Reducing the delay between job offer and start date

Tips to streamline your recruitment process for young people and reduce the delay between job offer and start date.

17 March 2023


The NHS Long Term Workforce Plan recognises that candidates for direct entry roles often drop out of the recruitment process as they can secure a quicker start date with other employers.

Providing good support and a streamlined recruitment process can help them feel valued and part of the team even before they arrive. It sets their expectations of working in your organisation and helps build a connection. This guide will support you to consider ways to reduce the time from job offer to start date and improve the candidate experience. It is based on feedback from young people and examples from NHS trusts.

Match the right local people to current vacancies

Nottingham University Hospitals NHS Trust recruits young people through Prince’s Trust pre-employment programmes into both clinical and non-clinical roles. The trust runs its programmes based on current vacancies. This ensures that on completion of a programme, jobs are available for those young people.

Some NHS trusts have broadened their social media reach by advertising vacancies and range of job roles on new platforms.

“Care4Notts have started using TikTok and it was incredibly well accessed!”  Emma Cross, Sherwood Forest Hospitals NHS Foundation Trust  

Coventry and Warwickshire Partnership NHS Trust has hired staff specifically to support new starters in a relaxed, informal café environment. This has been proven to be an effective way of keeping candidates ‘warm’ whilst overcoming the paperwork challenges involved with recruitment. 

“At careers fairs, interview people first to get to know them before discussing job roles.” Ruth Auton, Head of Education, Learning and Organisational Development at Northumbria Healthcare NHS Foundation Trust 

Maximise opportunities at key touch points

Conditional offer

Contact your new starter by telephone and agree how they would like to be contacted before their start date and how regularly. Explain the next steps of the employment process including how long it will be before they start and reduce post-offer dropouts by keeping in touch:

  • Introduce them to the team, either in person or over a video call, to connect them to the people they’ll be working with and build a sense of loyalty.
  • Offer an opportunity for them to ask questions and make them feel more comfortable about their first day.
  • Share a timetable for your new starters’ first day and week to help them visualise themselves in the role.
  • Send candidates postcards or updates to keep them engaged. The Dudley Group NHS Foundation Trust sends a series of three handwritten postcards from: the chief nurse, their ward leader and a colleague that they’ll be working with.
  • Create a closed Facebook group for new starters to engage with the team they will be working in.
  • Provide an idea of timescales and a regular update of progress.

Pre-employment checks

  • Make the young people aware of these standards and the documentation they will need to provide if they are successful in securing a role. Recommend that the new starter contacts their referees to ask them to look out for reference requests.

Acceptable documentation

  • If individuals are genuinely unable to provide any form of photographic personal identity, employers can request alternative documentation. For further information download the identity check standard.

Avoiding delays

  • Give overarching responsibility for pre-appointment screening to one department to ensure consistency and avoid unnecessary delays in getting the successful candidate started in the workplace.

DBS Checks

  • DBS application forms are often returned due to missing information or mistakes. This guide for applicants can be sent out to all candidates as part of the recruitment pack. 

Find answers and further information about NHS employment check standards in our employment checks FAQs

Set clear expectations

NHS Employers surveyed newly appointed healthcare support workers (HCSWs) in the North East and Yorkshire region. The findings highlighted in this resource show the need to communicate very clear expectations of the role from the beginning including shift patterns, role activities, and any additional requirements such as driving licences. It also recommended actions organisations can take to improve the attraction, recruitment, support and career development for new healthcare support workers and others.   

Read the results and recommendations from our survey of HCSWs.

Introduce online inductions

Kent Community Health NHS Foundation Trust created an online induction package. Successful candidates are given a log-in to the platform with their offer letter where they can complete statutory mandatory training. For details read the full blog.

East Kent Hospitals University NHS Foundation Trust developed a digital ‘new starter portal’ which allows new recruits to engage with the trust as soon as they are offered their new role. They can familiarise themselves with key information about their new place of work and its values to fully prepare for their new start.

Tips from three NHS trusts which have streamlined recruitment:

The Royal Wolverhampton NHS Trust

  • You can listen to a special podcast and read about the actions the trust took to streamline recruitment processes.
  • This interactive career path finder tool produced by the trust offers a series of video tours showcasing what life is like in a hospital and the numerous roles needed to keep a busy hospital running. You can click on the 'i' in each video to find out more about the roles.
  • The trust has taken action to offer candidates paper-based application forms.  This intervention to improve accessibility has helped to increase the number of applicants applying for jobs.    

East Lancashire Teaching Hospitals NHS Trust

  • The trust employs a pre-employment co-ordinator to act as a single point of contact for young people. The co-ordinator facilitates a taster day, helps complete paperwork, provides pastoral support and maintains contact with the candidates.
  • An allocated ‘paperwork day’ supports young people to complete necessary documentation accurately.
  • Complete DBS and occupational health check paperwork prior to the commencement of work placements.
  • Recruit young people onto the staff bank if substantive posts are not available. This provides a stepping stone to a substantive post so they are ready to apply when a vacancy arises.

University Hospitals Birmingham NHS Foundation Trust

  • The trust works with The Prince’s Trust to connect pre-employment programmes with current local recruitment drives and national strategies.
  • A ‘taster day’, held two weeks before pre-employment programmes begin, helps the trust to explain to candidates what documentation they will need for their pre-employment checks.
  • Identity, DBS and reference checks are prioritised at the beginning of programmes. Only the young people who have successfully provided these can continue.
  • Occupational health checks are completed before work placements commence. 
  • Enable those who are offered a substantive post within six months of the pre-employment programme to use their original DBS certification.

