how to write a personal statement for a job nhs

• HealthJobs Ltd
• 27 June 2018

How To Write A Personal Statement For Your Next Job In Healthcare

• Matt Farrah Nurses.co.uk Co-founder / Co-owner
• Save for later

An excellent personal statement is the key to success in every healthcare job application you make and in this article we look at the steps to follow in order to create the ideal one.

If you’ve written a personal statement before for a previous job application or university course application, you can use ideas and themes from that but you can’t simply use the same one again.

A personal statement must be tailored for each situation, and when you’re applying for healthcare jobs you need to tailor it according to the person specification and job description of the vacancy you’re interested in.

Start with a brainstorm of ideas

If you try to sit down and write your personal statement from scratch by starting with the first sentence, you could find your finished personal statement has no coherence and does not follow a logical order.

By brainstorming your ideas first you can prioritise the points you want to make and assemble all the evidence you want to mention that will back up the claims you’re going to make.

In order to avoid repetition in your personal statement, pick out a couple of points you want to make in your opening statement that really establish you as a serious contender for the job; for example, your qualification or current employment.

Then move on to the centre section where you should elaborate on the all the reasons why you are perfect for the job! Use the person specification and job description from the vacancy advert as a reference and try to check off the points you’re making with the requirements of the employer.

Your closing section should summarise the main points you want the employer to remember you for, especially your professional expertise if you applying for a doctor job , dentist job or any other senior healthcare professional job.

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Put words around your ideas

As you begin to put your ideas into sentences, be mindful of the length of your personal statement. It’s easy to write too much, but you are more likely to be successful if you are succinct and coherent.

It’s essential as you’re writing that you use a variety of examples from your experience to illustrate each point you’re making because you want to demonstrate the range of your experience.

It will also help to make your personal statement as memorable as possible because the employer will have a really good insight into your history and how your experience can make you ideal for their job vacancy.

Proof-read and edit your personal statement several times

When you think you have your personal statement completed go back and proof read it to spot any spelling errors, and to check that the information you have given is accurate.

Your personal statement forms part of your job application so you can be sure that when you apply you are required to confirm all information is correct to the best of your knowledge.

Whether you’re an experienced healthcare professional in a particular field, or you’re applying for your first healthcare assistant job , the personal statement is an essential part of the job application.

It’s your only opportunity to talk directly to the employer before they decide whether or not you are suitable for the job and therefore should be offered an interview.

Try to imagine the questions they will be asking themselves when reading your personal statement and provide clear, concise answers to as many of those questions as you can anticipate.

Once your personal statement has secured you an interview, you'll be wanting advice on how to smash your interview, right? Take a look at how to successfully prepare for interviews in healthcare to find out how to do just that.

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About the author.

I believe people working in healthcare should be able to choose to enjoy work. That is, choose an employer who reflects their values and provides them with a sustainable career. This leads to better patient care, higher retention rates and happier working lives in this most important employment sector.

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Making successful applications

Once you have successfully found a position you wish to apply for, you need to make sure your application does you justice and provides you with the best possible chance of getting an interview. This means reading the job description and person specification and taking time over your application demonstrating your skills and experience.

How good a match are you?

All employers will be judging how well your application matches the 'person specification' for the position you are applying for. The applicants who closely match the person specification will be the ones that are shortlisted for interview.

To stand the best chance of receiving an invitation is to demonstrate that you do have the skills and experience as stipulated within the person specification and provide clear examples within the supporting information section.

Never submit the same application form twice. Always adapt it to show how you meet the person specification of the particular post you are applying for.

Complete all the parts of the form

Read the instructions within the advertisement and application form very carefully and make sure that you complete all the sections of the application form. The information you give in the 'application for employment' section will be used to decide if you should be shortlisted for interview.

The 'personal information' and 'monitoring information' sections will not be used for shortlisting, but will be kept for administrative purposes only.

Provide good supporting information

The 'supporting information' section is your opportunity to sell yourself therefore make sure you use it to your advantage. You can include any information here that has not been covered elsewhere on the form. Demonstrate why you would be suitable and how you meet the person specification. You need to convince the recruiter that you have the required skills, knowledge and experience and that they should be inviting you for an interview.

You can include, among other things, details about:

• your duties and responsibilities;
• your skills, knowledge and/or experience which is relevant to the post;
• identify any employment gaps;
• voluntary work you have accomplished;
• research, publication and/or presentation experience.

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• Making a Successful Application

Using the supporting information section to your best advantage

This section is critical to complete well. It’s your chance to really sell yourself as a suitable applicant and get that invitation to interview.

As an external applicant you have up to 1500 words for this section to persuade and influence the recruiting manager that you could do the job and that you deserve an interview.

So how do you do this?

By tailoring your application i.e., by matching your skills, knowledge, and experience to the job requirements. You need to connect your current and past work experience to the requirements of the role you are applying for. This means you can’t just cut and paste any old thing. You need to make it specific to the job in question.

In the Employment History section of your application, you will have listed your previous jobs and the main duties and responsibilities of each. This will have given you some ability to link your skill set with the job in question, by one job at a time. However, the Supporting Information section of your application is where you can sell yourself and really stand out from the crowd.

You have the freedom to organise this section how you want, so you can do this by grouping your skills and work experience into broader themes and strengths that match the job you are applying for.

Using bullet points and subheadings is good. Long paragraphs and essays are not so good. Make it as easy as possible for the recruiters to find the information you need and want them to see.

