Growing for the future
New ways of working and delivering care
- New roles
Sussex Partnership NHS Foundation Trust (SPFT) is one of many trusts facing significant challenges on staff recruitment, retention, and vacancy rates, both now and anticipated in the future.
SPFT currently have 1,200 vacancies, against a workforce of 5,000. They face a range of challenges in terms of recruitment, particularly due to the large geographical spread of the organisation. The trust covers Brighton (a popular but expensive place to live), West Sussex (with very remote areas, lacking transportation routes), Hastings (an area of above-average health inequality), and the New Forest (again, including areas well off the beaten track).
SPFT's Board Assurance Framework risk radar sets ability to recruit to vacancies, and impact on eliminating use of agency and resourcing service expansion, as an extreme risk. In the face of these challenges, Gavin Wright, chief people officer at SPFT and his team, recognised that something different needed to be done with recruitment.
As a first step, Gavin set up the trust's workforce assurance group. The group’s purpose was to assess all of the disparate recruitment activity and bring it together into a more coordinated approach.
A key outcome was the creation of the trust’s workforce supply team. The group was clear that SPFT needed to rethink their recruitment practices. They looked to the private sector in terms of how they recruit and what do they do to make roles more attractive. What they found formed the structure of the recruitment hub, which is made up of three teams:
- The transactional recruitment team run the day-to-day recruitment activity, ensuring that vacant roles are on the system, and that they’re advertised. SPFT invested to increase capacity here, so that the team could keep in touch with shortlisted applicants throughout the application process. This change was based on feedback from surveys which the trust ran with former applicants, who consistently said that the lack of communication from SPFT throughout the application process was an issue. The transactional recruitment team now email and call shortlisted candidates to check in with them, and to ask if there is anything else they need as part of the process. This work has yielded significant return, with far fewer candidates dropping out of application processes.
The recruitment campaigns team is led by recruitment managers from the private sector. This was in order to bring a fresh perspective to SPFT's activity in this area. The team has created bespoke recruitment campaigns for difficult to recruit posts. They have also worked with the trust’s communications team to harness better use of social media to promote jobs and develop a new recruitment website to promote careers. The development of the website was informed by independently facilitated focus groups, comprising of new starters and longer serving staff, to understand the factors that made people want to join and stay at the trust.
The forward-looking team is focused on constantly checking the market, and proactively inviting people to open evenings and shadowing opportunities. Gavin notes that this switch from reactive to proactive recruitment has been one of the most significant shifts in the trust's approach to recruitment.
The work of these teams has increased the number and quality of candidates. In June 2020, the trust ran 179 recruitment assignments, in August 2021 1,100 recruitment assignments were run. The ability of the people team to handle such a large volume of work has risen hugely, thanks to increased investment in and focus on these new ways of recruiting.
Gavin also flags the benefits of the recruitment hub's aim to take as much recruitment responsibility as possible away from line managers (who are often frontline matrons or ward staff ). Moving this responsibility into the recruitment hub has reduced the average time between advertising and offering a role from 13 to 7.5 weeks. This is of clear benefit to the existing workforce, as well as to the candidates who do not have to wait as long to hear back from the trust.
New roles and the learning academy partnership
Another workstream from the workforce assurance group is the learning academy partnership. SPFT has partnered with Greater Brighton Metropolitan College (GB MET) to utilise a £200,000 grant from Health Education England (HEE). The organisations are working together to scope a model that provides learning opportunities and progression pathways that meet the strategic needs of SPFT.
The idea is to engage younger people in the local community and help them to see the NHS as a viable career option. Students on health and social care courses at GB MET spend some time seconded to SPFT to get a sense of what it’s like to work there. Students choose staff to shadow and are provided with pastoral support during their time at the trust. Gavin notes that this pastoral support has been important during COVID-19, with the increase in virtual working. The people team sponsor this work, once again ensuring that administrative duties are removed from frontline staff and managers. Students who enjoy the experience are then invited to join the trust in one of many apprenticeship roles (which can be clinical or corporate in their focus) and follow that route to qualification in a specific or generic role.
The workforce assurance group are overseeing the process of ensuring career pipelines for these roles, having realised that NHS apprentices often get taken on but aren’t always guaranteed a job at the end. This focused work has been backed up by the trust’s shift towards more strategic workforce planning, developing a comprehensive plan which will look 3 years ahead based on current vacancies, planned workforce expansion, current turnover, estimate for future turnover, and staff age demographic (including retirement). This is underpinning work such as the learning academy partnership, which focuses on building a staff supply chain.
Obstacles, enablers, and reflections
Gavin highlights the challenge of changing mindsets within the existing workforce. "Moving from traditional processes to something different can be unnerving, and it's about gaining trust to show it’s worth trying." A shift from regarding recruitment as an HR issue to an organisation-wide concern has required some public relations management from Gavin's team, to change the narrative of recruitment from "impossible" to "positive".
Investment to improve the trust's recruitment website has been an important part of this process, alongside executive and board events, and NED sessions.
As well as this, there have been issues of cultural acceptability regarding new roles. Existing staff are often unaware of how these new roles operate and where they fit into the team, so Gavin's team have run a lot of communications and engagement to bring existing staff along.
The enabler which Gavin particularly highlights is the need for recruitment activity not to be driven purely by finance. He recognises that this is controversial, but "because so much money is in the Long Term Plan it’s not just about spending it, it's about getting it right in terms of the types of people you want in your organisation."
SPFT's focus on strategic workforce planning has highlighted that this takes lead-in time, which is often overlooked in national policy – for instance, ICSs receiving millions of pounds of workforce funding and being expected to recruit instantly is very difficult to achieve. The work must be done to create staff pipelines, and this work pays dividends in the longer term.
Overall, looking beyond the NHS to creatively reassess recruitment activity has been hugely beneficial to SPFT. Investment has been key in making this work, alongside a supportive board who understand that there will be a lead in time to realise the benefit of the additional investment.