EurWORK European Observatory of Working Life

Newham NHS Trust, United Kingdom: Training and development


Case study name: 
Ageing workforce
Organisation Size: 
Health and social work
Target Groups: 
Other non-manual
Initiative Types: 


Organisational background


Newham NHS (National Health Service) Trust is a public organisation that provides health services across the Newham borough in east London. The primary care health centres are situated in four areas of the locality. Each area has a general manager and a matron for managing the clinical staff, including nurses and carers.

The Trust directly employs a total of 1,100 staff. In addition, approximately 600 employees are attached to the primary care health centres. The age profile of the workforce ranges from 20 to 65 years old, with a considerable number of older employees. In 2004, some 200 employees, 160 of whom were women, had completed more than 20 years of service within the health service.

Traditional difficulties in recruiting staff in areas like nursing has meant that the organisation has always tried to recruit and to retain older employees. In general, the Trust values all of its employees, irrespective of their age, and tries to implement an equal opportunities culture; however, it especially values the experience of older workers. For example, the guidelines of the ‘Improving working lives’ initiative (a recent national initiative for improving work–life balance within the health services) and also the ‘Agenda for change’ (the largest reform within the health sector for pay and working conditions) address all employees.

Social dialogue appears to be favourable within the organisation. Over the past decade, there has been some conflict between the unions and management of the Trust; however, new initiatives introduced in the last year, such as those mentioned above, place greater emphasis on partnership. This, in turn, has improved communication between management and the unions.

The original initiative

Policies relating to the recruitment process, training and development practices, and retirement arrangements are already in place. The Trust tried to ensure that advertisements and recruitment and selection procedures would not discriminate on the grounds of age. Opportunities for training were directed mainly at doctors who wanted to progress in their career, but were also available to older nurses who returned to employment. In addition, the Trust offered a degree of flexibility in the retirement age for nurses, and also allowed many staff to remain in their jobs past the normal retirement age, provided they had the necessary skills. The recruitment initiatives were implemented due to shortages of nursing staff, which made it necessary at a practical level not to discriminate against any applicant group. Such initiatives also underline the Trust’s desire to adhere firmly to its equal opportunities policy. The training initiatives were introduced to ensure that all employees can advance in their careers, while flexible retirement schemes were aimed at retaining employees with valuable skills and experience.

Over time, the initiatives have largely remained the same. However, during the past two to three years, training initiatives have become more standardised, due to: the recognition of great disparities in pay bands between different posts in the health service; the need for greater transparency in recruitment procedures, selection and training practices; and a more general need for all staff to advance in their careers. The outcomes of the standardised initiatives are not yet clearly visible; however, the Trust believes that, because these practices can affect payment (i.e. if someone does not reach the necessary competency levels for the post, then their salary will not be increased), all employees should be motivated to welcome the initiatives.

Good practice today

Along with the original initiatives, which remain similar today, three new initiatives have been introduced during the last year:

  • Recruitment processes – the Trust currently cooperates with Jobshac, an agency that helps local people to find jobs in the local health and social care sector. There are two main reasons for this cooperation. The first reason is to create a link between job-seekers and the Trust. This initiative has been particularly beneficial in directing older candidates returning to work after having been made redundant in their previous job, and who do not know where to start looking for a job. The second reason is to attract more local people into the Trust, who might have been looking for employment elsewhere in London and who had not considered the Newham Trust as a potential employer.
  • Health and well-being – in the past year, the Trust has been examining the possibility of having doctors and therapists ‘on the spot’, within the health centres across Newham, so that the employees can receive assistance for health-related problems. The Trust is about to initiate a ‘well-being road show’, where therapists will visit different health centres and talk about issues like diet, nutrition and hands-on therapies. This practice has been introduced mainly due to the suggestions included in the aforementioned ‘Improving working lives’ initiative, which emphasises the importance of promoting employees’ health and well-being. Moreover, the Trust itself believes that this will be a useful means of making employees feel valued in the workplace, improving the employees’ health and well-being, and also reducing absenteeism from work.
  • Awareness-raising programmes – national initiatives for improving work–life balance and also pay issues, such as the ‘Improving working lives’ and ‘Agenda for change’ initiatives, have been highly influential in changing human resource (HR) practices and policies within the health service. Nevertheless, the Trust believes that more information on these initiatives should be disseminated to all employees. As a result, it circulates a regular staff newsletter to employees; team briefings are also held every fortnight at which all employees are informed about ongoing processes and potential developments within the Trust. In addition, the Trust runs road shows and meetings at different health centres throughout the Newham area, to inform all employees about initiatives such as ‘Improving working lives’.

Communication between management and staff has been positive during the design and implementation stages of the above initiatives. It should be noted that, in the last year, the Trust has implemented a ‘Staff involvement’ policy, to ensure that all employees are actively involved in designing and achieving different HR policies and practices.

Traditionally, there have been no formal career structures within the Trust; therefore, the abovementioned initiatives have not intentionally taken a life-course dimension. However, the ‘Agenda for change’ initiative has recently brought about a cultural change within the organisation; it is the Trust’s objective to encourage all employees to advance in their careers, by gradually achieving the highest competency level for their post and climbing the pay scale.

It is too early to assess the outcomes of the initiatives outlined. Nonetheless, some positive results to date – especially arising from the health and well-being measures – are that employees feel more valued by their employer and that absenteeism appears to have been reduced.

With regard to future prospects, the HR initiatives and practices outlined have resulted in an important cultural shift within the Trust, and this can be challenging, especially for older employees who are not used to change. Nevertheless, the Trust believes that such initiatives can motivate employees to develop and improve their skills and, therefore, to provide better services. If this is achieved in the near future, then the ultimate objective of the NHS to become an employer of choice will also be fulfilled.

Further information

Contact: Audrey Hunter, email:



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