The critical thing to do here is to pay close attention to the requirements of the role you are applying for and give good examples of your achievements for each. Remember that now with NHS Jobs the shortlisting criteria are included with the advert. Recruiters will be scoring your application against these. So, make sure you cover these.

What makes a good example?

This will be covered in more detail in section 2 on Having a Successful Interview. A helpful framework to use here is the STAR example.

What is a STAR example?

STAR stands for:

• S ituation or T ask – what was the context and what were you being asked to do
• A ction – what you did to achieve this
• R esult – what was the outcome or result, e.g., money or time saved, better customer service, patient care, staff morale etc

In a good STAR example, you address all three elements concisely by writing about your previous experience.

For example:

“At Acme Ltd, as Trainee Accountant, I was asked by my manager, towards year end, to make savings from the budget. This was crucial to the business as we were overspending. I set up a team involving key people from across the business, such as department heads. I asked people to share their ideas and we then prioritised the best ones. For example, I decided to change our electricity supplier to a lower tariff and reduced our stock levels by 10% which improved our working capital. Overall, I achieved £20k in savings, almost 3% of the budget, and we hit the year-end target. My manager was really pleased, and I got a letter of recognition from the Managing Director.”

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• About Nurses.co.uk
• 28 May 2019

Claire's tips for writing your personal statement

• Claire Carmichael Registered Nurse
• Save for later

Your personal statement could be the make or break of you getting the job - but how do you stand out against other candidates? Claire shares her tips and tricks to help you get writing!

Hi everyone and welcome back!

So this is my top tips for writing those personal statements your job application as a qualified nurse.

So when you go online you'll have this important information section to fill out - this is where you write your personal statement for that job and really sell yourself.

Draft it up in a text document first

So firstly I would advise just writing this on word document first just because a word document can spell check it for you.

You can sort of adjust and edit it as you go along.

So I personally do mine on Word first and then I copy and paste from Word on to the personal statement.

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Make sure you proofread it and get fresh eyes to proofread too!

Along with this get somebody to proofread.

Proofread, proofread, proofread.

You don't want to make the mistake of making spelling mistakes or saying the completely wrong thing that someone else reading it might not understand, that’s gonna be a little bit embarrassing.

I'm not gonna lie I've done that myself.

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I can't remember exactly what I said but I was trying to say that I had basically had cared for a lot of people with challenging sort of behaviours and aggressive behaviour to show that I was a naturally calm person and can handle myself in those sort of situations and I'm quite good at it and I work really well under pressure.

However, the sentence that I wrote which I didn't realise until after I'd submitted it was something like ‘I have challenging behaviours but I can manage these well’ or something so it sounded like I had the challenging, aggressive behaviours but it wasn't me, it was the patients!

The way it sounded, I just thought ‘oh my god why didn't I proofread this? Why didn't somebody proofread this for me?’ and, oh I was so embarrassed!

Don’t be repetitive

Make sure, in your personal statement, you want to include brand new information.

You don't want to repeat yourself from what's already on the application form.

Put in brand new sparkly information that they're gonna go ‘oh this is good!’

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Do you match the criteria?

Make sure you read the job description and person specification because you're going to need that to include that into this personal statement.

You're going to sort of show how you particularly meet these requirements that they're asking of you in your personal statement and show examples that just shows as well that you've actually read what they want from you and that you can meet those things.

Following on from that, you want to make every single personal statement completely separate from each other.

So if you're applying to quite a few jobs in different areas, you want to make sure that this isn't a generic personal statement.

You have to make it specific to that place that you're applying, which might seem like a little bit more work but you don't want a generic email just going out to everybody.

You want to make it specific and relevant to that particular place and that's going to just help you massively.

I think it just shows that you're taking the time out to be interested in that particular company as well. It's going to go in your favour!

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Sell yourself, sell yourself, sell yourself.

So this is something I get really awkward about, I get really embarrassed with but you know what? You have to go for it.

You have to put all of those feelings aside and just sell yourself because sometimes it is just down to your little bit of confidence that you might have and selling yourself that little bit more that gives you the position over the other person that's got the exact same qualifications as you.

So make sure you sell yourself and write anything that makes you stand out from everybody else because as a nurse you're going to have all the same qualifications or if you're student nurse you’ll have all the same qualifications and experience as your fellow student nurses.

So you want to put in there something extra about you that you've done through university, volunteering and anything like that.

That's going to make you stand out and make this person think ‘okay, she's got something a bit extra than that person’, so just do that, put all fears aside and just go for it!

Also, with this, you want to look into this person spec and have a look what's been listed on the essential or desirable parts.

So you want to cover all of the essential parts in there so that they know that you're meeting those targets.

You can also use subheadings and underline in bold parts just to make things stand out and make it easier for the person to read because if you've got a really long-winded piece of personal statement it might just get a little bit jumbled.

I personally use head little subheadings using the star technique.

So the star technique is something that I learned at University - just to help structure things a whole lot better and answer anything I'm trying to demonstrate out there.

It just helps to mould and keeps me on target of what I'm trying to say if that makes sense.

The star technique just means situation, task, action and then the result of the whole situation.

However I would not put the subhead and star technique with everything listed like that, please leave all that out and just in your mind using the star technique and then write it out nicely.

You could put it there as a draft but then delete it all and just make it flow nicely into a paragraph, but don't put that as a subheading!

