Staff development pathways

This is a hub of information on career pathways and staff development.

12 June 2024

This guide showcases a range of your future roles infographics and highlights a series of short case studies demonstrating what trusts are doing to support staff development, enabling them to retain their workforce. 


The NHS Long Term Workforce Plan and the NHS People Plan,  focus on increasing workforce supply, supporting our current NHS staff, and growing the NHS workforce through retention. One of the top reasons for staff leaving is that they do not receive development or the career progression that they need. This highlights the need for staff support, development opportunities, and awareness of opportunities available in both clinical and non-clinical roles. 

This guide will provide ideas and routes to develop and retain your existing healthcare workforce.  It showcases examples and development pathways for staff in a wide range of band level roles from healthcare support workers to advanced practitioners

"The healthcare support worker role offers excellent career development opportunities and can also be the first step towards a lifelong career in the NHS. With the right support, many healthcare support workers go on to become our future nurses, nursing associates, and midwives if they choose to." - Ruth May, Chief Nursing Officer, England

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Routes into NHS careers

Our series of your future roles infographics showcase the variety of roles in the NHS and the routes that existing staff can take to enter these professions. They also cover funding, time scales, and entry requirements.  

Support staff may develop their skills and become apprentices, nursing associates or assistant practitioners. For more information about nursing associates, read these blogs 

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The importance of a robust induction programme

Whether it is called induction or preceptorship in your organisation, supporting staff when they join your organisation is important to ensuring their retention and that they feel valued in a new workplace.  

Preceptorship tends to refer to the period after which newly qualified practitioners transition to autonomous members of the workforce, but the same principles can apply to any role.  

A robust induction process can include mentorship and a buddy programme, regular check-ins with new members of staff, development discussions and the opportunity to feedback concerns.  

Read examples of good practice from employers below to consider how to implement a strong induction programme in your own organisation which will lead to the opportunities for staff to develop and consider their next career steps. 

  • The trust introduced an induction programme for their flexible band three midwifery support workers to support them to feel comfortable working in different maternity areas and increase their confidence. This included a five-week induction programme, run simultaneously to ward practice, followed by a catch-up day to share concerns. This was supported by the creation of a cohort specific WhatsApp group for discussion and increased in-person support from the training and development lead.  

  • West Suffolk implemented a student forum and student mentorship programme to support students on placement and encourage health and wellbeing. Whilst this programme was focused on students, the elements introduced are pertinent for support workers and other roles.  

We have created a comprehensive guide on preceptorship. The guide includes the benefits of preceptorship, ideas for support, case studies and good practice and further resources for employers.  

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Case studies demonstrating staff development in action

These short case studies provide insight into what trusts are doing to grow their own and support staff development, enabling them to retain their workforce. 

  • Medway NHS Foundation Trust was experiencing significant challenges in recruiting nurses within the emergency department. The trust's development workforce strategy focused on introducing several work-based educational programmes that would be used to support existing registered nurses to obtain a specialist award accredited at BSc or MSc level. 

    It also enabled unregistered members of the nursing team to gain new knowledge and skills and progress their careers from clinical support worker to associate practitioner, nursing associate and registered nurse. This model would improve patient care and outcomes, by enabling patients to be seen by the right person with the right skills first time.  

    The workforce strategy commenced at the end of 2015 at which point the emergency department had: 

    • a 65 per cent nursing vacancy rate 
    • 76 nursing staff, with only four nurses holding a specialist qualification 
    • a 24 per cent turnover rate within their nursing workforce. 

    The trust had several experienced healthcare support workers who lived locally and could be invested in via the apprenticeship route to become associate practitioners, nursing associates and then complete a degree as a registered nurse if they wanted to. This was beneficial for the organisation as it was important for the emergency department to develop staff from initial entry due to difficulties recruiting senior nurses and the increasing complexity of modern emergency nursing.   

    The aim to grow its own nursing workforce included developing a  Support Worker to Nursing Associate Development Pathway, which breaks down timelines and steps to becoming a nursing associate in the form of a visual document, ensuring staff members could see a future in the trust and knew how long each step would take. The document highlights all the training available and has been displayed within the emergency department to continuously remind associate practitioners and healthcare support workers that they are valued and with the right training there is a nursing associate role available for them. The trust has also created a continuing professional development chart for new nurses demonstrating a timeline for their journey from novice to expert. Both charts are an intrinsic component of the appraisal process. 

