Evidence and insights gathering, commissioned by NHS England, into the drivers of attrition of HCSWs indicates that a common sentiment amongst HCSWs is that they often don’t feel valued by their team or organisation. This is reflected in language used to refer to them. Often, HCSWs are referred to by their band or as ‘unqualified’, when they are unregistered, rather than unqualified. Often HCSWs’ skills and knowledge can be ignored, and they can feel as though they are perceived as the sum of their uniform.
If HCSWs don’t feel valued, they may become dissatisfied within their role and look to leave the NHS for other jobs.
Mitigating these challenges
Recognising and valuing HCSWs is the responsibility of teams, clinical setting managers, and organisations. Involving HCSWs in strategic decisions that impact their role within the organisation can be a crucial way of showing the organisation recognises their value.
Developing groups such as Shared Governance or Shared Decision-Making Councils chaired by HCSWs, can be another way to demonstrate the importance of the HCSW voice and can support your organisation in making informed decisions. HCSWs are also in a unique position to lead quality assurance programmes, due to their knowledge and experience of how clinical settings run and how teams operate.
Awards and initiatives that recognise HCSWs are a good way for organisations to show they understand the importance and value of HCSWs, whilst rewarding individual HCSWs for their work.
The principles of shared decision-making ensure that agreement is reached in a way that is inclusive collaborative, and non-hierarchical.
It is important for HCSWs because:
- Shared decision-making can be used to make decisions that affect the day-to-day running of wards and clinical settings and HCSWs.
- Coming together in this way, and underpinned by the relevant evidence-base, it can provide HCSWs with a strong collective voice and a sense of value.
- It can be a development opportunity for HCSWs.
Read more about NHS England HCSW Shared Decision-Making Council the on FutureNHS platform.
Case study: Shared Governance Council at Nottingham University Hospitals NHS Trust
A HCSW was the driving force behind setting up Nottingham University Hospital NHS Trust’s Shared Governance Council. Supported by a matron, clinical educators, and education leads, the HCSW set up a council for the ward in which they were based, to help improve the ward environment.
Some of these changes included:
- Being the first ward to implement the trust’s initiative of X40 + care of excellence passports
- Introduction of new digital medicine lockers to save time for registered nurses on drug rounds
- A new day room to improve patient’s mental wellbeing, with a tv, board games, books and arts and crafts
- A student workbook for placement area and welcome book pack.
HCSWs involved in the shared governance council feel empowered to use their talents to make positive changes. It also offers an important opportunity for them to learn and develop within their role. More information can be found in NUT’s case study ‘A strategy for HCSW retention’.
Case study: Raising the profile of the HCA at Dartford and Gravesham NHS Trust
After noticing a trend between perceived lack of value afforded to the role of healthcare assistants (HCAs) and attrition, Dartford and Gravesham NHS Trust sought to raise the profile of HCAs and emphasise the importance of the role within the trust. This included:
- Celebrating Nursing Support Workers’ Day
- Producing resources including ‘a day in the life’ of an HCA poster
- A Facebook campaign featuring photo storyboards.
The trust has also made improvements to the onboarding and induction process and the support available for HCSWs. The Care Certificate is now mandatory to complete, highlighting the importance of supporting HCSWs to develop their skills and the trust’s dedication to learning and development.
To coincide with this work, the trust is in the process of introducing the Kallidus Learn system; software which brings together and modernises onboarding, learning, development from initial hire to a highflyer and talent management. The platform holds the local and corporate inductions and will be home to HCAs’ personal development plans and appraisal documents.
Case study: TULIP award at Nottingham University Hospitals NHS Trust
Nottingham University Hospitals (NUH) NHS Trust has introduced the TULIP award to formally recognise the value and achievements of HCSWs. TULIP stands for ‘Touching Unique Lives in Practice’ and is an award given to non-registered nursing staff at NUH in recognition of those who go above and beyond their duty.
The TULIP award was inspired by the DAISY award – a similar award for registered nurses and midwives. The awards were introduced by the trust in 2018, after a HCSW worker raised a query in a Staff Experience Council about how HCSWs were recognised.
More tools to support the retention of HCSWs through ensuring they feel valued and recognised, can be found in the Value and Recognition Toolbox on the FutureNHS platform.
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