So the ‘situation’ part is just explaining the situation briefly.

Then, the ‘task’ is just briefly explaining what you have to do in that situation.

So action is the most substantial part of it, around 50 to 70 percent of it is going to be the action.

This is where you can use examples of when, where, how and why all of that of helped you solve this problem or whatever they're asking you, just to provide an example of how you met that target.

Then the ‘result’ of your actions, you're just going to explain what the outcome was, what happened as a result of this basically, and that's pretty much it for the star technique.

It’s quite simple I think, if you sort of break it down and it just really helps you manage that.

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Why this job?

In your personal statement, you want to explain why you particularly want to work for the company that you are applying to or the area or the field that you're applying to why them specifically, and how you can be a benefit or use to them.

So, it's about what you've got to bring to them but also what they can bring to you and what sort of things stand out for you to actually want to work there if that makes sense.

I think that's going to look really good on a personal statement as well.

We're going to put in things like why you're applying for that job, why they should hire you over everybody else and again just using the job description to your advantage to help you do that.

Skills and qualities

Just a few skills and qualities that you can include in your personal statement could be including things such as team working and what you brought to that team.

So, working within the multidisciplinary team in the NHS or on your placements, wherever you've been and or whether you're currently a qualified nurse in a job.

What have you done to that team and what can you bring to this future team that you're applying to?

So all about assessing the complex needs of patients, because it's all about the patient.

You want to make sure that the patient's in there!

Care planning, implementing, evaluating and using appropriate nursing interventions.

You might want to put communication skills, so what sort of communication skills you have, and that you're exceptionally good at understanding confidentiality because we are high on confidentiality in the NHS and healthcare setting.

You might want to put something about, if you've done any, teaching or mentoring as you've gone along.

You could put in something about the NMC code of conduct and what you understand about it, you might want to put in about clinical governance safe medication management, things like that.

Also, probably a little bit about your continuous professional development, so what you've done, extra training and extra awareness days that you've gone to, events, congress conferences, any extra things that you've done to sort of update your own knowledge - put that in there.

Your passion for nursing

And lastly show your passion and enthusiasm around nursing through writing, if you can. Just make sure you put it all in there, make sure you sound amazing and make sure they want to interview you.

So that's it from me!

I hope some of these tips have been useful to you, let me know if you bagged that interview, let me know if you've got any other advice or tips for personal statements - drop a comment below and let somebody else know.

Let's help each other out, and good luck! 

About the author

I am a Registered Nurse with over 12 years healthcare experience including: elderly care, orthopaedics, sexual health / family planning, qualified GP nurse, transgender healthcare and now in my new role as an assistant lecturer (as of Nov 2022). I believe that nursing gets a lot of bad press, so I create blogs and vlogs to help anyone considering their nursing career and to create positivity surrounding our profession as I'm so passionate about nursing.

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How to wite your CV

How to write your CV

Doctors Direct has years of practice in recruiting the best candidates and as a result has a wealth of knowledge to pass on when it comes to writing a CV that will get you noticed, for all the right reasons.

Knowing what to include in your CV and in what order can be quite daunting. This guide aims to help you on your way to creating a CV that provides succinct and impactful information, that best represents you and your achievements.

Getting started

TIP: Use a confident tone and positive language when writing your CV.

Your CV should be no more than 1 -2 pages long and only communicate the information you feel is most relevant or important to the role for which you are applying. Keeping your CV short and sharp will help to hold the attention of the reader.

At the top of your CV you need to provide your full name, home address, email address and telephone number.

Most people then like to add a short bio, or ‘personal statement’ summing up your current personal situation, and your career aspirations. This should only be a few sentences long but should highlight your skillset enough that the reader wants to know more about you.

TIP: Look at the key information that the role rquires and tailor your personal statement to highlight the skills you have that match what they are looking for.

Your Experience

Next you need to add your work experience [1] in reverse-chronological (most recent at the top). You will want to confirm where the experience took place (organisation and location) and the duration.

TIP: Update your CV regularly. Sending an old CV will look unprofessional, so make sure that yours is up to date to meet the requirements of any roles you see advertised.

It can be helpful to differentiate between paid and voluntary work. The areas of expertise and skills you used during this time need to be included along with any projects you worked on. It can be easy to overcomplicate your CV with too much detail on the role, as often this will have been copied from a job description. In your CV you want to get across transferable skills and personal strengths that will be of interest. CV’s should detail specific skills, systems and processes you have used.

Your Education

Again, this is ideally displayed in reverse-chronological order. This section often takes up valuable space on your CV but try to include the most relevant information here. You will want to add the dates you were studying, the establishment name, location, course and grades achieved.

Gaps in your CV

If you have had any time during study or employment it is useful to explain this on your CV.

For example

‘X date to X date – travelling round South America’

‘X date to X date – volunteering with “Charity name” providing basic infection control information to young families in remote villages in Africa.

Closing your CV

At the end of your CV it’s good to add any additional information that is relevant to your application but does not necessarily fit in to any of the other sections.

It may be that you have some interests, hobbies, experience or short courses that you want to share, here would be the best place for them.

TIP: Ask someone to look through your CV to check for any mistakes you may have overlooked.

Your can download our CV writing guide by clicking the button below

https://nhspbank.com/wp-content/uploads/2019/08/How_To_Write_Your_CV.pdf

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Sample Supporting Statements

For Students and Newly Registered Nurses, Nursing Support Workers, and Nurses and Midwives.

