Sandwell and West Birmingham NHS Trust

Using the Staff Retention Action Plan Tool to drive a Quality Improvement Initiative



What interventions or actions did you put in place to support nurses or midwives?

Commenced a quality improvement initiative to help teams work collectively to identify and implement evidence-based solutions to improve staff experience and retention. This aligns to our organisational actions identified via the Staff Retention Action Plan Tool. Our Health Visiting team took part in the initial phase and identified health and wellbeing as a key area for improvement. Team members were engaged to develop solutions to improve this. Interventions focused on measures to improve the management of workload, which was a key stressor, through implementing protected case management days for all Health Visitors to help reduce number of incomplete ‘tasks’ in their electronic system and the introduction of universal 6-8 week assessment clinics to reduce travel time to domiciliary visits.


Why did you decide this was important?

Utilising a quality improvement approach to staff experience and retention means teams participate in identifying and implementing solutions that will benefit them and their patients/service users. Teams were encouraged to focus on what mattered most to them and what would make the biggest difference. The approach fostered the use of positive psychology to create a sense of psychological safety and allow for creative solutions to be found. Actively listening to staff feedback and acting on that feedback allowed staff to influence their own working environment and to work as a team to achieve this.


How did you go about it?

Following training in quality improvement methodology, we conducted a deep dive of our quantitative workforce data and staff survey results to identify trends. We then undertook staff engagement using an Appreciative Inquiry approach in order to create a sense of psychological safety and creativity of thought. We collectively agreed change ideas with the team, then worked with them to implement the ideas that were prioritised. We had clear action plans and measurables in place to help keep track of progress.

How do you know it has been sucessful in supporting colleague's to continue their NHS Career and not leave the NHS?

Within Health Visiting, this intervention resulted in a reduction in the overall number of incomplete tasks by 31.47%.  100% of the staff who are utilising the protected case management days and 6-8 week clinics have reported an improvement in their workload. The team’s stability index has increased by 1.54% during the first phase of the project. Further evaluation will take place in October 2023 as it takes time for improvements to embed.  Our Pharmacy team also took part in the project and saw an increase in its stability index of 6.93% and a reduction in average rolling 12m turnover of 11.11%, as well as an improvement across all People Pulse Survey metrics.


What 3 suggestions would you make to colleagues considering implementing similar change?

1. Make sure you create time to properly engage your teams in the quality improvement process.

2. Don’t try to do everything – focus on the actions that will have the biggest positive impact on the whole team.

3. Focus on the root cause of the issues at team-level and ensure your interventions address this.


Our initiative has improved staff experience and has improved retention rate.  Adopting a QSIR methodology has enabled us to continue to engage with our staff and listen to their voices.  This has supported us to employ evidence-based approaches to implement changes in response to what they have asked for.  The methodology that we have used has facilitated positivity across our service and supported us to reframe the way that they think and deliver messages.  This has resulted in high levels of engagement of our staff and has further enhanced kindness and compassion.
Yvonne Copeland,
Sandwell and West Birmingham NHS Trust