Supporting people in early and late career

The National Retention Programme works closely with systems to help improve staff experience, retain our NHS people and support organisations to undertake a range of actions to help staff feel valued, through the themes in our People Promise.

As around 30 per cent of our NHS workforce are aged 50 and over, and a significant number of people choose to leave in their first two years of employment. This page looks at ways to best support people to enable them to choose to stay in the NHS. It includes information, tools and resources tailored to our NHS people in their late and early career stages. Some of these resources are applicable to all NHS staff, at all stages of their career, and may find the offers set out here useful.

Improving staff retention: a guide for line managers and employers has been jointly updated by NHS England and NHS Employers. It contains information on early and late career support for line managers and employers and others supporting our NHS people.

Support is also available via local regional colleagues and our regional retention teams.

Approximately a third of the NHS workforce are in the later stage of their career and play a vital role in leading and supporting colleagues, passing on knowledge and inspiring new staff.

What people want from their career can often change over time and it is important that those in the later stages of their career feel supported.

Where possible, our NHS people should have access to development opportunities which meet their career aspirations and be supported to think about how they can use their skills, experience and knowledge in different and flexible ways.

Retaining doctors in late stage career guidance
We have launched guidance, and a supporting infographic, to support the retention of doctors in late stage career in collaboration with the Academy of Medical Royal Colleges. The guidance provides ten recommendations for systems and employers to consider when supporting doctors in late career, working in secondary care settings, to stay and stay well in the NHS. The recommendations are aligned to the NHS people promise and include holding retirement conversations, supporting flexible working and health and wellbeing.
Legacy mentoring
Legacy mentors are experienced nurses, or colleagues in other regulated professions, usually in late career, who provide coaching, mentoring and pastoral support. This can support organisations to keep the valuable skills and experience of colleagues in late career who may otherwise retire, and can help support those at the start of their career to stay and stay well.
Case study
Nottingham University Hospitals launched a ‘Late Career Hub’ hosted by the innovative Care4Notts platform to support staff across the ICS. The platform provides resources for late career healthcare professionals, their managers and mentors.

Two-thirds of those with experience of menopausal symptoms believe their symptoms have had a negative impact on them at work and over half said they had been unable to go into work because of their menopause symptoms.

Menopause is defined as having occurred when there has not been a period for 12 continuous months (for those reaching menopause naturally). The menopause usually occurs between 45 and 55 years of age and in the UK the average age for a woman to reach the menopause is 51. In the NHS workforce, about 1 in 5 women* are aged between 45-54 and could be going through the menopause transition.

*Women under the age of 45 may also be affected due to family history, surgery, a medical condition and/or treatments. Transgender, non-binary, and intersex staff may also experience the menopause, resources on this are available below.

The National Menopause Programme within NHS England is committed to improving the experiences of those experiencing perimenopause and menopause, both among the NHS workforce where 75% of staff are female, and among the wider population.

For more information about the programme please contact

There are a number of resources available to help raise awareness, improve workplace environments, and support line managers to help NHS people experiencing the menopause or those indirectly affected.

These resources include:

  • National menopause guidance developed by NHS England for line managers and colleagues experiencing the menopause. This guidance helps NHS organisations, line managers, and those working in the NHS understand more about the menopause, how they can support colleagues at work and those experiencing menopause symptoms.
  • A guide on recording menopause related sickness for line managers, HR and ESR users to help better record the impact of menopause. By recording these absences accurately, we can gain a better understanding of the impact menopause is having on our NHS colleagues.
  • You can also find tips for managers and leaders on how to support colleagues affected by the menopause in the ‘Supporting colleagues in late career’ chapter of our retention guide for line managers and employers.
  • NHS England and Health Education England (HEE) have launched an e-learning for health module about the menopause. Developed specifically for NHS staff, it covers the common symptoms of the menopause, how it can impact people at work and how we can support colleagues going through the transition. There is also a dedicated e-learning module for occupational health colleagues.
  • A SelfCare factsheet is available for those affected by the menopause transition and may also be useful for colleagues and line managers to help understand and support those affected.
  • The NHS website is also useful for menopause information and advice
  • Access to a range of health and wellbeing offers through the national health and wellbeing support programme
  • For those colleagues going through the menopause, there are local menopause support groups and peer networks you can join to meet others with similar experiences, or you may wish to consider connecting with a wellbeing champion within your organisation
  • Advice around trans and non-binary people and the menopause can be found on the TUC website.
  • NHS staff can also access the Unmind and Headspace apps which have dedicated menopause areas
  • More information to address menopause and the workplace is available on the NHS Employers website.  This includes case studies which highlight improvements/ best practice that can be incorporated within the workplace environment to support people better.
  • NHS Leadership Academy provides information on good practice for managers on how to approach wellbeing conversations,
  • The Chartered Institute of Personnel and Development (CIPD) has developed resources to download to help you break the stigma within your team/organisation, such as Let’s Talk Menopause: Facts and a podcast called The ultimate taboo. They also provide support to line managers or HR professionals.
  • Further advice on menopause and the workplace is also available on the Faculty of Occupational Medicine website.

