A strategic approach to health visiting retention


07 / 11 / 2014 1pm

A workforce strategy is simply, a plan of action designed to achieve a long-term or overall aim for your staff. 

By 2015, the health visiting workforce will be larger and rejuvenated, thanks to your work to recruit and develop the workforce. 

Having a strategic approach to retaining your health visitors (HVs), when it is needed more than ever, will help you to engage the right people in planning and implementation. It will help you to identify, deliver and measure the improvements that are really needed.

Developed by NHS Employers for you, our HV retention briefing and checklist  brings together suggestions and tips to help workforce and HR managers and staff side representatives work together to develop a retention strategy for your health visiting workforce. 

NHS Employers has also worked closely with numerous HV leaders to support them as they grow and develop their workforce. Many trusts have implemented strategies to help them to retain the HVs they value and reduce turnover. The guidance included in our briefing above, and the tips below are there to help you to consider how to get the most out of your own strategy. 

What makes a successful retention strategy?

Building on the initiatives mentioned in our briefing, we found that some of the features of successful retention strategies were:

They consider the wider context the health visiting service is working in

  • As well as making clear links to the Government's Health Visitor Implementation Plan, successful retention strategies acknowledge relevant recommendations made in recent reviews to improve patient care, such as Francis, Cavendish, Berwick and Clwyd-Hart.  They also complement wider organisational strategies and values. Read more about the policies driving developments in health care and health visiting on our 'Health visiting - what you need to know' web page.

Successful strategies have Board buy-in

  • The trusts we have worked with who have implemented successful retention strategies, have engaged their Boards and gained their understanding and commitment to developing the workforce, and improving retention. They have approved dedicated resource to taking this forward.

Effective strategies set out both strategic intentions, and the operational effects of these

  • Planning is essential if you are to produce a well thought out and thorough strategy. An action plan will help you to communicate and deliver both outcomes and outputs. Some trusts have appointed a steering group to ensure plans are realised.  

They were evidence based 

  • A retention strategy  based on local and recent evidence about what matters to the workforce and the community it serves is much more likely to improve outcomes for those people. 
  • Trusts have benefited from using information and intelligence that they already have to inform plans for their workforce. Tools such as the Electronic Staff Record (ESR), e-rostering records, caseload data, feedback and complaints, and exit interview records can all provide rich information to help you understand and retain your workforce. Find out how ESR can support your HV retention strategy in this slideshow, presented at a recent NHS Employers HV event. 

Health visitors were engaged at every stage of the development and implementation of the strategies. 

  • Making sure your health visiting teams are happy and supported is key to ensuring that you retain their skills. Some trusts have held staff engagement events to find out what mattered to their HVs. Find out how Walsall Healthcare NHS trust improved retention among health visitors starting with engagement. 
  • Making a concerted effort to identify and improve low morale among HVs, and reducing feelings of stress and burnout can have a positive impact on who stays with the organisation. Things such as heavy caseloads, poor IT systems and equipment, lack of dedicated work space and administrative support contribute to stress. Find out how to improve the health and wellbeing of your staff, and develop long term plans to continue to do so, in our dedicated health work and wellbeing web section.
  • Provision of a professional development programme for HVs at every stage of their career will help to equip them with knowledge and skills to deliver the new service vision for health visiting, and contribute to improved morale. A robust preceptorship programme will help your newly qualified HVs make the transition from studying to practice at the very beginning. There are numerous learning opportunities for HVs, which don't have to cost the trust money, such as Building Community Capacity and NHS Leadership Academy programmes. Linking your retention strategy to good career pathway and training programmes - and letting HVs know about the opportunities available to them - is highly recommended. 

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