Role of the employer

trainee doctors

Employers need to assure their board that the quality of care and experience not only meets the desired standard, but is continually improving. This is achieved through a variety of employment and workforce practices. 

This section provides information on:

Employer-led assurance 

There are several priority areas for the employer which, when reviewed against the expectations of the service, can provide assurance of the competence of their whole workforce.

  1. Recruitment: clear expectations, the use of employment checks and induction.
  2. Supervision: systems in place to provide supervision to individuals where appropriate and for the overall care being delivered to patients.
  3. Continuing Professional Development: to ensure all staff continue to meet the requirements of the role they are employed to undertake.
  4. Clear standards, expectations and boundaries: to ensure appropriate delegation and assure individuals do not operate beyond their scope of competence.
  5. Appraisal: using the many different tools available to support the assurance process.
  6. Policies: embedded into practice that support staff to challenge issues of concern and deal with unacceptable behaviour or poor standards of care in an appropriate way.

These actions help to create a local system that puts patient safety at the heart of employment practice. We know there is compelling evidence showing links between high levels of staff engagement and overall organisational effectiveness, so the actions need to be underpinned by a set of behaviours that create a culture of patient safety and continual improvement in quality:

  • Strong leadership
  • Environment where staff are happy to raise concerns
  • Staff engagement drives service delivery
  • Effective team working and a team ethos to delivering care.

Fair recruitment requirements

Some healthcare practitioners are eligible to join more than one register, depending on their qualifications and it is important employers don't limit the pool of candidates by requesting statutory registration with a regulatory body when in some cases, this doesn't exist for the individual. Our top tips to get the most out of voluntary registers section explains more.

Examples include:

  • Healthcare scientists - some who are statutorily regulated by the Health and Care Professions Council and others who register with the Academy for Healthcare Science or indeed both.
  • Sonographers - some who may have already trained as a nurse or radiographer and therefore are regulated by the Nursing and Midwifery Council (NMC) or HCPC and others who trained through a direct entry route and who are voluntary registered with the Society and College of radiographers. You can find out more in the medical radiography and ultrasound workforce section of the website. 

Professional indemnity

Under the Health Care and Associated Professions (Indemnity Arrangements) Order 2014, all healthcare professionals are legally required to confirm that they have relevant indemnity insurance. This is to cover the different aspects of their practise in order for them to register, or remain on a register, with a professional regulatory body in the UK.  

We would strongly recommend that NHS organisations provide information to all healthcare professionals that are contracted, either directly employed or contracted through an agency or third party supplier. Organisations should explain what indemnity arrangements are offered and the scope of that cover. This will enable individuals to make an informed decision about whether or not they need to seek their own professional indemnity insurance.  

What questions might staff ask?

Our Q&A document, developed in partnership with health unions and professional regulatory bodies to help employers field some of the basic questions that may be asked by staff about indemnity arrangements. 

Please note that NHS Employers cannot respond to individual queries from staff about the scope of local indemnity arrangements as this will be determined by local agreed terms of employment. 

Healthcare professionals may seek further information about indemnity cover from their:

  •  employing organisation's human resources or personnel department
  •  professional regulatory body.
Where healthcare professionals have taken out a separate indemnity policy, they should contact their insurance company to ensure they continue to have the correct level of cover for the type of services they are or will be providing.

Further detailed guidance can be found in the NHS Litigation Authority, NHS Indemnity document.

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