Case study

Senior nurses at Sherwood Forest Hospital Foundation Trust recognised that staff sickness absences were sometimes related to menopause symptoms. Over 12 months, the organisation carried out a research intervention study which included expertise from menopause clinical colleagues to develop action plans to educate line managers. 

Here is a selection of other case studies from organisations

Those joining the NHS for the first time, or in the early stages of their career, play a vital role in shaping the future of the NHS workforce.

It is important that people feel supported to develop their career pathways in a way that suits them and encourages them to continue working for the NHS.


A robust induction provides colleagues with practical information needed to work effectively and helps them to feel part of the team and understand where they can go to for support.

There are a range of approaches to inductions which helps to promote a culture where people feel valued and supported in their new roles, for example regular catch ups or one-to-one meetings will help assess progress and offer help, as well as offering new employees additional support through a buddy, or a network with other new starters. This helps to promote a culture where people feel valued and supported in their new roles.

NHS Employer’s guide on inductions offers support for internationally recruited staff.

Also see the ‘Supporting new starters and those moving roles’ chapter in the Improving staff retention guide.


Preceptorship helps newly qualified practitioners to translate their knowledge into everyday practice, grow in confidence and have the best possible start.

Having a robust and consistent approach to preceptorship can help support our NHS people to feel valued and that their development is considered important. It supports socialisation into the organisation and a sense of belonging. Most importantly it can improve clinical skills, improve clinical outcomes and therefore the quality of patient care.

The National preceptorship framework for nursing, launched in October 2022, seeks to set national standards for preceptorship for nurses and establishes a framework for good practice that can be adopted across all regions in England.

The National preceptorship framework for midwifery, launched in March 2023, seeks to set national standards for preceptorship for midwives and can be used as a core set of standards where multidisciplinary preceptorship programmes are in place.

A preceptorship framework for allied health professionals is also available.

For further information on preceptorship can be found on the below links:

Case study

Oxford University Hospital Trust introduced a three-tier foundation preceptorship programme where preceptors helped to inform organisational changes through the identification of common themes. New nurses indicated the preceptorship programme had positive value and improved the experience of newly qualified nurses during their first year of clinical practice

Mentoring and coaching

Mentoring and coaching can help maintain engagement among new starters beyond the induction phase and also help those in later stages of their career feel valued.

Colleagues in later career may also want to share their experiences with newly qualified healthcare professionals through mentoring, and some organisations have made this into an attractive alternative career for experienced NHS staff.

For more information see NHS Employers webpages on education and training and NHS Leadership Academy’s Talent Management toolkit , designed to support organisations to develop and embed inclusive, sustainable approaches to talent management for staff at all levels. The NHS Leadership Academy also have a dedicated webpage on mentoring opportunities, which includes a register for NHS staff to search for and sign up to be a mentor.

HEE’s quick guide encourages AHPs in late career to consider supporting students with their practice-based learning.  This concept can be expanded to include other newly qualified practitioners and those moving into new roles or roles in new settings.

Legacy mentors are experienced nurses, or colleagues in other regulated professions, usually in late career, who provide coaching, mentoring and pastoral support. This can support organisations to keep the valuable skills and experience of colleagues in late career who may otherwise retire, and can help support those at the start of their career to stay and stay well.

Case study

Barking, Havering and Redbridge NHS trust have implemented legacy nurse mentoring, where experienced staff provide mentoring and pastoral support to new employees. They have reported a reduction in both their turnover and vacancy rates and the scheme has now expanded to provide mentoring and pastoral support to midwives, allied health professionals and healthcare assistants due to its success.

Flexible working

Flexible working supports our NHS people to have greater choice in where, when and how they work, and allows for a work-life balance which takes into account changes in circumstances, commitments and interests outside of work.

It may not always be easy to accommodate individual work preferences, but being a more flexible, modern employer, supports us to retain our existing people and attract new talent. Flexible working can positively impact on staff attendance, morale and job satisfaction leading to engaged staff delivering the best patient care.

Flexible retirement can allow people to continue working in a different way and for organisations can retain valuable skills and knowledge. Being informed about retirement options and having open discussions about retirement plans, may help those considering retirement to approach it in the best way for them.

More information and resources are available on the We work flexibly webpage.

Further information on flexible working is also available in our retention guide, including suggested actions for leaders and managers, case studies, tools and further reading.

Health and wellbeing

Enhancing the experience of our NHS people, and helping them to stay well, means that our highly valued workforce are likely to stay longer. There is a comprehensive package of health and wellbeing support in place for our NHS people which includes access to a 24 hour text service, free self-help apps, as well as training, coaching and guidance for teams and leaders and 40 staff mental health and wellbeing hubs.

Further information on how line managers and employers can support health and wellbeing can be found in the retention guide.