    As a result of all the hard work, in 2021 the emergency department had a total of: 

    • 189 nursing staff made up of 138 registered nurses 
    • One apprentice trainee nurse 
    • Nine nursing associates  
    • 24 associate practitioners  
    • 17 healthcare support workers. 

    Reducing its nursing workforce turnover rate to around 8 per cent for the last three years, the department has also created a similar development pathway tool for nurses to build on their existing skills and develop as autonomous practitioners. 

    In 2018 the team shared access to its educational programmes with other emergency departments within the South East. Each year 24 nurses from a variety of departments in the South East now undertake a specialist award at Medway NHS Foundation Trust.  

  • Northamptonshire Healthcare Foundation Trust is a community and mental health trust running a new to care programme for healthcare support workers. It aims to attract and recruit new staff with no experience in mental health care and provide training and development to help increase its healthcare support workers workforce. The trust uses a values-based approach instead of just focusing on the applicant’s experience.  This has been a major benefit to recruitment as the trust has been able to reach out to a wider audience from the local community. 

    Staff on the New to Care programme are trained, including starting their care certificate, for eight weeks as a Band 2 within the nursing directorate, with visits to clinical areas before being placed into service areas and getting their care certificate signed off. This is then followed by a six-month preceptorship programme as a Band 3 and continued support by the practice education team, which has been useful retaining new healthcare support workers. 

    This new group of healthcare support workers also enables the development of a pipeline for career progression opportunities into higher clinical apprenticeships, such as nursing associate and registered nurse degree apprenticeships. Subsequently, supporting recognition, retention, and the ability for the trust to sustainably grow its own clinician and nursing workforce from the bottom upwards, allowing for more healthcare support workers to be recruited through New to Care. 

    The trust has also developed a free, dedicated work experience pathway programme, called Volunteer to Career, to support individuals such as those who are unemployed with no healthcare experience wanting a more gradual route into employment to gain experience using functional skills courses and the care certificate to find roles in the NHS. Again, once in a bank or substantive post within the trust, there is the opportunity to develop further to become potential clinicians through apprenticeships if viable.  

    The trust also runs partnership apprenticeship programmes across the local health and care system which have been developed to support system-wide working. The programmes allow employers to offer bespoke training with local providers to allow colleagues within the Nottingham Health and Care partnership system to learn from each other. This includes primary care and social care, which gives apprentices the opportunity to also work in these areas during placement, allowing staff a broader insight into the different areas of health and social care while supporting a system-wide collaborative approach. Take a look at the new to care presentation and find out more about Northamptonshire Healthcare Foundation Trust’s volunteer to career and new to care programmes on the Future NHS platform. 

  • Since 2020, the Greater Manchester Health and Social Care Careers Hub (hosted by Manchester University NHS Foundation Trust) has been working closely with colleagues from the Department for Education and local further education providers on pilot initiatives supporting the long-term rollout of T Levels. The hub delivered a T Level scoping project to build placement capacity in Greater Manchester and made the case for a coordinated approach with their health and social care partners. 

    • The project aims to widen participation of local communities through proactive recruitment and careers promotion, while supporting the growth of the future workforce. The hub views engagement with T Levels as a fantastic opportunity to: 
    • promote community-based career pathways in health and health and social care 
    • showcase directly to local learners what they have to offer 
    • create meaningful employment opportunities. 

    The hub is working on publishing a paper with a regional picture of the expected T Level placement delivery plans and benefits across the Greater Manchester system to advocate for T Levels to be included in the future strategic workforce plan across local trusts. 

  • Dorset Healthcare University Foundation Trust designed its own online Bands 2 to 4 career development platform and planning tool to support staff learning and development in both clinical and non-clinical areas. 

    This was a result of NHS survey feedback highlighting that Bands 2 to 4 staff wanted a dedicated resource with information and guidance around developing or changing their career. The feedback led to the formation of a working group representing a range of services to create a one-stop-shop set of web pages that could be used on any device, allowing access both in and out of work hours. The accessible online resources support members of staff through their journey of finding a career pathway that is right for them within the organisation, both supporting staff development and retention. 

    Since launching the resource, the platform has been a double winner in the 2020 Nursing Times Workforce Awards for Best Use of Technology to Improve the Working Environment and Best Employer for Staff Recognition. Read the trust’s case study in detail. 

  • Leeds Teaching Hospitals NHS Trust introduced a healthcare science apprentice pathway for audiologists to attract new talent and develop staff. 

    Due to increased competition, it was no longer guaranteed that the trust would be able to recruit students who have completed an undergraduate healthcare science degree into the organisation. The trust realised that by investing in apprentices it could develop it's staff, support those with a passion for audiology, and benefit from the amount of valuable time apprentices spend with the team compared to a university student’s shorter placement. 

