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NHS Recruitment: Six lessons from Royal Devon University Healthcare NHS Foundation Trust

Tags: Recruitment Process, Recruitment Transformation

It’s certainly true that the NHS faces some deep recruitment challenges. Anyone who recruits into the NHS knows it’s “beset by chronic workforce shortages”. 

Budget is an issue. Bureaucracy is an issue. Those things aren’t going away.

But despite these challenges — perhaps because of these challenges — the NHS’ people teams have to work especially hard to hire, train, and retain great people. And the result is often something all recruiters could learn from. 

Royal Devon University Healthcare NHS Foundation Trust is a fantastic example of a proactive, joined-up recruitment strategy that’s a credit to the NHS. And should give us all hope for the future of the healthcare services we rely on.

We chatted to Hannah Foster – Royal Devon’s Chief People Officer — about this journey. Watch this episode of The View on-demand here. Or keep reading for the key takeaways. 

 

Complex, varied, and extremely remote: recruiting for Royal Devon

Royal Devon’s recruitment is enormously complex. They hire into two acute hospitals, two A&E departments, the Nightingale hospital that was repurposed after COVID support to become a diagnostic centre, an orthopaedic centre, and a load of community sites. 

Overall, they juggle 50 to 60 sites across Devon, which extends over an enormously diverse and often extremely remote geography. (One of the acute hospitals Royal Devon run, Royal Devon and Exeter, is the most remote hospital on England’s mainland.)

Royal Devon has around 15,000 employees covering more than 200 professions — jumping to 36,000 people when you consider mental health providers, acute care, and community workers. 

This scale and diversity of requirements paired with the geographical remoteness makes recruitment somewhat challenging, to say the least. But Hannah and her team have proved themselves equal to the task.

Here are some of the tactics that have worked for Royal Devon. 

 

1 – Proactive demand generation

Recruitment marketing has been a huge focus for Royal Devon. One of Hannah’s main priorities from her wealth of experience in senior positions in the private sector was the need to proactively nurture a pipeline of talent

Royal Devon have enjoyed hiring success by:

  • Creating prospectuses to attract candidates to Devon as an area, not just  centring on the service
  • Creating an internal executive and specialist search team for headhunting, instead of relying on agencies
  • Offering relocation support and family support, not only internationally but domestically (including helping people find a home or second home)
  • Asking lead clinicians to have initial conversations with prospective candidates – clinical staff talking to clinical staff, rather than recruiters
  • Giving candidates the opportunity to work for a few days on-site, to get a sense for the service (worthwhile despite huge compliance complexities)

 

2 – Funding cultural cohesion for international recruitment 

Many trusts within the NHS have a complicated relationship with international recruitment. Hannah points out the ethical considerations: 

“It’s critical not to deplete the developing world’s healthcare workforce, that’s not moral. Plus there are social mobility and inclusion considerations from a UK perspective. Devon has some areas of huge coastal deprivation, so we should look at developing employment here to benefit people in the area.”

Nonetheless, Royal Devon has a thriving international recruitment hub with communities going back 20 or 30 years. Since COVID though there are new challenges here. Hannah explains how the cultural dynamics have changed:

“Historically, you’d often focus on one geography and we’d hire a cohort of people together who have the same cultural heritage. What’s happening lately is we’ll get a very diverse cohort from four or five countries, so there’s a whole intercultural understanding piece needed to help people feel welcome and understood.” 

Supporting cultural cohesion and funding pastoral care has been critical to success from an international recruitment perspective, especially since Royal Devon has much more diversity than the local population. 

 

3 – Deliver a cast-iron people promise

Retention is one of the three prongs of the NHS’ Long Term Workforce Plan, which was unveiled in June 2023 — and it’s one that’s absolutely vital to get right, to build a sustainable recruitment function that’s successful for the future. Retention is one of the healthcare industry’s biggest challenges

As Hannah puts it, “the long term workforce plan just does not work if we don’t retain better. That’s your bread and butter.”

One of the best tools in the NHS’ arsenal here is the People Promise. Royal Devon use this as their EVP and have a proactive cultural development roadmap that includes broad topics like wellbeing, employee experience, inclusion, and patient safety, to outline how the people team will deliver the promise to the workforce.


Read more: 11 ways to bring your EVP to life


The NHS has an inclusive, diverse culture with enormous integrity, honesty, and psychological safety. Ensuring this comes across is critical to improving both retention and attraction. 

Some of the most important elements to boost retention have been:

Hannah points out:

“Half our hires in the past year aren’t from the NHS, but from the general population. You’re not designing recruitment technology for people who are used to the NHS, but for the 16-year-olds coming out of college.”

 

4 – Take a strategic view to workforce reform

When you’re dealing with more than 100% capacity for 365 days a year, it can be difficult to step back and take the 1000-yard view. But Reform is one of the key pillars of the long-term plan — and critical to ensuring NHS recruitment is proactive and moving towards sustainability, not reactive.

For Royal Devon, that’s meant things like:

  • Ensuring senior doctors aren’t spending time on more junior tasks
  • Exploring how to enable people to stay at home for end-of-life care
  • Understanding which new roles might evolve and developing these
  • Ensuring they have the right tech: legacy tools are a major hurdle to progress

 

5 – Develop apprenticeship routes

Apprenticeships can be challenging, especially in clinical areas. NHS recruitment is a roster environment with minimum staffing levels and constant budget pressure on a year-by-year basis. Meanwhile, apprentices take three to four years to start delivering full value and you’re paying for a full-time equivalent but losing them 20% to 40% off the job.

Despite this though, Hannah emphasises the value of apprenticeships to building a sustainable workforce:

 “There’s something very valuable about the apprenticeship route in terms of building resilience and learning the culture and protocols that help someone thrive in the NHS long-term.”

Apprentices aren’t an immediate solution to the NHS’ recruitment challenges but they’re an important element of delivering against the long term plan. 

 

6 – Prioritise digital transformation

To meet growing demand for healthcare, the NHS is planning to grow from 1.4 million people today to 2.2 million people by 2038. Critically, the people function needs to stay flat for that growth to be affordable — which places enormous pressure on people teams across the NHS.

“How as a people function can we work smarter, because we cannot do any more to work harder?, Hannah asks. 

Investing into the right technology will be one critical piece of the puzzle. As Hannah puts it:

“The technology question is massive, both in the clinical area and in the enabling functions area. There’s lots of inappropriate segregation and siloes and lack of operability with ESR, for example. It’s a big steam ship to turn around but it needs to happen.”

To meet their long term workforce plan, Royal Devon are pioneering on digital transformation. In fact, we couldn’t be prouder that they’ve become the first trust in the country to break the mould and use Tribepad for their end-to-end recruitment. 

Recruiting for the NHS brings challenges – we all know that. But many trusts are making brilliant progress to modernise and transform their hiring, often overcoming huge hurdles to do so. It’s progress like this, from the brilliant, committed, passionate people we see working so hard within healthcare, that should make us all feel hopeful about the future of our most important public services. 

Tribepad is the trusted tech ally to smart(er) recruiters everywhere. Our talent acquisition software is a springboard for faster, fairer, better recruitment for everyone. 

Trusted by organisations like Royal Devon University Healthcare NHS Foundation Trust, British Medical Association, Bupa, Signature, NHS Professionals, Turning Point, and HCRG Care Group, 25-million people in 16 languages use our talent platform. 

See how HCRG Care Group increased applications by 47% and reduced time-in-compliance by 62% with Tribepad.

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