Maximising retention through pastoral support

Pastoral support for healthcare support workers (HCSWs) should be holistic and focus on wellbeing needs, as well as training and development needs. Recognising the challenges of the role and providing training and support to mitigate the impact of these challenges are vital to retention, particularly for younger HCSWs and those new to healthcare in their first year of NHS service.

Pastoral support for HCSWs can take many different forms and can be delivered by a variety of people, including managers, education teams and HCSWs themselves. It can include formalised initiatives and informal support such as:

  • A comprehensive and supportive induction for HCSWs, particularly those that are new to health and care
  • Formal support – for example, regular meetings with managers and mentoring opportunities
  • Informal support – for example, buddying schemes and developing peer-to-peer support networks
  • Understanding the learning and development needs of HCSWs and having training and information available to support these
  • Making sure HCSWs feel valued and able to flourish and demonstrate their skills
  • Supporting HCSWs to take their breaks.

How can a lack of pastoral support impact upon retention?

Without pastoral support, HCSWs can lack confidence in their ability to do their role well, leading to anxiety and frustration as they don’t feel able to contribute to the multi-disciplinary team.

HCSWs that receive good pastoral support will feel happier, more confident, and more resilient in their role. They will also be empowered to share their thoughts and ask questions. In turn, this leads to HCSWs delivering the highest possible quality of care.


A mentor can provide guidance and support to a HCSW, helping them to achieve their professional ambitions. They also act as a role model and provide a positive influence, separate to a line manager.

They can come from a range of professions. For example, a nurse, a matron, or a practice educator, depending on what the HCSW’s ambitions are. They could also be drawn from groups or networks within trusts, such as LGBTQI+ groups or BAME leaders’ groups.

Mentoring should be structured and happen at a clearly defined regular intervals, agreed between the mentor and the mentee.


A buddy is another HCSW with a lot of experience and knowledge about the organisation and clinical setting, who can show new HCSWs the ropes and support them when they join an organisation.

Buddying schemes can be set up at an organisational level for HCSWs. A good buddying scheme provides training to ensure consistency in the experience of the HCSWs receiving a buddy. Buddying can help new HCSWs to develop relationships with their peers and can be an important element of an induction process.

You can find more information in the guide ‘The Benefits of Buddies – A practical guide to peer support for new healthcare support workers’ on the FutureNHS platform.


Case study: Developing and supporting resilience at West Suffolk NHS Foundation Trust

As a small trust based in a rural market town, West Suffolk competed for HCSWs with larger, better-known hospitals nearby. In addition, a significant number of HCSWs left before completing their initial 12-week training. Reasons for this varied, but often they felt overwhelmed in a busy environment.

The trust reformed its Care Certificate policy and now makes a commitment to new staff in the form of a timeline with milestones, including information about the skills and training they will receive over the 12-week induction period and once they start the role.

Those on the programme are also given a ‘blue flash’ to wear in their top pocket to signal they’re a new staff member, encouraging more experienced staff to support and guide them. They are also allocated a ‘buddy’ in their practice area to mentor them during their first months in post.

After the Care Certificate policy was overhauled, more recruits enrolled for it and more completed it. The percentage of staff leaving employment within 12 months of starting reduced from 27% to 10%.

Case study: HCSW training programme at Lincolnshire Partnership NHS Foundation Trust   

Lincolnshire Partnership NHS Foundation Trust wanted to recruit and retain HCSWs, maintain a low vacancy rate and implement a ‘grow your own’ pipeline. They introduced a more comprehensive training package at induction, along with more intensive pastoral support and the offer of additional bank shifts to substantive staff.

The trust used a workbook approach for the Care Certificate and invited bank staff to complete this alongside substantive staff. The Education team also asked current HCSWs what they would have found helpful in terms of training when they first began in their role. The results of this provided the foundation upon which to build the HCSW development programme.

The additional Care Certificate training provided an opportunity for HCSWs to bring their Care Certificate portfolio with them and discuss what they were finding difficult, to help identify what support was needed.

As a result, the trust was able to reduce its vacancy rates to minimal levels and maintain this.

Case study: Associate educator at Imperial College Healthcare NHS Trust

This trust has developed a Band 4 associate educator role to focus on HCSW training and education. The associate educators fully understand and support HCSWs and introduce a culture of education and learning for HCSWs.

The role includes supporting the Education team in designing and co-ordinating the delivery of the Care Certificate and other clinical educational programmes and service-situated learning opportunities for HCSWs.

More tools to support the retention of HCSWs through robust pastoral support can be found in the Pastoral Support Toolbox on the FutureNHS platform.

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