The supporting statement is the most important part of your job application. This is effectively where you convince the employer that you're the right person for the job and explain why they should hire you.

This page offers sample supporting statements and a tutorial to help you. we can also offer feedback on your supporting statement via email..

Different employers will have different instructions or expectations with regards to supporting statements, but generally they'll be looking to see if you're applying for the right reasons and that you meet the essential criteria. If you haven't already done so, read the general advice on writing job applications first. To help give you an idea, have a look at our sample supporting statements which have been written to correlate to a sample Person Specification. In particular, pay attention to the way the sample supporting statements:

• Cover all the essential criteria listed in the Person Specification
• Use examples or evidence to demonstrate how the criteria is met
• Follow the order of the Person Specification as much as possible.

The samples should be used as a guide only. Your own supporting statement should be structured around the job and person specification you're applying for. You may also want to watch the Supporting Statements tutorial below.

• Apply for jobs that are right for you
• Never write a 'one size fits all' supporting statement
• Explain why you want the job, showing your passion/interest and motivation
• Demonstrate how you meet all the essential criteria from the person specification using examples or evidence
• Demonstrate how you meet any organisational/trust values if there are any
• Imagine you're being asked the question, "Why should we hire you?"
• Run a spelling and grammar check

Supporting Statement Tutorial Preview

Resources for nurses and midwives: improve your employability or explore options and ideas if you're at a career crossroads.

Career resources for Healthcare Assistants, Assistant Practitioners, Nursing Associates and Support Workers.

Resources to help you write your first nursing CV or job application, and tips on how to stand out at interview.

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How to write a personal statement for a NHS assistant psychologist

By jayne thompson / in family.

A personal statement, sometimes called a profile or career summary, is the section at the top of your CV or a pro-forma job application which summarises your career skills and experience and sets out your ambitions for the future. It is a standard part of any National Health Service (NHS) application. The function of a personal statement is to enable a recruiter to quickly identify whether you are suitable for interview, so it needs to be punchy. If drafted carefully, a personal statement can give your application a dynamic impact.

• A personal statement, sometimes called a profile or career summary, is the section at the top of your CV or a pro-forma job application which summarises your career skills and experience and sets out your ambitions for the future.

Get hold of the NHS assistant psychologist (AP) general person specification. This specification is common to all AP jobs across different specialities and sits alongside the job specification which differs between roles. Read the general person specification and spend some time covering off the requirements. That way you will have done a lot of the groundwork before you come to apply for specific roles. Refer to the Guide to Core Competencies published by The British Psychological Society (see Resources) for assistance.

Read the individual job specification carefully. The purpose of your personal statement is to describe how you meet the exact specifications of the job description. Describe how your skills and experience match each requirement.

Decide whether you are writing in the first or third person. There are no hard and fast rules about this and everyone has their own preference. Try writing your statement both ways to see what flows. Do not interchange the two.

• Read the individual job specification carefully.
• Try writing your statement both ways to see what flows.

Show, don't tell. Explicitly state your experience against each criteria in the job and person specification and then explain what you have learnt from your experience. Saying that you're "adaptable" is forgettable - describing a situation where you filled in a gap in a skill set at short notice is impressive. Phrases like "passionate about" and "interested in" are fluff. Chances are the recruiter will have read them a hundred times before and you don't have room to ramble.

Keep it short. While the NHS does not have a word limit on personal statements, other industries expect a good statement to have impact in just 200 words. NHS job specifications tend to be lengthy, and this requires a lengthier response, but you should still aim to deal with everything in a single page.

• Explicitly state your experience against each criteria in the job and person specification and then explain what you have learnt from your experience.
• NHS job specifications tend to be lengthy, and this requires a lengthier response, but you should still aim to deal with everything in a single page.

Proof read. It goes without saying that your spelling and grammar should be perfect. Your spell check should be in British (rather than US) English.

The personal statement is not just about previous employment experience. Include anything relevant, such as practical work you have undertaken, voluntary work, conferences you have attended, community events and articles you have read or contributed to.

Avoid tired phrases. It goes without saying that you're a good team player.

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The future of the NHS depends on its workforce

Read the full series: the bmj commission on the future of the nhs.

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• Peer review
• Mary Dixon-Woods , director 1 ,
• Charlotte Summers , professor of intensive care medicine 2 ,
• Matt Morgan , professor of intensive care medicine and columnist 3 4 5 ,
• Kiran Patel , chief medical officer and consultant cardiologist 6
• 1 THIS Institute, Cambridge, UK
• 2 University of Cambridge, Cambridge, UK
• 3 University Hospital of Wales and Cardiff University, Cardiff, UK
• 4 Curtin University, Australia
• 6 University Hospitals Birmingham and University of Warwick, UK
• Correspondence to: M Dixon-Woods mary.dixon-woods{at}thisinstitute.cam.ac.uk

The future of the NHS depends on the people who work in it, so workforce stewardship should be a key priority

Achieving a high quality, sustainable NHS is currently challenged by major workforce problems. Staff are the most significant element of NHS expenditure 1 and its most important asset in providing care for NHS patients, but stewardship of the workforce is not optimised at policy or service level. Based on knowledge of the field, the literature, and listening to patients and staff, we identify three key interlinked areas in which action is urgently needed: configuring the workforce, improving conditions and working environments, and enhancing career and training pathways. We propose what might be done to tackle the current challenges, emphasising that workforce stewardship needs to be highly intentional about diversity, inclusion, and equity and needs to be done collaboratively with staff, patients, and the public.