    The apprentices enjoy the balance between their regular roles, a day spent in college and a half-day of further study time. This can include a 1:1 discussion with their mentor where their professional and personal development is discussed using a personal record plan designed by the department. The apprentice, and their work-based assessor or mentor, regularly meet with the college to assess their progress and review their overall knowledge, skills and behaviours at the workplace.  

    On successful completion of their apprenticeships, the apprentices rejoin the team as senior hearing care assistants paid at Band 3, with the opportunity to continue onto a Level 4 associate audiologist apprenticeship or after a slightly longer period of training become a hearing aid dispenser.  

    The trust has been impressed with the enthusiasm of the apprentices and how well they have integrated into the team.  The improvement to ensure a sustainable talent pipeline through the team is now considered a valuable part of their approach to recruitment. Read the trust's case study in detail.   

  • The two trusts, Derbyshire Community Health Services NHS Foundation Trust and Derbyshire Healthcare NHS Foundation Trust have a joint venture agreement on delivering recruitment and development and have witnessed the great impact that a focus on internal staff development can have on progression and retention. 

    The original focus was to increase the number of learning disability nurses within their organisations. Numbers of learning disability nurses had declined in previous years, and the trusts were approaching a point where there would not be enough learning disability nurses to support patients. To mitigate this issue, they collaborated with Derby University which was running an MSc in learning disability nursing, and advertised this opportunity internally across the two trusts. Those who held a relevant first degree, the required level of maths and English, and clinical experience were welcome to apply. Their university fees were funded via the apprenticeship levy, and they received a salary during their learning. This was a successful initiative and all eight successful applicants secured learning disability nurse roles within the integrated care system (ICS). 

    This success led to further system-wide initiatives including: 

    • the development of a new rotation model for newly-qualified nurses that allowed students to rotate in placements across four trust hospitals, a hospice, a social care setting, and a fifth NHS organisation. 
    • the introduction of an apprentice-first approach to employ those who have completed BTECs, T Levels in health and social care or individuals who are new to care as trainee healthcare assistants with the anticipation that, in due course, they will become nursing associates. Nursing associates are then offered the opportunity to train to become either a learning disability nurse, a mental health nurse, or an adult nurse.  
    • the introduction of a system-wide approach to increase cohort numbers for allied health professional apprenticeships with a particular focus on physiotherapists, occupational therapists, and podiatrists.  
  • Newcastle upon Tyne Hospitals NHS Foundation Trust has around 1,500 support workers in its workforce. It has developed innovative ways to support this workforce, to aid retention and improve the culture so all support workers feel valued and can develop their skills.  

    In 2022, the trust held its first support worker celebration day, which has since been repeated in 2023 with activities taking place over a week. This is a week to celebrate the work of its healthcare and maternity support workers across its two sites. The celebration week includes spending time with senior members of staff, small gifts to thank colleagues and the opportunity to have tea and cake together. Senior colleagues ensure to visit the wards to address concerns and hold forums where nurses and nursing associates can talk about their career journey. The trust also created role profiles of staff on posters which were displayed to share information about the duties of those in different support worker positions.  

    The week also supports a wider range of activities developed to support colleagues, including the creation of a support worker wisdom group, an informal version of a shared decision council. Ideas are shared with members who provide feedback and advice on any proposals which allows senior staff to understand the outcome of any proposed changes. Members of the wisdom group are also asked to speak to colleagues to share changes and gather feedback or any new ideas. The trust has also established a dedicated communications colleague for support workers, who has created an individual graphic identity for anything support worker related. This enables the staff to quickly understand if information relates to their roles. It also boosts morale by creating a shared team identity amongst support workers.  

    The trust has created a mentorship programme where colleagues who have been in the post for over a year can undertake a day of training to support new joiners. These mentors can then do an institute of leadership qualification to further develop their skills. 

    The trust has had positive results after these interventions, noting that they used to implement changes and not hear feedback from staff. It now regularly receives feedback, which allows them to make changes in consultation with staff to improve their experience in the workplace. The trust is also seeing a positive impact on vacancy rates highlighting the benefit of feedback channels, a collaborative approach and mentoring support. They are however clear that the work is not yet done, and they look forward to doing more in this space to improve the experience of support workers.  

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Support for managers

Below are further resources that may be useful to managers when they consider how to encourage their support staff in their development. 

Join our free NHS Employers education and training network to connect with experts across the NHS, network, and share good practice. 

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