Flexible working and e-rostering are key to keeping more nurses in the health service, a new report by NHS England suggests.
The organisation has published a new analysis of its People Promise staff retention initiative, which has seen trusts offered support to implement changes to prevent staff from quitting.
“I’d encourage all NHS organisations to prioritise retention”
Em Wilkinson-Brice
Of the 23 trusts that made up the first cohort of the programme, all but one recorded a significant decrease in their all-staff monthly leaver rates.
Across all the trusts, leaver rates fell collectively by 11.8% more than non-exemplar trusts over the 20-month pilot – a reduction of 4,465 full-time equivalent leavers.
The programme, which has been led by NHS England since April 2022, has since been expanded to a further 116 organisations – including more mental health and community trusts, as well as primary care and ambulance services.
Employers taking part are supported to implement a bundle of interventions that incorporate different elements of NHS England’s People Promise.
The People Promise was informed by feedback from NHS staff about the things that will improve their experience of working in the health service. These included being in a workplace that is compassionate and inclusive and where staff are recognised and rewarded, safe, always able to learn, have a voice and can work flexibly and as a team.
Among the interventions that trusts have rolled out under the People Promise staff retention were actions to improve representation of Black, Asian and minority ethnic at all levels; rolling out pension awareness seminars to help staff understand how the scheme works; and making sure Freedom to Speak Up Guardians are in place and have ring-fenced time to carry out their role.
Other measures included establishing a “local listening strategy” for staff to be heard; appointing wellbeing guardians; making sure a minimum of 25% of permanent roles are advertised with clear flexible working options; and efficiently introducing e-rostering to give staff more control over their shifts.
The report found that e-rostering, supporting flexible working and flexible retirement and local listening sessions for staff had the biggest impact on improvements to leaver rates.
NHS England said the improvements to retention gained through the programme had helped to cut the overall leaver rates from the health service to the lowest level in recent years.
In the 12 months up to September 2024, the leaver rate for hospital and community healthcare workers was 10.1%, the best recorded since the year up to March 2021 when it was 9.2%.
Improvements have also been seen in the retention of nurses and health visitors specifically.
In the year to September 2024, the leaver rate for nurses and health visitors was 8.8% – matching the March 2021 rate, which was the best recorded since 2011.
Em Wilkinson-Brice
The People Promise staff retention initiative is led by nurse Professor Em Wilkinson-Brice, director for staff experience and leadership development at NHS England.
Commenting on the new analysis, she said: “Our People Promise staff retention programme shows what’s possible when you work closely with staff to make changes that improve their lives, whether supporting flexible working or making simple alterations to rostering processes.
“I’m delighted that we’ve been able to expand the initiative to a further 116 organisations so that we can provide a world-class service that’s appreciated by both staff and patients across the country.
“I’d encourage all NHS organisations to prioritise retention by making changes that will improve the everyday working experiences of their teams.”
Caroline Waterfield, director of development and employment at NHS Employers, welcomed the retention improvements achieved, but noted that they were only possible through investment and support for trusts.
“It is welcome to see the fall in the number of workers leaving the NHS and the positive impact of the sustained focus on actions that make a difference to staff experience and ensure our talented staff do not leave,” she said.
“Local employers and the national NHS England team leading this work should be proud of these achievements, which have been made in the toughest of contexts.
“We know from talking to employers that the support, focus and resources from the national team, including providing funding for dedicated local project managers, has been instrumental in enabling this work to deliver positive outcomes.
“As the NHS faces even tighter financial constraints, it becomes even more essential to prioritise investment and focus on the actions that work to retain staff.”