Configuring the workforce for the future of the NHS

Staff shortages.

The future of the NHS depends on having the right numbers of staff in the right roles, at the right times, and in the right locations. At present, the NHS simply does not have enough staff to deliver on its goals and commitments: it has fewer doctors, nurses, and managers than peer countries. By June 2023, there were over 125 500 vacancies in hospital and community health services in England. 2 Over 1 in 10 nursing posts were unfilled, with mental health and community nursing especially affected. 2 Although the overall number of doctors in hospital and community services has increased to 134 000, representing an additional 39 000 medical staff since 2010, 2 the NHS is currently short of nearly 11 000 doctors (a 7.2% vacancy rate). The vacancy rate in clinical professional roles is compounded by difficulties in recruiting and retaining high quality staff in other roles, including administrative, managerial, scientific, and technical staff, as well as estates and ancillary staff. These groups make up nearly half of the workforce and are essential to the NHS but receive much less recognition than their clinical counterparts. Despite the essential nature of their work, some are disparaged in policy and media discourses as somehow not “frontline.”

Staff shortages directly affect quality and safety of care, patient experience, and staff experience of work. 3 Less than a third (32.4%) of respondents to the most recent (2023) NHS staff survey said that there were enough staff at their organisation for them to do their job properly. 4 The unequal distribution of vacancies across geographical locations contributes to inequalities, leaving some areas, including those most disadvantaged, under served, affirming the persistence of the inverse care law. 5 The strategy of shoring up workforce shortages through overseas recruitment is unsustainable, especially as attention is drawn to its moral and ethical problems. So too is the increasing reliance on temporary staff, which is not only expensive—the annual cost of using locum, agency, and bank staff in the English NHS rose to £10.4bn in 2023 6 —but also introduces other risks, 7 such as those linked to lack of familiarity with local policies and environments and disruption of team bonds, and might not be positive for patient experience or outcomes. 8

The NHS Long Term Workforce Plan , 9 published in June 2023, offers some welcome commitments to workforce planning and development. But it does not fully tackle the range of problems—including, for example, those relating to the capacity of educational institutions, the availability of suitably trained educators, quality of training, availability of clinical and educational placements, research leadership, and training and support. It also does not adequately tackle the important challenges of retaining and developing existing staff. Its implementation (including scale and pace) is currently uncertain, as is its economic viability. 10 Given that the plan is intended to represent a fundamental reshaping of the NHS, its workforce, and its operations, it must be subject to sound evaluation to assess its risks and opportunities and benefits and harms.

Role diversification

Role diversification has become an increasingly prominent feature of the NHS in recent years, with primary care providing an important example. Although the number of fully qualified and permanent full time equivalent (FTE) general practitioners is declining and stood at 27 487 in December 2023, 11 the number of FTE staff in primary care who provide direct patient care but are not GPs—such as nurses, paramedics, social prescribers, and physician associates—increased by 34 380 between March 2019 and September 2023. 12 The number of staff providing direct patient care now stands at 45 701, with the recent increases largely driven by the Additional Roles Reimbursement Scheme. 12

Some roles, such as advanced nurse practitioners, have already been operating successfully as key members of multiprofessional teams in primary, secondary, and community care for many years. Some new roles are faster and less expensive to train than others; physician associates, for example, take a two year masters or postgraduate diploma, so they can enter the workforce rapidly. In principle, new and innovative professional roles might add value to teams. But some of these roles, particularly those that take on activities previously undertaken by other professional groups, have also created new challenges and risks associated with like-for-unlike substitution. The overall effects on patient safety remain largely unevaluated, and much of the available evidence, for example in nursing, already indicates that substituting less qualified staff for registered nurses is associated with worse outcomes and risks. 13 Major concern has also been raised about the effect of new roles on the training opportunities available to other clinical staff.

Also unclear is whether increased role diversification will deliver all the hoped for benefits. In general practice, for example, the increased diversity of roles adds complexity: it requires sound processes for matching patients to the most appropriate professional and might also involve reassuring patients of the equivalency of care, create the potential for duplication and inefficiencies, and, perversely, may increase GP workload through the extra coordination and supervision burden. 14 15 16 It is now clear that, for new roles, issues such as team and task design; scope and boundaries of practice; effects on current roles and grading of other team members; and governance and quality assurance all require substantially more consideration and consultation, including with patients and the public, than they have so far received.

Careful planning, monitoring, and a research and evaluation programme are needed to more effectively plan and manage new roles, ensure clear scope of role, carry out work system design combined with safety assessments to clarify which tasks can be safety assigned to whom, design and implement appropriate regulation, and safeguard training and development opportunities across different roles. At the same time, hard policy decisions might need to be made about what can reasonably be offered to the public based on the resources available to the NHS compared with other public sector priorities, including those that are related to health such as housing and environment.

New technologies

Configuring the workforce for the future of the NHS is, of course, not just a matter of tackling vacancies. It also requires thinking about the work to be done and how it can be undertaken effectively and efficiently. The dynamic and often rapidly shifting nature of scientific developments, demographics, service innovation, and technology, for example, must be taken into account. Staff take a long time to train and reach peak competence, but the work they need to do might change more rapidly. New technologies, including artificial intelligence, remote care, digital health, and genomics based medicine, might be rich with opportunity but are also highly disruptive. As these innovations penetrate more fully into healthcare, agility and responsiveness will be needed in planning not just for roles but for skills and for how the design of work systems and roles can evolve in both patient centred and staff centred ways. This is likely to require far more collaborative and co-design techniques than the NHS is used to—for example to ensure that “non-technical” skills, operational systems, training, and communication and decision making with patients are prioritised 17 as key elements of technology deployment.

