Case Study

Supporting staff to work for longer: University Hospitals of Derby and Burton NHS Foundation Trust

Read how University Hospitals of Derby and Burton NHS Foundation Trust introduced a new initiative to support the retention of its older workers.
Workforce supply

2 March 2020

University Hospitals of Derby and Burton NHS Foundation Trust (UHDB) developed a ‘working for longer’ project, to support its staff to stay in work for longer. Over 15 months the workforce transformation team, which oversees the project, has introduced several initiatives to support the retention of older workers.

What the organisation faced

Current trends show that the average age of an NHS worker will increase to 47 by the year 2023. UHBD’s data showed that 28 per cent of its workforce was 51 or over. While factors meant that people are intending to work for longer, this group were the unhappiest in the trust’s 2018 staff survey.

What the organisation did

The aim of the working for longer project was to improve the retention of older workers by improving the things that mattered most to them. The project was led by the workforce transformation team, which is responsible for looking at wider workforce initiatives and provide a long-term view to the future workforce.

The project led to the creation of several initiatives, some aimed directly at staff, such as additional targeted advice and training sessions on the options around pensions and retirement. Other initiatives were aimed at educating managers to support their older workers, including new guides, resources, roadshows and events.

To inform the project and make sure it worked locally, the team engaged with staff and asked them what the barriers and enablers to working for longer were. The mechanisms the trust used to do this included a trust-wide survey where staff were given the option to remain anonymous, focus groups of five to ten people and one-to-one interviews which took place across each of the trust’s five sites. Alongside this, the team researched national guidance and resource documents with the same aim of understanding what would make a difference to staff, to encourage them to work for longer.

The feedback gathered from staff changed perceptions about what older workers wanted or needed to remain in work. It informed an action plan with smaller interventions that would ultimately work to bring about cultural change in the organisation.

After reviewing the information it had gathered, the trust understood what the key messages they needed to promote and deliver were. The team brought in a number of different bodies, such as occupational health, pensions, trade unions, and developed a short action plan for each team, so they could understand the challenges and identify what their role was in overcoming them. As an example, the trust looked at its appraisal process and brought in the learning and development team to review appraisal information. In particular, the trust looked to ask questions where staff set five-year targets for development, rather than just the one year.

Information guides for staff and managers were produced by specialists within the trust, about topics including menopause, carer commitments and deafness and hearing loss. These were housed on the trust’s intranet and communicated directly to managers and promoted at events, such as the Working for Longer Conference. Menopause awareness sessions were held at all trust sites, giving staff the opportunity to explore the support available and give feedback.

The Working for Longer Conference was developed following feedback from staff which told the trust that managers had the highest influence on staff ability to stay at the trust. The event featured internal and external speakers who spoke about topics that staff had told the trust affected their ability or desire to work for longer. Through a mixture of workshops and speaker Q&A sessions, the conference provided managers with information on menopause, stress, reasonable adjustments, engagement, flexible working and musculoskeletal conditions. More than 80 managers attended the sessions and dedicated time to think about actions that could support their staff to work for longer. The conference also included a section for managers to consider their future team to address future shortages, for example promoting careers to younger generations and considering skills mix changes.

Managers play a key role in how staff are supported to work for longer at UHDB, and they continue to be supported through quarterly manager email bulletins containing guidance and resources, such as checklists to help them think creatively when responding to flexible working requests.

The workforce transformation team worked with other parts of the organisation too. Actions were developed with departments including pensions, organisational development, learning and development, occupational health, equality diversity and inclusion and HR business partners. These departments bought into the work as all the information collected by the workforce transformation team clearly showed the need for action and how those departments could share their expertise to ensure the project was a success.

Having data and information from staff engagement to display, made it easier for staff in other departments to understand where there were issues and what they needed to do.

Results and benefits

Working for longer was part of a wider programme of retention that has achieved a decrease in turnover, at a time when staff were going through a merger, therefore meaning fewer vacancies, less bank and agency expenditure and improved patient experience. An increase in the numbers of staff completing retire and return means that the trust is better retaining the skills and knowledge that would otherwise be lost to them.

Alongside this, the work the trust has done has had a positive impact on staff experience, such as:

  • Improved retention.
  • Improved staff engagement.
  • Issues that matter to staff are addressed.
  • Vital skills and knowledge remain in organisation.

Staff who, after seeing that their feedback was asked for and acted upon, have stated that they feel listened to and that the trust proactively supports and values its older workers.

Managers have found the information shared informative and helpful and it has supported them to understand the trust’s offer to employees and their role in promoting what’s available to staff.

By continuing the work of the working for longer project and encouraging managers to think creatively about how to support their staff as they age, whether that is with flexible working, health and wellbeing or carers commitments, UHDB hopes that flexibility and support can become part of the culture at the trust, and progress on this will continue to be monitored.

Key outcomes

The project ran at the same time staff were going through a merger of two trusts, despite this, turnover has decreased and UHDB has one of the lowest turnover rates of nurses in the region.

  1. Overall staff turnover has reduced from 10.32 per cent to 9.86 per cent.
  2. Nursing turnover has reduced from 9.63 per cent and 12.24 per cent across the two organisations, to 8.84 per cent in one.
  3. Retire and return rates overall increased from 38 per cent (2018) to 44 per cent (2019), and for nursing staff from 38 per cent (2017/2018) to 53 per cent (2018/2019) – this equates to 11 more nurses retained.
  4. Tailored support for staff and managers and information about considerations of new ways of working has increased.

Overcoming obstacles

The project took place during a merger of two former trusts, when policies and practise were not aligned. Ensuring the work reflected expectations across both organisations was important. Enlisting the help of the organisational development team helped to ensure cultural differences were considered and that information was displayed in the best possible manner.

Gathering the data that informed the project, analysing it and prioritising what was important was valuable however it was also time consuming. There were considerations around GDPR and the type of information being requested, so early advice about GDPR requirements for the organisation was beneficial. Breaking down goals into more manageable actions helped the team make progress and not become overwhelmed by the task at hand. Having the data made it easier to display why the work was important to stakeholders.

Things to consider

  • Multi-disciplinary team input is essential.
  • Changing cultures and approaches is a longer-term goal, so change will be gradual.
  • Your people are your experts, engage and involve them in making the organisation a place where they want to work for longer.

Further information For more information about the work in this case study, contact Vicky Bailey, Senior HR Advisor, University Hospitals of Derby and Burton NHS Foundation Trust: vicky.bailey3@nhs.net

Takeaway tips

  1. Use data and staff views to inform actions.
  2. Try to identify key themes and give those priority when developing an action plan.
  3. Map out stakeholders and identify where their expertise can benefit the project.
  4. Tap into the expertise of people within your organisation when producing written resources aimed at specific groups.
  5. Don’t be daunted by the size of the task, break down action plans into more manageable goals. Find a way to keep stakeholders informed of progress, such as through staff intranet pages.