Looking beyond our shores to address the workforce challenge

Jonathan Higman profile picture

02 October 2019

Jonathan Higman
Chief Executive
Yeovil District Hospital NHS Foundation Trust


 The first step in tackling the workforce challenge within a trust is to dispense with the notion that it is inevitable and unavoidable. True, it is a complex problem and much of the cause lies beyond our control, but there is still much that we can do at a trust level to recruit creatively, and make ourselves supportive, nurturing employers.

The first step in tackling the workforce challenge within a trust is to dispense with the notion that it is inevitable and unavoidable.

Jonathan Higman    Chief Executive

For us in Yeovil Hospital, the solution to our historic nursing vacancy issue – like in many other trusts, was driving substantial agency expense, affecting operational effectiveness, and diminishing staff morale – started with treating the overseas as a primary market, rather than one which simply enhanced or bolstered our domestic recruitment activities.

In establishing our dedicated overseas recruitment team we ensured that the levels of commitment and investment - both in capacity and funding - were commensurate to the scale of the problems we were addressing. Our recent recruitment activities in Dubai and the Philippines, with our experiences of alternative recruitment models, had proved that visibility and accessibility are crucial when entering into a new overseas market. Therefore, we sent our own teams abroad for prolonged periods to conduct intensive recruitment programmes, aiming for several hundred recruits at a time.

Our recent recruitment activities in Dubai and the Philippines, with our experiences of alternative recruitment models, had proved that visibility and accessibility are crucial when entering into a new overseas market.

Jonathan Higman    Chief Executive

For recruits, being able to meet and establish a relationship with an employee of our organisation during an interview is the first step to creating a relationship with our hospital. Maintaining this investment in the individual throughout the vetting, travel, arrival and training process is just as vital – not only in supporting their retention but also to help ensure their clinical effectiveness as a Yeovil Hospital team-member in the long-term.  Getting the basics right and supporting new recruits through every step of their relocation is a key success factor.

The results speak for themselves. Our ward based nurse vacancies have now been eradicated and our in-house OSCE (practical examination) training programme is delivering a 100% pass rate.

However, all the success of creative, collaborative recruitment can be immediately undone if you don’t give retention the same level of attention. In 2017, our hospital had a poor nursing and midwifery turnover rate at 22.8%, putting pressure on both staff and finances. A working group, led by our deputy director of nursing, took a multi-faceted approach to addressing the problem. This  included reducing the reliance on exit-questionnaires, which we found to be of limited value and something of an ‘after the horse has bolted’ activity ; an increase in the number of pre-emptive, proactive career guidance conversations with staff identified as likely to leave, led by senior leaders and our head of education; an increase in the profile and accessibility of opportunities for internal promotion, progression, and training; and the launch of our health and wellbeing programme, which offers a wide range of activities and events aimed to increase mental and physical staff wellbeing and promote cohesion amongst the workforce. This final point led to us achieving the best results for staff health and wellbeing in the latest NHS staff survey.

However, all the success of creative, collaborative recruitment can be immediately undone if you don’t give retention the same level of attention.

Jonathan Higman    Chief Executive

As a trust with a primary care operating arm, called Symphony Healthcare Services, we were also in the privileged position of being able to develop portfolio contracts for staff interested in working across acute and primary care settings. Additionally, the creation of a staff ‘transfer window’ helped us enable staff to move across departments and wards in a planned and coordinated way. Turnover for these roles dropped significantly and now stands at 15%, and even lower for overseas nurses.

With a stable and successful model in place for our nursing workforce, we are now offering the same level of attention to addressing our medical shortages, where arguably the challenge is more nuanced and the prize is equally as significant.

Jonathan is chief executive for Yeovil District Hospital NHS Foundation Trust.

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About the author

Jonathan Higman profile picture

Jonathan Higman
Chief Executive

Jonathan Higman joined the board of Yeovil District Hospital NHS Foundation Trust in January 2009 and became chief executive in March 2018. During this time he has held a number of director level posts, including director of strategic development and director of operations at the trust.

Jonathan has over 20 years' experience working across the NHS in the south west and south east of England. He is passionate about the benefits integrated care models and finding new solutions to long standing problems.

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