More generally, workforce planning and new roles need to be treated as major, novel interventions that require consultation and rigorous design to ensure that they are specified, evaluated, managed, and regulated appropriately and rigorously, with clarity about boundaries with existing roles, and adequate consideration of unintended consequences and risks of deepening inequities.

Improving conditions

Satisfaction and value.

Pay is an important source of dissatisfaction for NHS staff, with less than a third (31.2%) of respondents to the 2023 NHS staff survey saying that they were satisfied with their pay. 4 The survey shows that pay satisfaction remains about seven percentage points below pre-pandemic levels (2019). Among medical and dental staff, satisfaction with pay is now 23 percentage points lower than in 2020, at 32%. 4 Pay dissatisfaction is, of course, a major factor in current industrial action.

Despite its importance, pay is only one of several factors that influence staff experience. 18 A sense that NHS systems do not always seem to value people as people but instead as resources to sweat is deeply implicated in issues relating to job satisfaction and retention. 18 A 2021 survey of nearly 5000 staff found that 47.5% of staff felt their work was undervalued by the government, 20.6% felt undervalued by their employer, and 17.7% by the public. 19 For some, working for the NHS might feel exploitative at times; only 45% of staff report that they are satisfied with the extent to which their organisations value their work. 4

Working conditions

Linked to this, working conditions in the NHS are a major source of concern, with 41.7% of staff reporting feeling unwell as a result of work related stress in the past 12 months. 20 Workload pressures are often overwhelming. Many staff feel overstretched, demoralised, or burnt out. A majority (71%) of GPs, for example, report that their job is “extremely” or “very” stressful. 21 Staff increasingly experience moral injury linked to the inability to provide the care they think they should be able to give 22 ; the sense of letting patients down is highly damaging for people’s experience of work. 23 Workload stress is compounded by the highly complex and demanding nature of the institutional and regulatory environment of the NHS generally, 24 which means that services, and the staff who work in them, might end up being answerable to a large number of different bodies and agencies whose rules, principles, and procedures might conflict or fail to cohere, adding to the workload. Inspections and other regulatory actions that result in unfavourable outcomes might be especially challenging for staff, with effects including fear, stigma, and shame. 25

Practical challenges are highly consequential for people’s ability to participate in the workforce and for their experience of work. NHS staff are often expected to work unsocial hours without support for transport and childcare, with the mismatch between housing costs and NHS salaries compounding these problems. Despite NHS Employers guidance, 26 the basic needs of staff are frequently poorly met, 27 with routine workplace facilities often lacking adequate toilets, fridges, chairs, lockers, and access to food and water, and staff reporting that they feel they cannot take breaks. 28 People’s experiences of starting new jobs are often poor, with fundamental problems such as onboarding—setting up identity badges, IT accounts, and permissions—often taking far too long. Basic administrative infrastructure to support staff is often lacking and has huge effects. Payroll errors, for example, can compound low pay and are corrected very slowly. By contrast, Australia, for example, has fortnightly pay cycles.

High stress environments

People in the NHS frequently have to work in highly stressful, demanding settings, while using poorly optimised work systems. 29 Healthcare professionals often spend a substantial proportion of their time doing tasks that take them away from doing the work that they’re qualified for, which indicates a toleration of suboptimal use of the workforce and corresponding waste. Daily work is often frustrating: only 58.5% of staff say they have adequate materials, supplies, and equipment to do their work. 4 Operational failures—ranging from poorly functioning IT systems to obscure referral pathways—are pervasive, causing frustration and damaging the daily experience of work. 30 That these challenges are also deeply problematic for patients too only adds to the sense of professional frustration, yet only 55.9% of staff feel able to make improvements in their area of work. 4

Many of these issues can be tackled through better operational management and systems improvement, with knock-on positive effects not just for staff satisfaction but for productivity—as demonstrated by work in other sectors, including manufacturing. 31 But better operational management will not occur simply by wishing for it or denigrating management as pen pushing bureaucracy. 32 It will require recognition that unglamorous, mundane problems really matter and a corresponding policy commitment to building up effective management functions in the NHS using best practices at all levels.

Workplace behaviours

Behaviours in the workplace—encompassing the behaviours of colleagues, patients, relatives, and the public—are a major concern for the NHS workforce. Some workplace cultures in the NHS are highly adverse, leading to poor experiences of work, mental health difficulties, and consequent negative effects on patient safety and quality, including those that erupt into organisational crises. 33 Some staff, especially those who are minoritised, are particularly at risk of experiencing poor behaviours and culture, to the extent that the NHS has been described as diverse but not inclusive. 34 Although around a quarter of NHS staff are from ethnic minority backgrounds, they are less likely to progress to senior and leadership roles, for example. 34 Reported rates of bullying and disrespect, harassment, including sexual abuse and worse, and racism and discrimination, are alarmingly high. UK REACH (a research study into ethnicity and covid-19 diagnosis and outcomes in healthcare workers) found that around a fifth (21.2%) of staff surveyed between October and December 2021 reported that they had experienced discrimination in the previous six months, either from patients, colleagues, or both, but only half of those who had experienced harassment, bullying, or abuse said that they or a colleague had reported it. 19

