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Retention of NHS support staff

Posted on 1/05/2019 by Grace Keenan


Retaining skilled and experienced staff is a crucial part of maintaining the NHS workforce. Although the focus does tend to be on the clinical staff on the front line, keeping the turnover of non-clinical support staff low also has an important role in providing continuity of care and meeting patient demand.

There is no magic bullet that will instantly improve retention rates. Instead, it’s a result of continuously working to support staff and encourage them to remain with your organisation.

Why do support staff leave?

Recent research from NHS Digital looked at the reasons for leaving by staff group. For voluntary resignations among support staff, these were the most common reasons for leaving:

As you can see, there is a wide range of reasons for support staff choosing to depart the NHS, but many of these issues can be addressed through HR policies and management practices.

Flexible working

The desire for a better work-life balance is by far the biggest reason for leaving; responsible for nearly a quarter of departures, and flexible working is the main way to improve this balance. An additional 6% leave as they have to care for child or adult dependents, although offering more opportunities for flexible working might help them to stay.

Flexible working no longer means part time jobs for working mothers – nearly all staff want or need some form of flexible provisions. There are many different flexible working arrangements, suitable for all types of staff of all ages. Some of the most common include:

  • Part time working - A reduction in hours.
  • A change of working hours - For example changing to earlier or later shifts.
  • Core hours working - Having a range of time that must be worked, but the rest of the hours can be worked at any point.
  • Annualised hours - A set amount of hours to work over the year, but no set schedule as to when they are worked.
  • Flexi-time - Having a set amount of hours to work per week, but no set working hours.
  • Job sharing - Two people working in one full time role sharing the workload and responsibilities.
  • Term time arrangements - An agreement that different hours or unpaid leave can be taken in school holidays.
  • Home working - Working from home, whether permanently, flexibly or on specific days.
  • Location changes - Working from a different location.
  • Sabbaticals/career breaks - An extended amount of unpaid leave (sometimes for up to 5 years).
  • Zero hours contracts - Working ad hoc.

The best way to approach flexible working is not to employ a ‘one-size-fits-all’ approach, but instead to offer a range of options, so that all members of staff can support their work-life balance and life needs. Due to the needs of the organisation, it’s not always possible to honour all flexible working requests, but a compromise can usually be reached through employer and employee working together.

For example, Calderdale and Huddersfield NHS Foundation Trust employs two assistant

HR directors on a part-time basis. One had a pre-existing arrangement which she maintained when promoted to a senior HR manager and then Assistant Director of HR.

Offering opportunities for flexible working is also a great way to attract new members of staff and can help to address gender imbalances at senior levels.

Reward and career progression

9% of support staff quit the NHS in order to find a better reward package, while an additional 5% left due to a lack of opportunities for career progression.

Salaries in the UK started to rise in 2018, after over a decade of stagnation, and are expected to continue increasing in 2019. Support roles are generally far more transferrable than clinical jobs, so employers need to stay competitive in the salaries they offer or risk losing employees to the private sector.

You can get an idea of average salaries for new NHS administrative jobs using the Indeed salaries tool. For more tailored advice on your particular role, get in touch with the TPP Health & Social Care team on 020 7198 6080 or

It’s also important to offer opportunities for career progression wherever possible. By creating set career pathways, employees can easily visualise how their careers are likely to progress with your organisation. Staff will know exactly what they need to achieve in order to advance to the next rung on their career ladder. It’s also important to make sure that all new roles are promoted internally, giving existing staff a chance to apply.

TPP’s top tips for support staff retention

  1. Use tools like exit interviews, morale surveys and appraisals to find out exactly what motivates staff to leave and how they are currently feeling. This insight will allow you to build a plan to address these issues.
  2. 9% of support staff leave due to health issues. By supporting your employee’s health and wellbeing, both physical and mental, you can help avoid losing your staff needlessly. The NHS can be a stressful place to work, so employees need to feel they can speak up about problems rather than hiding them.
  3. Up to 20% of employee turnover happens in the first 45 days. By creating an effective onboarding process for new starters, you can make them feel welcome and supported.
  4. 3% of support staff leave due to ‘incompatible working relationships’ and there’s a saying that “people leave managers, not organisations”. Every member of staff should have a good working relationship with their colleagues and line managers and problems in these areas need to be nipped firmly in the bud.
  5. Don’t delay recruiting when you have a vacancy. Your existing staff may be able to cover the role, but it could damage workplace morale and leave no contingency for emergencies. If you need to buy more time, TPP Health & Social Care can supply skilled temps with NHS experience, often at very short notice.

Useful resources

Advice from NHS Employers on improving retention

Flexible working in the NHS: the case for action

HEE Talent for Care strategy