Background
Wirral Community Health and Care NHS Foundation Trust provides a range of community health care services, including sexual health, urgent community response and health visiting, supporting people throughout their lives both at and close to home.
The trust employs around 1,850 members of staff, 90% of whom directly support patients and service users. The workforce represented 76% of the trust's expenditure in 2022-23 and is the most important and valued resource. Investment in the workforce is core to the ethos of the organisation.
The state of play in the Wirral
Over the past few years, Wirral Community Health and Care NHS Foundation Trust (WCHC) has worked hard to improve recruitment and retention across the organisation. Reflecting on the results of the 2023 NHS Staff Survey, the trust saw its highest level of engagement and their best results to date following an intensive programme of activity which included a dedicated staff engagement plan to encourage staff and managers to have their say. Staff turnover rates also fell from 14.6% in September 2022 to 9.5% in June 2024. Members of the team say progress has been supported by work to improve retention and staff engagement.
The role of Wirral Community Health and Care NHS Foundation Trust as an anchor institution
Leaders at WCHC are very proud of the work the trust is doing to support local people, particularly those from disadvantaged backgrounds, to start a career in the health and social care sector. The trust works closely with system partners and local schools to carry out community engagement, targeting people living in areas with high levels of long-term unemployment.
This involves building career pathways with entry level opportunities based on skills and potential, breaking down the barriers to employment and supporting people from all backgrounds to start a career in health and care. The trust is building career pathways from entry level through to registration and beyond. These are aligned to national apprenticeships and the trust is supporting apprentices to obtain the necessary qualifications on that journey.
WCHC is also leading the way in the roll out of the NHS Cadets Programme, in partnership with NHS England and St John's Ambulance which encourages young people, often from deprived families, to get involved in the health and social care sector. The Cadets programme provides an insight into the various opportunities available within the sector, including what it is like to volunteer and work in the NHS. More broadly, it can support participants to develop their confidence and life skills, including around leadership and first aid awareness. The programme is now in its fourth year and is going from strength to strength.
One Cadet said: "My confidence has improved massively, I've learnt my own personal skill sets and found my strengths with the help of the staff, I can talk confidently and proudly of many different roles in the NHS. I am very passionate about my future career choice."
The importance of career development and skills mix
As well as supporting local recruitment into the sector, WCHC recognises the importance of learning and development for existing staff within the organisation. The trust therefore works hard to retain staff in various ways, including by providing development opportunities where possible; this may be through formal apprenticeships or training, or through on-the-job learning.
Ensuring the trust has the right skill mix to deliver timely and high-quality care for local communities is also vital. WCHC is therefore considering the composition and size of their workforce against expected future demographics in the area. Current projections suggest there are insufficient numbers of registered nurses to meet anticipated demand. The trust is therefore thinking differently about how staff can work with partners to proactively identify people at highest risk and best utilise their shared skills to optimise hospital avoidance, ensuring that the highly skilled community resource is allocated appropriately to address need and support a reduction in health inequalities.
Enablers to success
The trust leadership team is positive about the improvements made in workforce recruitment and retention, with less than 10% staff turnover in 2024, down from 14% in April 2023, and agency staff usage down to 1.3%. The various recruitment and retention initiatives described above, and the strong emphasis on the value of staff, are viewed as key enablers to reducing the use of agency staff.
The trust was recently successful in securing funding for a 12-month people promise manager position. The successful candidate has previous experience as a clinical team leader. Her experience with practical frontline issues is crucial on the journey of identifying the appropriate level of resource to ensure the trust has the right number and mix of staff to deliver sustainable care both now and in the future. The fact that the people promise manager has frontline clinical experience provides invaluable insights supporting the trust’s community nursing transformation programme.
In order to be able to go further, faster, leaders at WCHC would welcome a national focus on ensuring appropriate staffing levels, benchmarking of best practice, and effective career pathways.