When talking about the People Promise, retention, and culture, I often hear ‘Oh, you do the soft stuff’. On the contrary, there’s a hard business edge evidenced through the correlation between staff engagement, productivity, and retention. It’s also genuinely hard work to create lasting improvements to working culture.
As part of my role as National Director for People, I regularly spend time working clinically as a nurse in a provider trust. In my clinical role I’m privileged to hear colleagues and teams talking about what matters most to them, which tends to include flexible working, health and wellbeing, a sense of belonging and what’s happening to create a different environment in their workplace.
These themes are of course represented within 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.
In my previous blog, I said we’d be sharing progress against actions we’d recommend at organisation and system level. Since then, NHS England’s National Retention Programme Team has been using the People Promise as its overarching framework, together with an insatiable curiosity to truly listen to colleagues across the service. The adoption of a continuous improvement approach has been vital, working across organisations, systems and regions to ensure data is in the hands of those who can best effect change.
The numbers of staff leaving the NHS completely (the leaver rate) is reducing month on month since August 2022. I’m sure this is in no small part down to the line managers and leaders making the People Promise real. You can look at your own trust or system level data in Model Health System.
Last April we launched the People Promise Exemplars programme with 23 NHS provider organisations. The aim was to test the hypothesis that the adoption of a suite of interventions reflecting the People Promise and delivered in one place simultaneously would improve staff experience and retention. We’re now seeing emerging evidence of the leaver rate falling faster in the exemplars – here are some good practice interventions:
Improving staff retention
West Hertfordshire Teaching Hospitals NHS Trust has improved, refined, and streamlined their induction process for new starters and estimates that four days of admin has been saved each month. This has created capacity for further learning and development initiatives to take place to help improve career progression.
Lancashire and South Cumbria NHS Trust launched its ‘Lets Talk about Flex’ campaign, helping leaders support teams to access flexible working opportunities. As a result, applications for flexible working increased from 32 in May 2022 to as high as 122 in January 2023. There’s also been a huge improvement in satisfaction with opportunities for flexible working, from 59.8% in 2021 to 64.1% in the 2022 national annual staff survey.
Resources to help support the implementation of flexible working in your organisations include the NHS Flex for the Future programme and flexible working guides for both line managers and individuals.
Colleagues in Devon are doing great work through their general practice nurse legacy mentoring scheme and have 21 active legacy mentors working across the county to mentor 25 nurses.
Several organisations are already working with legacy mentors, supported by resources such as template job descriptions, business cases and person specifications.
Bradford Teaching Hospitals NHS Foundation Trust has improved in all themes of the NHS Staff Survey, including every element of the People Promise. This includes being the most improved in their trust type for ‘We are a team’. Key areas of focus include cultural leadership, flexible working, including rostering optimisation, reward and recognition, and induction for International Medical Graduates. The trust has also delivered an Outstanding Theatre Teams initiative, leading to significant improvements in staff engagement and theatre utilisation and activity. Insights have been shared with other trusts as part of the national elective recovery programme.
As we approach our 75th birthday it’s vital that we continue to sustain our ambitions to make the NHS a place to work which both attracts and retains incredible talent. I increasingly see the impact of the People Promise translating into practical interventions which when embedded, directly respond to what colleagues have said matter most to them. That’s when we see retention as an outcome.
We can’t afford to dismiss this as the ‘soft stuff’ – having enough people to provide safe, high quality, productive, affordable and compassionate care to the citizens of this country is very definitely ‘hard stuff’.