Related resources

Watch the recording of the Reducing time to hire for young people webinar (19 October 2022) discussing how processes for recruiting young people to the NHS could be simplified and streamlined safely. This webinar discussed the key issues and challenges faced by organisations and candidates during the recruitment process and provided an open forum for discussing the potential for streamlining the recruitment of young people.

Reducing time to hire for young people webinar

Webinar Q&A

  • What can employers do when the DBS check is outstanding but you cannot chase it until it after 60 days?

    Due to their individual nature and complexity, DBS checks can take differing amounts of time for each applicant. Delays are often due to missing information or mistakes on the application. This step by step guide can be sent to candidates as part of their recruitment pack to prevent errors.

    An application will go to a police force if there’s a potential match against the details on DBS systems. The police may need to gather information from other organisations and their performance can vary month-by-month as a result of any combination of factors. This means some DBS checks may take longer.

    If an application has been with a police force or law enforcement agency for more than 60 days, you can submit a request online to check if the application can be sped up, or you can call the DBS on +44(00) 3000 200190.

    How can we recruit to urgent, need-to-fill posts when we don't have control over the timeline for DBS returns?

    There are some options to consider:

    • In 2020 the DBS introduced measures to allow employers to process DBS check applications before seeing original identity documentation. Employers can continue to conduct documentary verification remotely, providing original documents are seen and verified in person when the individual commences work. These measures are detailed in DBS guidance and may help speed up the process.
    • Depending on the type of role, the Adult First Service might be an option to speed up DBS checks. This service allows employers to obtain a fast-track check against the adults barred list. This check does not remove the need for a full enhanced disclosure, but it can help to mitigate risk where any delay to recruitment would have a significant impact on services and/or patient safety. If the individual is not barred from working with adults, and all other recruitment criteria has been met, they can start work under supervision while waiting for the outcome of the full enhanced disclosure.
    • You could opt to use the free-of-charge, fast-track DBS check service for urgent cases where the person is being appointed to deliver pandemic related treatment, care or services. However, use of this service should be the exception to the rule and where there is an explicit and demonstrable link to the legal eligibility criteria.  
    • In exceptional circumstances, you may make a risk-based decision to allow individuals to take up their appointment before the outcome of their DBS check is known. Exceptional circumstances include where individuals must complete a period of induction or training ahead of starting their role. It may also include allowing individuals to start work or volunteer in a limited capacity, for example, restricting duties to non-regulated activity.

    Why can't we use the checks carried out by another trust if the person is moving within a three-month period?

    The NHS standards require that pre-employment checks for identity, right to work, work health assessment (occupational health) and professional qualifications need to be checked if an individual is moving from one NHS organisation to another, regardless of timescales. This is so the employer has full assurance in employing an individual whose circumstances may well have changed.

    Depending on the type of role the individual is moving into, a different level of DBS check may be needed. You may choose to accept a disclosure certificate obtained for a previous role based on risk assessment, but you must always check the applicant’s identity matches the details on the certificate, and that the certificate is the right level and type for the role applied for.

    For references, employers must, as a minimum, obtain a reference from the applicant’s current or last NHS employer. Employers may decide to obtain additional references covering a longer period where this is relevant. There is an element of discretion here for employers to do this if they choose.

    When will NHS employment check standards recognise Identity Validation Technology (IDVT) standards?

    NHS Employers is in favour of aligning the NHS standard for identity checking with the use of IDVT/Identity Service Providers (IDSPs) for digital identity checks. But we need the policy and governance in place to give necessary assurances to us, to employers, to the Department of Health and Social Care and the Care Quality Commission before making changes to the NHS standards.

    The Home Office and DBS have digital identity arrangements in place. However, it is not possible to align with their arrangements because the type and level of assurances required to prove a persons’ right to work and/or to match to a criminal record could be lower or different to those required for NHS identity purposes. We need confirmation that certified IDSPs can provide the level of assurances against identity standards in the NHS. We are working alongside key stakeholders to progress plans that would support this.

    We use face-to-face ID checks. If someone lives in a different area, how can we avoid requesting original ID be sent by post?

    The NHS identity check standard still allows for remote checks of identity documents initially, as long as the original documents are verified in-person on day one of the individual’s employment. This option can be used instead of applicants sending documentation in the post.

  • Can we accept CVs through NHS Jobs and Trac?

    NHS Jobs allow applicants to apply using a CV if employers have allowed this option. Applicants will be asked to copy and paste their CV information into the application.  Trac also gives employers the option to make CV uploads optional or mandatory. The applicant is still required to complete the application form in full and the details provided in the form remain the primary source of information used to assess applicants.

    Will you feed back to NHS Jobs the issues raised in this webinar around application forms?

    Yes, NHS Employers has regular meetings with the NHS jobs team at NHS Business Services Authority. Feedback from the webinar has been shared and the new NHS jobs service will include a revised application form. We will share further details to explain the new application form shortly.

    Can NHS Blood and Transplant share their recruitment profiles used as an alternative to job role/personal specification documents?

    This case study details how the trust uses a two-page recruitment profile alongside benefits information to advertise roles. The profile is a condensed version of the job description and person specification using plain English, making it more accessible and appealing to candidates. The first page provides a description of the duties in plain language, an organisation structure and an 'about us'. The second page details values and behaviours that apply across the organisation and job specific information.

    If only recruitment profiles are used to advertise roles, how does that affect job evaluation and objectives?

    Job description and personal specification are still used in the recruitment pipeline to influence job evaluation and to create objectives. The documents are provided to candidates at job offer and contract stage.

Further resources