NHS organisations continue to show major weaknesses in tackling these problems. The NHS People Plan is clear that everyone should benefit from effective management, 35 but the realities are often very far from this aspiration. Line managers are often under-resourced and poorly trained and supported for the roles that they are asked to take on—frequently on top of other duties. 36 Efforts to improve employee voice (speaking up and speaking out) remain highly variable in implementation and effectiveness, 37 to the extent that lack of psychological safety 38 remains a persistent problem in the NHS. Less than two thirds of staff (62.3%) feel safe to speak up about anything that concerns them, and only half (50%) are confident that their organisation would deal with their concern. 4 Interventions are now becoming available to tackle unprofessional 39 or transgressive behaviours, 40 and priority should be given to their implementation and evaluation.

A major challenge is that human resource (HR) services in the NHS are not always fit for the challenges they have to deal with. HR departments vary widely in the quality and practice of local procedures for grievances, disciplinary processes, and whistleblowing. 41 They are frequently characterised by an adversarial approach focused on organisational risk mitigation, often linked to avoiding expensive litigation processes with uncertain outcomes. Further problems arise because the seam with professional regulators is not always neatly stitched, causing confusion about which problems should be dealt with by employers and which by regulators. 33 Loss of confidence in the transparency, consistency, and fairness of professional regulatory practices and decisions is now evident, not least because of the risk of death by suicide associated with a regulatory referral. There is particular disquiet about the disproportionate rates of regulatory referral of professionals from ethnic minority backgrounds and those trained outside the UK. 42

Clearer, collaboratively built standards and the right support would be very valuable here. But also important is tackling the wider legal environment for employment practices, which is likely to be implicated in the emphasis on procedural compliance seen in NHS organisations, 41 and neither promotes positive workplace relationships nor is well suited to the specifics of healthcare environments.

Enhancing career and professional development

Professional development and career progression are essential both to retaining staff 43 and to ensuring that their competencies are fit for purpose. Education and training capacity is needed for all staff groups to support selection, supervision, assessment, and development and maintenance of the optimum skills and behaviours. This is expensive, and prone to cuts or to being badly implemented—for example, through poorly designed e-learning modules that staff are forced to do in their own time. More effective approaches, such as simulation and skilled debriefing, 44 are underused.

The current unprecedented level of attrition from professional training pathways, including in medicine, is an increasingly important major threat to the future of the NHS. The reasons are multiple, but for doctors in specialty training, aside from the prominent issues of pay restoration and student debt, they include bureaucratised, rigid training programmes characterised by “portfolio blight”—burdensome, poorly designed, and inflexible requirements for documentation. Doctors in training are among the groups especially affected by the practical challenges mentioned earlier, including bad rota systems and costs and inequities associated with training requirements. 45 Because of the way training is organised through rotations, this group is especially vulnerable to experiencing transactional, unsatisfying relationships with organisations and to disruptions of their personal lives that are difficult to manage. These include limited or absent support for transport and childcare and rota scheduling that does not accommodate planning for family events. Negative experiences of training are amplified by failures to offer a sense of belonging, support, and ownership, which are so important to employee wellbeing. 46 Confusion and concern about new professional roles (such as physician and anaesthesia associates) have, in some cases, further contributed to the undermining of morale—for example, by creating the sense that these roles are competing for training opportunities, are paid better than doctors in training, and are more highly valued by employers. 47

Of further major concern is that the clinical academic workforce—vital to the research, educational, and training enterprises of the NHS—is in major difficulty. A recent House of Lords Science and Technology Committee noted, 48 with alarm, the shortage of clinical academics and its consequences, including the long term future of clinical research and trials. Identifying financial disincentives as a key problem, the committee made several important recommendations. The NHS workforce plan did recognise the need for a more cohesive approach to clinical academic pathways, but delivering on this aspiration will require following the parliamentary committee’s recommendations more comprehensively and making corresponding investments.

Doctors are not, of course, the only group affected by issues in professional development and career progression. Some staff groups—including clinical and non-clinical support staff and administrative staff—remain neglected in terms of investment and opportunities for training and development, 49 and a much more transparent, fair, standardised, and comprehensive approach is needed to meet their needs.

Conclusions and recommendations

The future of the NHS depends on the people who work in it. A bold vision ( box 1 ) is now needed to make stewardship of the NHS workforce a top priority. Quite apart from the ethical imperative to look after the NHS workforce, secure their satisfaction and pride in their work, and assure their wellbeing, there are strong arguments that doing so will improve efficiency, productivity, and patient experience and outcomes. As the largest workforce in Europe (1.7 million people), investing in the staff of the NHS is also a sound investment in population health.

A vision for the future NHS workforce

NHS workforce stewardship is regarded as a key priority and important responsibility at all levels

Staff are respected for their rich diversity and feel valued and proud to work in the NHS

Roles and competencies are appropriately configured, with sufficient people in those roles to deliver high quality, safe care

Working environments support all staff to thrive

NHS careers in all roles are seen as attractive and interesting, are capable of enabling progression, and are suitably financially rewarded

Regulation is designed and functions well to protect patients and secure the confidence of staff

Career pathways are well designed, supported, and resourced, offering a positive experience in all roles

We make three specific recommendations to achieve this vision.

