Promoting partnership working in the NHS

Developing a people strategy in partnership - The Hillingdon Hospital NHS Foundation Trust

Listen to this new podcast from the SPF, learn how the people strategy at Hillingdon has benefitted the trust and its workforce.

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The organisation

The Hillingdon Hospitals NHS Foundation Trust is the only acute hospital in the London Borough of Hillingdon and offers a wide range of services including accident and emergency, inpatient care, day surgery, outpatient clinics and maternity services. They provide clinical services to over half a million patients a year, including over 94,000 emergency department attendances. 

The challenge

The employer and staff side recognised that the trust’s ambitious clinical strategy could only be achieved through partners working collaboratively to put patient care at the centre of all they do. To achieve this, they had to address a range of workforce issues that the trust was facing such as high vacancy rates and high turnover of staff. The time the trust took to recruit was one of the longest in London. There was also a high percentage of staff leaving within 12 months of starting and increasing expenditure on bank and agency staff.

The aim

The aim of the project was to develop a people strategy in partnership to ensure issues important to staff were identified and addressed. The trust wanted to create a people strategy that was developed, owned and implemented by staff, carers and patients.

The process

The development of the people strategy was a collaborative exercise - engaging 3,500 plus members of staff to develop a vision. A range of tools and techniques were used to facilitate engagement including structuring discussions around key questions, social media, presenting at formal meetings, leading focus groups, using surveys and holding one-to-ones.

The strategy was developed iteratively, with staff side feeding back at each stage to ensure ongoing engagement and support. A communications strategy was developed to support the development of the people strategy. Booklets and a strategy document were shared with staff and an animation was developed for the trust’s website and intranet. This was jointly voiced by the staff side chair and the director of people and organisational development (OD). A detailed work plan was produced in partnership to ensure regular monitoring of progress.

The trust and trade unions were brought together in this exercise first and foremost because of the positive mindsets and effective working relationship between the chair of staff side and the director of people and OD. Together they built a framework for developing the strategy that involved staff and identified the issues that were the most important to them. Both agreed that the trust’s values - CARES (communication, attitude, responsibility, equality and safety) should be the foundation of the strategy.


The people strategy has accelerated a range of improvements for staff and patients. This includes a learning management system, which has improved the learning experience of staff and supported induction to the organisation. An employee value proposition was developed. This has supported recruitment both from overseas and the UK. An overseas recruitment campaign has led to a steady pipeline of nurses from overseas to fill vacancies. Recruitment processes have been streamlined and the trust has improved the experience of candidates and new starters.

The people strategy and related activity has reduced the organisation’s vacancy rate from 15.32 per cent to 12.76 per cent. Agency spend has reduced by around 25 per cent from £1,156,175 to £874,972 and time to hire has reduced from 57 days to 33 days, delivering savings of £342,181. Turnover has reduced from 14.75 per cent to 12.17 per cent and fewer new starters are leaving within twelve months, 8.4 percent compared to 15 per cent.

Top tips

  • Build a foundation of mutual trust and ability to challenge, starting from the top, in this case staff side chair and the director of people and OD, but working all the way down, framed within the organisation’s values.
  • Focus on real issues that staff care about and use language they understand, avoid management speak.
  • Ensure clear processes for planning, implementing and monitoring – so that things stay on track. 

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