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How to recruit and retain a top-performing workforce

22 September 2023

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‘Employee value propositions’ can have a positive impact on recruitment, retention, productivity and engagement at a GP practice. HR expert George Lepine explains what they are and how to create one

In a tight recruitment marketplace, what is going to make talented people want to join your practice and stay?  Increasingly, the onus is on employers to ‘sell’ their attributes and working experience to employees.

For practices that struggle to do this, the impact can be significant staff turnover. Since 2021, Qualitas has surveyed 2,300 practice staff across 115 practices. In these surveys, only 54% agree or strongly agree that they will be at their practice in the next five years.

In addition to damaging employee morale, replacing a staff member can result in significant financial costs. Replacing one staff member was estimated to cost £30,614 nearly a decade ago – adjusted for inflation, that’s approximately £42,000 today. 

That’s why practices should consider investing time in creating an Employee Value Proposition (EVP). It will help you recruit the right people – and keep them.

What is an employee value proposition and why should anyone care about it?

An EVP describes what you stand for, what you expect and what you offer as an employer.  It should be done in a way that is inspirational and realistic, and that sets you apart. It should tell me a candidate why they would want to come and work with you – and what will make them stay.

You might assume that employees move jobs in pursuit of higher income but that is not always the case, especially in primary care. The staff surveys mentioned above found that of the 138 general practice staff  – 6% of the total number of respondents – who said they strongly disagreed that they would be in their practice in five years’ time, only seven mentioned pay as being a factor.

The bigger considerations are related to organisational culture, trust, leadership, recognition, respect, and communication. And that’s where your EVP comes in.

EVPs are not just a question of branding. When EVPs fail, it’s usually because they make promises that are at odds with the employee experience. So, your EVP needs to be constructed with integrity. Involve your employees in the process of writing it and remember that simplicity and brevity are virtues.

Once you have your EVP it will become a means of knitting together the people, policies and practices that support each stage of the employee lifecycle.

So, what are the steps to creating an EVP?

Step 1:  Be clear about your mission and vision

First, think about the why for your practice or PCN. This isn’t what you do. It’s your purpose, cause or belief and the reason that you (and everyone who works with you) get out of bed in the morning.

Once you know the why, start to think about the big picture and determine your shared vision. What would it look like if you were successful in achieving your mission?

The ‘how’ is as important as the mission itself. Think about how your practice brings the vision to life. It’s not enough for these fundamental elements to be created by leadership and placed in a seldom-referenced document. They should be developed together with staff, acting as a guiding light for the daily demands of every member of staff’s work.

Step 2: Drive a positive culture by developing clear values

Now that you’ve identified the why and have a shared vision of where you’re going, consider the values that bring these to life. What are the core principles that guide your work, the moral code for your practice or PCN? How does stuff get done and what does that look like?

These values support the culture of your practice. They shape the behaviours demonstrated by leaders and employees.

This is the foundation for building a competency-based approach. That’s an approach that defines the measurable and observable behaviours that go hand in hand with your mission, vision and values and contribute to enhanced performance, increased engagement, and organisational success.

In the Qualitas survey, 64% of practice staff reported that they have a clear understanding of their practice vision and strategic goals. And 92% of staff believe they understand their practice values and how this sets expectations for their culture and behaviours. This sounds positive, doesn’t it? 

However, a separate survey of practice partners showed that only 14% shared their vision and values with their teams and even fewer actually ‘bake’ these into the formal and informal approaches to HR and ways of working. Staff incorrectly assuming that they know a practice’s vision and values could have unintended consequences for practice culture, consistency of experience for patients, and even affect quality of care.

Step 3: Embed your culture and values into your recruitment processes

While finding candidates with the right skills and abilities is important, it is also important to assess cultural fit. If you recruit skilled and experienced clinical staff who do not share the values of your team, they may not work well in the practice.

That’s why it’s important to be sure that your values are shared clearly and consistently in every step of the recruitment process, for clinical and non-clinical staff. Make them part of your job descriptions and include them in your advertisements. Ask candidates to tell you what matters to them in their application and, in your interviews, ask people for examples of times when they have demonstrated your values.

With clinical capacity particularly in short supply, you may have to take on a competent clinician whose ‘fit’ with your culture isn’t good. Being mindful of the implications of this and how to minimise the associated risks is key when balancing a clinical need with any potential damage to the patient experience and existing team morale.

Recruiting with a clear sense of your own why and what that means in terms of the values that you need someone to bring to your work will make your practice/PCN more attractive to applicants, improve job satisfaction, enhance organisational commitment, and reduce turnover.

Step 4: Align people policies with your Employee Value Propositions

You’ve found the candidate, they accepted the offer, and now it’s time to manage performance. This is when your values really get to shine. Look at your most important people policies – the ones that support the employee lifecycl – and practices, and ask if each of these embodies and reinforces your EVP.  Think about how performance management works, how you grow and develop people, and how you recognise and reward people.

There are two common pitfalls for practices struggling with performance management. One is focusing on deficit-based feedback, that is, what a person isn’t doing. And the second is taking a tick-box approach where they allot less time and/or focus than is needed to engage staff in continued growth and development.

At best, these result in ineffective appraisals but may also reduce employee job satisfaction.

For those looking to improve their performance management, we suggest taking a strengths-based approach.  This encourages people to focus on what has most motivated them to do a great job and to talk about their future aspirations within your practice/PCN. 

This can improve staff feelings on the areas that most impact retention:

  • Flexibility
  • Fairness
  • Attention to wellbeing
  • Career development and progression
  • Empowering people to drive change
  • A diverse and inclusive culture

Ideally, your reward and recognition structure should also reinforce your mission and vision, motivate staff to continue to develop, and recognise high-performing staff.

As the general practice landscape and the recruitment market continue to evolve, a clear and authentic EVP will set you apart and give people a compelling reason to join and stay. By aligning your values with your recruitment processes, cultivating a positive organisational culture, equipping your leaders to be coaches and embedding these principles into your people policies, you will measurably increase employee satisfaction, engagement, and wellbeing.

At a time where practices need strong teams more than ever, investing in a well-crafted EVP is a foundational step towards achieving sustainable success.

George Lepine is an associate at healthcare advisory and training company, Qualitas. To find out more about Qualitas’s work on high performing teams see here.