How to get the best staff in primary care

Top primary care trust 2009

NHS Islington

Serving a diverse, inner-city population is the sort of challenge NHS Islington’s staff relish – and their enthusiasm has helped to propel the trust to top of the table for primary care organisations. 

Far from making recruitment more difficult, the challenging nature of providing care in Islington is what often attracts its staff. Ian Tritschler, associate director of business development, says: “Certainly some applicants see this as a challenge and as something quite positive. Staff often say they applied because their last job was too easy!”

The organisation is also known for its training, which makes it attractive to many employees, he says, although it can mean they then move on to higher grade jobs elsewhere. The PCT’s training package for district nurses, for example, can help people move on to a community matron job.

“We’ve got a reputation for training, especially for our junior staff, we’ve got a reputation for getting things done and a reputation around innovation and quality,” Mr Tritschler explains. 

The PCT employs a head of research and innovation in order to champion these areas and the organisation has established a bi-monthly “Bright Ideas” competition for staff aimed at improving quality, user experience and budgeting.

Like all PCTs, Islington has been living through a period of change due to the impending separation of provider and commissioner roles. Good communication has been very important for keeping morale high and allaying anxieties. 

“The only constant is change,” says Mr Tritschler. “The name of the job on the pay slip may change but the frontline staff are often doing a similar job. The core services will always need to be there.” 

He adds that the organisation has got its “systems, culture and style aligned” to help deliver the PCT’s objectives rather than work against them.

Changes in PCTs have unsettled many staff – which may explain why 18th is the highest place achieved by any PCT. But Islington receives some of the warmest comments from its staff. There is a lot of praise for managers and the chief executive is described as “fantastic”.  

Mr Tritschler puts this down to the open, honest culture that the organisation endeavours to cultivate.  “There is an open culture where management really support staff and which helps to make it a friendly place in which to work, a lot of people have worked here for a number of years because of it,” he says. 

There is regular communication and meetings held between frontline staff, the chief executive and senior management. Different members of staff are also invited to do presentation on what they have been working on at quarterly meetings. The PCT is keen to involve staff in decision making and the organisation does not have a “hierarchical structure”. 

“Senior management do expect staff to come forward with problems and solutions and there is a sense that projects are tailored to what frontline staff want and need,” Mr Tritschler explains. 

The way the organisation responds to staff feedback is also praised. “I feel confident that senior management will support frontline staff through changes,” says one employee. 

Staff are also encouraged to look after their own health the PCT’s annual “work fit programme” as well as providing them with information on health eating and lifestyle advice there are organised walking and jogging sessions, health checks and yoga.  And good performance at the PCT is rewarded with parties to celebrate successes. 

“Ultimately there is a strong commitment from senior staff to make it a good place to work,” Mr Tritschler says.

The Healthcare 100, researched by Ipsos MORI on behalf of HSJ and Nursing Times, is based on the results of an exclusive poll of the employees of participating organisations. It is open to both NHS and independent healthcare providers in the acute, primary care, mental health and ambulance sectors.