Using induction to support retention

A good induction process can be key to ensuring healthcare support workers (HCSWs) feel welcomed into an organisation and supported in their role, especially HCSWs that are younger or are new to care. This is critical to retention, mitigating early attrition and to empowering staff to deliver high-quality care.

A good induction should provide HCSWs with the skills, knowledge, and competencies they need, through a theoretical understanding gained from the Care Certificate (or its equivalent) and offer supernumerary training as a practical space for HCSWs to develop these competencies and skills, whilst building their confidence.

What retention challenges can arise at induction?

  • An unsupported early experience due to inadequate induction.
  • The Care Certificate provides a comprehensive induction for HCSWs, but its implementation varies from trust to trust.
  • Not all trusts or organisations provide a period of supernumerary training, which can mean HCSWs don’t feel confident when delivering care.

Mitigating these challenges

A good induction has several key components – a corporate induction, orientation, the Care Certificate and supernumerary training.

Corporate induction

A corporate induction welcomes HCSWs to the organisation and the trust’s community. Having a corporate induction led by an organisation’s CEO or member of the senior leadership team demonstrates the importance of HCSWs as integral members of the workforce.


Orientation ensures HCSWs are familiar and comfortable in their organisational and clinical settings. This includes HCSWs gaining a good understanding of the layout of the trust and clinical setting and being able to navigate around it.

The Care Certificate

The Care Certificate ensures HCSWs have the knowledge, skills, and competencies to deliver high-quality patient care. Organisations should offer HCSWs support to complete it, such as drop-in sessions and ensure a good number of people are trained as assessors to sign off completion.

Care Certificate

The Care Certificate is an identified set of standards that health and care professionals adhere to in their daily working life. It’s based on 15 standards which individuals need to complete in full before they can be awarded their certificate.

It is an induction process designed to give everyone the confidence that health and care professionals have the same introductory skills, knowledge, and behaviours to provide compassionate, safe, and high-quality care and support in their own workplace setting.

The Accelerated Care Certificate

The Accelerated Care Certificate was developed to accelerate the delivery of the Care Certificate.  Through a blended approach of online learning and practical, competency-based learning, it reduces the time taken to complete the Care Certificate from 12 weeks to between four and six.

Supernumerary training

Supernumerary training ensures HCSWs can build confidence in using their skills in their specific environment. It has been proven to reduce anxiety and build confidence in HCSWs and enables them to gain confidence both in skills and competencies, and in working within their environment.

A core part of this is giving HCSWs the opportunity to explore their skills in their ward or environment before they start delivering care. Supernumerary shifts provide an opportunity to shadow other teams that the HCSW will be working with, for example, tissue viability teams and pharmacists. Eight to twelve supernumerary shifts over a period of six months provide an incredibly comprehensive induction experience and lead to confident and informed HCSWs.

Case study: Onboarding development at Frimley Health NHS Foundation Trust

To reduce turnover of HCSWs and improve career progression, Frimley Health NHS Foundation Trust developed a robust, six-day induction process using a blended learning delivery model.

This is underpinned by a clear pathway to progress from Band 2 HCSW roles, to level three apprenticeships, with further options to undertake a level 4 Associate Practitioner Foundation Degree or a level 4 Nursing Associate Foundation Degree.

New recruits are inducted together to add a layer of pastoral support and are provided with a buddy on their ward. The induction process takes place over six months and includes periods of supernumerary training, study, and practical skills.

Programme participants have reported they feel it gives them the key information they need to safely start work in a clinical environment. Wards and departments have also said that new healthcare support workers seem more confident and equipped to provide care from the outset.

More tools to support the retention of HCSWs through induction can be found in the Induction Toolbox on the FutureNHS platform.

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