Streamlining internal transfers for nurses

Overview

Sherwood Forest Hospital (SFH) NHS Foundation Trust set up an internal transfer scheme to allow staff to apply for a fast-track, sideways transfer to another ward, department or speciality. The scheme reduced vacancy rates and retained knowledge and talent in the organisation. 

Key benefits and outcomes

• Reduced vacancy rates and staff turnover.  
• Reduction in the cost of recruitment and the time spent filling vacancies.
• Retention of knowledge and talent, increased staff skills, shared knowledge between departments and specialities, improved quality of care for patients. 
• Improvements in staff motivation and job satisfaction through reducing time spent searching and applying for vacancies, and an increased possibility of promotion. 

What the organisation faced

Between April 2019 and March 2020, 50 band 5 nurses left the trust and in April 2020 there was a total of 137.45 whole time equivalent (WTE) band 5 nursing vacancies within the trust, a vacancy rate of 18.54 per cent. SFH recognised that there were many reasons why staff members chose to leave. However, feedback collected from nurse exit interviews highlighted a lack of opportunities for career progression and personal development contributed to their decision to leave.  

In 2020, an MSc student working in human resources at SFH shared the results of a questionnaire-based research project, which studied band 5 nurses’ attitudes towards an internal transfer process. It showed 48 per cent of respondents had considered working in a different department or ward at SFH and 37.5 per cent of respondents would be interested in applying for an internal transfer. The respondents who replied yes to being interested in the scheme also stated they were more likely to stay at the trust if the scheme was available.  

What the organisation did

The trust decided to take a centrally managed approach to support the internal transfer of band 5 nurses into identified vacancies to help retain nurses with valued skills and experience and reduce the length of time it takes to recruit into a post. 

The trust appointed a chief nurse clinical fellow on a 12-month secondment for 15 hours per week to implement the scheme for band 5 nurses. It was piloted for a six-month period between June and December 2021 and available to registered band 5 nurses who: 

• worked for the trust and had been in their role for a minimum of six months 
• had completed preceptorship if newly qualified 
• had an appraisal in the last 12 months 
• received agreement from their current line manager.  

Prior to implementing the scheme, the project lead carefully considered the process and sought feedback from ward and department leaders over a period of three months via face-to-face meetings, video calls and email correspondence. This meant the buy-in from staff was good.

Results and benefits

The total number of enquiries received about the scheme during the pilot period was 45, of which 17 were finalised and processed. 

When the scheme launched in June 2021, there were a total of 157.34 whole time equivalent band 5 nurse vacancies, a vacancy rate of 20.08 per cent. As of December 2021, there were a total of 113.38 whole time equivalent band 5 nurse vacancies, a vacancy rate of 14.55 per cent, a drop of more than 5 per cent in just six months. The continued positive reduction in vacancies of band 5 nurses highlights the joint efforts currently underway with recruitment and retention at SFH.  

During the pilot period, only one nurse involved with the scheme left the trust. The average number of days from transfer meeting to starting in post was 59.8 days.  

An online link to a bespoke, anonymous questionnaire was completed by all who had transferred and started in their new post during the pilot period. The questionnaire captured their demographics and opinions on the internal transfer process. Of those nurses who transferred, 58 per cent had been registered nurses for more than 10 years.  

Transferees were asked to what extent they agreed or disagreed with certain statements about the scheme process. Key findings from the survey: 

• All transferees agreed the scheme helped them to develop their knowledge and skills and allowed them to develop in their career.  

• All transferees agreed that the internal transfer request form was easy to complete.  

• 85 per cent of transferees agreed that the transfer process was fast. 

• 75 per cent of transferees agreed that they were supported by their line manager through the process.  

• All transferees agreed that they were supported during the process by the project lead.  

When asked, two transferees reported they would have preferred a six-month trial instead of a permanent move, and only one would have preferred a rotational post instead of a permanent move. All transferees said they were either likely, or extremely likely, to recommend the scheme to colleagues. A positive outcome is that all transferees reported that they were not currently considering leaving the trust. 

"Communication with the project lead for the internal transfer scheme was amazing. I was kept updated throughout the whole process which gave me great hope with finding what I was passionate about and what I wanted to achieve. I think the scheme is very good and benefits the trust by retaining staff who may have been employed for years." - Feedback from a scheme participant. 

Overcoming obstacles

Negotiating timely start dates within six weeks of the transfer meeting was problematic at times. Ward and department leaders are accustomed to nurses working an eight-week notice period, so suggesting this should be shortened for an internal transfer made some feel anxious. Support from senior leaders was critical to provide reassurance and reiterate the positives of a fast-tracked recruitment process, ensuring the scheme made it easier for staff members to stay within the trust than to leave.  

Not all nurses have access to trust communications, so ensuring band 5 nurses were aware of the scheme needed a multi-level approach. This included:  

• placing posters in communal areas on wards and in departments 
• sending dedicated trust emails to band 5 nurses  
• creating accessible links to an intranet web page which provided further information 
• social media posts 
• computer screensavers 
• attendance by the project lead at group preceptorship meetings. 

The experience of transferees who used the scheme was positive; this supported the promotion of the scheme through word of mouth.

Takeaway tips

• Engage all key stakeholders and respond positively to feedback when implementing a new scheme. 

• Use a wide variety of channels and promotional avenues to advertise the scheme. 

• Be responsive, empathetic, and supportive to members of staff who seek to use the scheme.  

• Ensure confidentiality and provide a safe space for nurses to speak about their career. 

• Create a simple and easy-to-complete request form. 

Contact details

Anne Wildgoose, chief nurse clinical fellow at Sherwood Forest Hospitals NHS Foundation Trust. Email: sfh-tr.internaltransferscheme@nhs.net