Attracting and retaining talent to safeguard patient services

Written by
Mary Appleton

21 Dec 2016

21 Dec 2016 • by Mary Appleton

What are the biggest challenges currently facing you as an organisation, and how are you planning to meet these from an HR/recruitment perspective?

Demand for NHS services is rising by around 8% a year, linked to an ageing population, at the same time as the government seeks to balance the books, imposing severe budget restrictions and cuts. Recruitment and retention is a major challenge. Nationally, there have been insufficient funded training places for nurses and doctors and this is hitting trusts hard. We are all constantly looking for innovative ways of attracting, recruiting and retaining valuable staff – this has a direct link to standards of care and patient safety.

Local workforce planning, and a daily focus on attraction and recruitment, is starting to pay dividends and some of the vacancy gaps are reducing. However with an estimated 22,000 national nurse vacancies and around 2,000 in this region, it is not a challenge that will disappear any time soon. 

As we question whether some tasks can be done differently, or by less skilled people, a range of new roles are being developed to help bridge the gap. These are increasingly arising from providing more integrated, patient- centred approaches to delivery of health and social care. 

We are also focusing on increasing workforce engagement and use Listening into Action (LIA) to help with this, via a better engagement strategy.  As a teaching trust we and our staff place a high value on education, training and personal development. We work closely with two local universities for medical and nurse training, and supplement this with a range of in-house and online activities and approaches. 

Talent and succession is increasingly important and we are currently refreshing our approach to this so that people are clear about their own career pathways and choices, and how we can support them to reach their career goals, as well as ensure we have the talent we need for now and in the future. 

Tell us about any recent change initiatives that have affected the organisation, how you overcame challenges and the business results achieved

UHL, and the wider NHS, are in a constant state of flux, arising from national performance targets, cost-savings required, and local partnerships with the rest of the health and social care system, as well as the task of improving standards of patient care and safety.

This constant change, combined with pressure on services, is hard on staff. The quality of leadership and line management needs to be very high.

To achieve a more consistent approach to managing change and improving personal and organisational performance, we have developed the ‘UHL Way’, which brings together our expectations about how things will be done, supported by methodologies, toolkits, and the ‘UHL Academy’.


Most of my own career has been spent in the public sector so I’m not sure I would agree. The challenges facing the public sector are similar, but with different constraints, and the public sector is not one single organisation or sector, so generalisation is unhelpful.  I’ve seen many private sector HR professionals struggle with the transition into working in complex public service organisations where national and local politics drive decision making, to a large extent. Of course, many also thrive and make their mark.  

HR directors in large public sector organisations are focused on the same things as their private sector counterparts: attraction, recruitment, retention, talent, performance, cost and pay-bill reduction, productivity – the list goes on. The challenges are overwhelmingly about people and culture, including the quality of leadership at all levels. Value and behaviours have been developed with staff, and are embedded through performance management, senior manager role models and in how we provide services to the public. We don’t always get it right – and that includes patient deaths and harm: learning from our mistakes and being open and apologetic with families and patients is a key feature. 

Investment in ‘people’ is high in some parts of the public sector. For example, the quest in the NHS for formal qualifications is high. This is understandable when doctors, nurses and many other health professionals are undertaking such highly skilled roles. People move jobs frequently as they climb the career ladder and leadership and management development opportunities are provided nationally, regionally and locally.   

‘Necessity is the mother of invention’ and this is true for public service organisations. Increased pressures, including budgets, have driven changes to how services are delivered and how workforces are managed. In the face of headcount and pay-bill reductions, local government has led the way over the past few years, by re-shaping and re-providing HR, payroll and occupational development (OD) services. They are more focused on addressing the major people challenges as well streamlining the transactional offer, via shared services and e-HR solutions. The NHS is following their lead, with a further national push for local ‘back-office’ integration. 

In the year during which I have worked in the NHS, many things have changed, or are changing, at a very fast pace; for example, there is the new national requirement for 44 sustainable transformation plans (STP) based on a local area. In my case, this covers Leicester, Leicestershire and Rutland and around eight different public health and local authority organisations. The STP will inform our budget allocation, which services are commissioned, how we collaborate on back-office provision and integrate some frontline services to local people. 

The ‘system’ workforce and OD implications are significant. Since January 2015, the workforce and OD leads from the various organisations have been focused on a single workforce strategy, OD and culture change and workforce planning. Attraction and recruitment is also becoming more joined up. As the recently appointed system lead for back-office integration, I will be scoping the whole programme for this, as well as expanding the focus on the HR service elements as a range of strategic-enabling and transactional services. 

What are your expectations for the future of the public sector?

The public sector is growing tougher – all services are under pressure from demand, public expectations and budget constraints, and this can only get worse. However, at the same time, we are a sector that is reliant on people with the right skills and the motivation to do a good job – in some cases, to save lives.

For the HR profession, it is a golden opportunity to make a real difference for staff and patients, through progressive strategies and enabling employment policies and processes. We must use our unique skills to help our organisations meet their challenges through the people we employ.


How can HR professionals develop the skills to succeed in the public sector at a time when there may be no budget for professional development opportunities?

It’s true that budgets are under pressure. However, there are plenty of opportunities to learn and develop as a professional, many of which involve looking for opportunities to get more involved in specific projects, and finding a mentor or coach. 

What our organisations need are HR and OD professionals who have a good understanding of the business they work in and can use their knowledge of tools and techniques to develop practical solutions that resonate with staff and managers. Be inquisitive and look beyond your own organisation or sector for ideas that you could adapt to a local solution. Too often, people’s ideas for improvement or change are hampered by their lack of exposure or knowledge of the wider business/public service world, and how their HR services have responded to challenges.  

The final challenge is about OD knowledge and skills – these are now key for all HR professionals whether in an OD role, or in business partnering. OD is about change and transformation across systems, process and people (not learning and development, as seems to be the commonly held misconception). You cannot offer the solutions and interventions that are needed for future public services and across emerging ‘systems’ without these.