Workforce stewardship —Workforce stewardship should be recognised as a key priority and responsibility requiring active planning, design, investment, and evaluation through all levels of the system from a policy level through to employers.

Improve workplace conditions —NHS England and their equivalents in the devolved nations should introduce a collaboratively designed national framework for NHS employers to improve working environments for all NHS staff, including pay and conditions. It should set out:

Minimum standards for the workplace, including on matters such as transport, availability of food, rota scheduling, rotation systems, and pay cycles

Standards aimed at improving people management, including improved systems for line management and HR, defined by strong commitments and action on equality, diversity, and inclusion

Standards for what “good” looks like for anti-racism and anti-discrimination

Measures to protect NHS staff from unwanted sexual behaviour, violence, and aggression

Systems for managing problematic and transgressive behaviours, conduct, sexual misconduct, and poor practice, supported by a comprehensive review of the legal frameworks relevant to employment in the NHS

A revised pay review process

A programme of investment to improve physical infrastructure

The funding, investment, incentives, and enforcement methods to ensure the success of the framework, including board accountabilities where appropriate.

Government, NHS England and their equivalents in the devolved nations should prioritise funding and support improvement in administrative infrastructure, operational functioning, and work system design. This should use high quality systems co-design, human factors principles, and pilot innovation and change before scaling up.

Improve workforce planning —Government and system stakeholders should collaboratively develop a comprehensive programme of consultation and evaluation on workforce design and planning, including:

New roles and how they can best be configured, with due consideration to the design of work systems and the right set of roles for providing high quality patient care

Effects of scientific development and technological change, including artificial intelligence, for how work is done and how the workforce needs to be configured and supported

Recruitment and professional development of staff in “non-clinical” roles

An independent review should be commissioned by the government by the end of 2024 to identify how to improve the quality of training pathways in the NHS, with a particular focus on improving experience and conditions and financial support, including options such as student loan forgiveness and other rewards and incentives. Finally, system stakeholders should implement in full the recommendations of the parliamentary committee on clinical academics, including those on the role of research in the NHS.

Some of these recommendations can be managed at organisational level. Others will need to be led from the top of government and the NHS centre, as they require dealing with some of the structural challenges and behaviours outside any individual organisation. Much stronger leadership and accountability for people and their development at all levels, from Whitehall downwards, is now needed for workforce stewardship.

Recommendations

Make workforce stewardship a key priority

Improve workplace conditions through a collaboratively designed framework of standards, design, and investment

Improve workforce planning through a comprehensive consultation and evaluation on workforce design and planning, an independent review, and full implementation of the parliamentary recommendations on clinical academics

Acknowledgments

We thank Rosie Lindsay for help with the bibliography for this article. The Healthcare Improvement Studies (THIS) Institute, which is led by Mary Dixon-Woods, is supported by the Health Foundation—an independent charity committed to bringing about better health and healthcare for people in the UK.

Contributors and sources: All authors are members of the BMJ commission. MD-W leads a programme of work to improve the evidence base for improving quality and safety in the NHS and has longstanding research interests in issues relating to workforce, teams, employee voice, and culture and behaviour. She is a member of the BMJ International Advisory Board. CS is a clinical academic with a longstanding interest in embedding research into NHS care. She was deputy director/director of clinical academic training for Cambridge (2017-2022) until she became director of the Victor Phillip Dahdaleh Heart and Lung Research Institute, a new University-NHS collaboration that brings together more than 450 population health, laboratory, and clinical researchers with the aim of improving cardiovascular and lung health. MM is an adjunct clinical professor at Curtin University, Australia, an honorary senior research fellow at Cardiff University, UK, consultant in intensive care medicine in Cardiff, an author, and an editor of BMJ OnExamination. KP is chief medical officer of one of the largest NHS trusts in the NHS in England with over 24 000 staff and has been a responsible officer for over 10 years, covering not only secondary care but also primary care while he was medical director for NHS England (West Midlands). In each of these roles he has led the implementation of programmes to recruit, retain, and reward the workforce and also participated in initiatives to promote innovation at a workforce level. MD-W produced the first draft of the paper, and all authors contributed to ideas and revisions. All authors agreed the final draft. MD-W is guarantor.

Competing interests: We have read and understood BMJ policy on competing interests and declare: MD-W is currently undertaking evaluative work for the Care Quality Commission. She is an unpaid director and founder of THIS Labs. CS gave oral evidence to the House of Lords Science and Technology Committee Inquiry into Clinical Academics and the NHS. She is employed by the University of Cambridge, is an honorary consultant at Cambridge University Hospitals NHS Foundation Trust, and is director of studies in clinical medicine at Selwyn College, Cambridge. MM is an employee of The BMJ and has acted in various advisory roles for the health service including for the Welsh government. KP has no interests to declare.

Provenance and peer review: Commissioned; externally peer reviewed.

This article is part of The BMJ Commission on the Future of the NHS ( https://www.bmj.com/nhs-commission ). The purpose of the commission is to identify key areas for analysis, lay out a vision for a future NHS, and make recommendations as to how we get there. The BMJ convened this commission, which was chaired independently by Victor Adebowale, Parveen Kumar, and Liam Smeeth. The BMJ was responsible for the peer review, editing, and publication of the papers of the commission. The BMA, which owns The BMJ , grants editorial freedom to the editor in chief of The BMJ . The views expressed are those of the authors and may not necessarily comply with BMA policy.

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