine workforce programme, ensuring success in phase one, with the delivery of 15 million vaccinations. The programme recruited and trained over 250,000 people including 90,000 clinicians and 70,000 volunteers, in a few months, to launch one of world’s fastest programmes. He also led the deployment of student nurses in the wave one and two pandemic response, with 71 universities in England.

Mark has led other major NHS, workforce policy and delivery programmes as National Senior Responsible Officer for domestic supply for the government’s 50,000 nurses manifesto commitment, led the expansion of 5,400 additional places at universities and 7,700 additional placements in the NHS to support expansion.

Mark qualified as a nurse in 1994 and has previously worked in anaesthetics, preoperative assessment, perioperative care, critical care and A&E in the UK and Europe. He was a Consultant Nurse in Perioperative Emergency Care and worked as an advisor to the Department of Health, the National Confidential Enquiry into Patient Outcome and Death, the Medicines and Healthcare products Regulatory Agency and The National Institute for Health and Care Excellence on a range of areas including perioperative hypothermia, emergency management and nurse prescribing.

He is also a Professor of Nursing at Birmingham City University and Coventry University, with research covering emergency care models, advanced practice, staffing, risk modelling, clinical decision-making, expertise and sociological issues in healthcare.

He has published widely on advanced practice nursing and perioperative care.