It is striking how much work has been undertaken to support the NHS workforce over the past 18 months, as the service has faced the greatest challenge in its history. Staff are the backbone of the NHS and have risen to the challenges posed by COVID-19, but many are now exhausted. A renewed spotlight has been placed on workforce issues and trust leaders are demonstrating innovation and commitment to recruiting, retaining and sustaining their workforce. This report provides a snapshot of just some of the excellent work being done across the country in this regard, which we hope will act as a springboard for driving further change and innovation.

It is no surprise that a healthy, happy, and inclusive workforce leads to better patient care and outcomes. Key learnings on how this can be achieved have emerged from all the case studies in this report and, in line with the focus of the NHS People Plan, many are centred around inclusive and compassionate leadership. This was echoed most by trusts when discussing staff wellbeing and belonging. For example, board buy-in is critical to embedding the success of innovative approaches to workforce issues. This was highlighted by Dorset County Hospital when driving a culture-shift to meaningfully address workforce inequalities, with a particular focus on race. Berkshire Healthcare shared how an approachable, visible executive team has ensured their ability to break-down barriers and create a culture of openness and listening. Similarly, Solent described how being a values led organisation with compassionate leaders has been key in enabling them to embed freedom to speak up practises into all aspects of their culture.

It is no surprise that a healthy, happy, and inclusive workforce leads to better patient care and outcomes.


Regarding new ways of working, trusts have demonstrated remarkable innovation. Key learnings include the willingness to collaborate with, and foster strong communication between, organisations. The North East Ambulance Service focused on this when partnering with local GPs and Northumbria Healthcare NHSFT to embed a new model for home visits, conducted by paramedics. This relieved GP pressures and ensured continued high-quality service delivery. Sussex Partnership also highlighted the importance of collaboration through their learning academy partnership, which sees local students from Greater Brighton Metropolitan College shadowing healthcare workers to help them realise the NHS as a tangible career path.

A long-standing conclusion in conversations around retention is the importance of flexible working. In an innovative move towards enabling this for frontline staff, University Hospitals of Derby and Burton have set up internal transfer programs which give nursing staff the option of working in a different department that can meet their flexible working preferences or allow for a period of respite from a busy ward or give the opportunity to gain professional experience on a different ward. The trust is planning to embed the transfer program as a formal process to widen participation and build elements of it into their flex for the future programme.

This work is evidence of how trusts are constantly adapting to support their staff, and all of the trust leaders we spoke to emphasised that this is an on-going journey with many moving parts to it. The focus remains on continuously challenging mindsets, ensuring compassionate leadership is seen at all levels, driving innovation, and engaging openly in difficult conversations. Last month, Solent launched The big conversation, which aims to dive more deeply into issues relating to race, sexuality, religion and disability. University Hospitals of Derby and Burton is looking to transfer what they have learned about retaining nursing staff and widen this to allied health professionals. Mid Yorkshire will be combining more physical wellbeing into their wider wellbeing offer to staff, with an inventive project focusing on musculoskeletal care already planned.

Workforce remains the number one concern for NHS trust leaders, and the basis of everything that the service does.


Workforce remains the number one concern for NHS trust leaders, and the basis of everything that the service does. It is paramount that key learnings, innovation, and outcomes are shared to ensure that best practise is disseminated and adopted at this critical juncture, given ongoing operational pressures and upcoming legislative changes. It is crucial that NHS staff feel supported and heard in this process, and there needs to be understanding of what they're facing from both the public and policy makers.

While the type of work detailed in these case studies goes a long way to improving staff experience in the NHS, huge workforce shortages and the resulting unsustainable workload on existing staff can only be tackled with a robust long term workforce plan. We continue to call for a national fully costed and funded, multi-year workforce plan, based on input from providers, as a matter of absolute priority. This has to come alongside increased longer-term investment in workforce expansion, education and training.

In the meantime, trusts can continue to look to NHS Providers for examples of best practise and key learning, and to represent them at a national level as the NHS and its workforce prepare for the winter months ahead.