Art & science
If you would like to contribute to the Art & science section, email [email protected] or @NSclinicalEd
The synthesis of art and science is lived by the nurse in the nursing act
Josephine G Paterson
Improving staff selection processes Cerinus M, Shannon M (2014) Improving staff selection processes. Nursing Standard. 29, 10, 37-44. Date of submission: March 24 2014; date of acceptance: May 30 2014.
Abstract This article, the second in a series of articles on Leading Better Care, describes the actions undertaken in recent years in NHS Lanarkshire to improve selection processes for nursing, midwifery and allied health professional (NMAHP) posts. This is an area of significant interest to these professions, management colleagues and patients given the pivotal importance of NMAHPs to patient care and experience. In recent times the importance of selecting staff not only with the right qualifications but also with the right attributes has been highlighted to ensure patients are well cared for in a safe, effective and compassionate manner. The article focuses on NMAHP selection processes, tracking local, collaborative development work undertaken to date. It presents an overview of some of the work being implemented, highlights a range of important factors, outlines how evaluation is progressing and concludes by recommending further empirical research.
Authors Marie Cerinus Director, NMAHP Practice Development Centre, NHS Lanarkshire, Hamilton, Scotland. Marina Shannon Practice development practitioner, NMAHP Practice Development Centre, NHS Lanarkshire, Hamilton, Scotland. Correspondence to: [email protected]
Keywords Collaboration, evaluation, midwifery, nursing, recruitment, selection, training and information, values and competencies
Review All articles are subject to external double-blind peer review and checked for plagiarism using automated software.
Online For related articles visit the archive and search using the keywords above. Guidelines on writing for publication are available at: rcnpublishing.com/r/author-guidelines
RECRUITMENT AND SELECTION of high-quality staff is crucial to the success of any organisation. NHS Lanarkshire, in common with most if not all health boards and trusts, is a major local employer responsible for employing a wide range of professional and support staff in significant numbers. Nurses, midwives and allied health professionals (NMAHPs) and their support workers constitute the largest proportion of these staff in terms of numbers and turnover and, given their importance to care delivery, form a critical staff group for recruitment and selection. The Scottish Government (2008) launched Leading Better Care (LBC) a policy that initially supported the role and development of senior charge nurses and team leaders in nursing and midwifery. Nationally, it has evolved since its launch to focus on how these roles affect patient care and experience directly. Locally in NHS Lanarkshire, allied health profession (AHP) team leaders have been included in its implementation. As part of the local implementation of LBC, the recruitment and selection of NMAHPs was identified as an area that would benefit from developing greater rigour. Initial local discussion focused on the selection of staff for the pivotal position of senior charge nurse or team leader but it became apparent that this was too limiting and that, to develop leadership capacity and continue to deliver high-quality care, consideration should be given to all levels of NMAHP selection (band 2 and above). This article presents the main impetus for change in NMAHP selection, discusses what was changed, and highlights areas that require further development.
Impetus for change To implement LBC in a meaningful way 12 key areas for development were identified, as shown in
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Art & science leading better care series: 2 Box 1. Each of these areas was deemed important in the work of senior charge nurses or team leaders and their teams. Engaging high-quality staff is essential to maintain and improve care standards as well as clinical leadership capacity. However, there were issues about consistency and rigour. The current personal selection interview did not conform to clear or consistent standards, and there was also a lack of appetite for onerous assessment centre activities or engagement in multilayered psychometric testing. While the way in which the personal interview was conducted was criticised for its limitations, it was nonetheless valued. If conducted better, applicants could exemplify their actions, reactions and responses, and the interview could uncover deeply held values and opinions that reflected their personal attitudes. Another facet in the selection interview we considered was related to the composition of interview panels and whether staff were well prepared to conduct interviews. Line managers were tasked with involvement in the selection interview for vacant posts, but many stated that they had never received formal preparation. The question of how best to address selection knowledge and skills also emerged. The outcomes of these early discussions reflected the findings of previous exploratory work – undertaken by NHS Lanarkshire’s NMAHP practice development centre in 2010/11 in conjunction with human resource (HR) colleagues – which showed that selection relied on a relatively unstructured personal interview. Although this interview was always conducted by at least two interviewers and an administrative process was in place, it was not clear who should be involved and the preparation and questions used lacked consistency. In addition, the scoring system for evaluating an applicant’s interview performance and the decision of whether to appoint was not robust, objective or focused. Therefore it was
BOX 1 Key areas for development (work packages) Human resource recruitment and selection process. Workforce integration. Line manager development. Care documentation. Research and evaluation. General ward nursing dashboard. Support worker development. Band 5 development. Band 6 development. Band 7 development. Leading Better Care communications. Programme management and administration.
challenging to reconcile selection processes with espoused organisational values (Table 1). Such unstructured processes did not provide assurance about the appointment of the ‘right’ person – that is, the one with the right values, attributes, behaviours and skills – even though that was the intention. The time for change was ideal: clear need had been identified, policy opportunity existed and there was an enthusiasm to address NMAHP selection.
Local context In NHS Lanarkshire, NMAHPs constitute about 70% of the total workforce, approximately 7,500 people, with an average annual turnover of 6.5%. Recruitment activity represents a significant investment where the majority of NMAHPs have a lifetime career of 40-plus years until retirement. Attree (2001) identified that an inappropriately selected employee can harm the quality of care provided, patient and carer experience, staff relationships and organisational reputation. In addition, it takes much time and effort to improve his or her practice or to terminate employment equitably. Inappropriate selection is to be avoided, where possible. In 2012/13, NHS Lanarkshire advertised 695 nursing and midwifery posts, generating 7,326 applications, accounting for 50.73% of all recruitment activity and indicating that the process of selection was important. While at times some positions are difficult to fill, many vacancies are well or over-subscribed, demonstrating that attracting potential recruits is not an issue. The challenge lies in ensuring that posts are offered not only to the ‘right’ applicant – those possessing appropriate skills, qualifications and personal attributes – but to the ‘best’ applicant – those who can demonstrate value-added attributes or potential to develop further, given the career-long retention of most NMAHPs selected. These considerations further reinforced the need to reshape local selection processes.
Selection considerations Selecting the best candidate involves a collection of tangible and more elusive assessment methods. Qualifications and demonstrable clinical skills, while important, are insufficient, a point made by Roberts (1997) and highlighted by Mitchell et al (2013). The importance of values-based recruitment has been emphasised in respect of healthcare assistants (Nursing Standard 2013). For selection processes, the more challenging
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assessment lies in ensuring that each new appointee is an effective, competent, caring practitioner able to provide patient-centred and continually updated care. It is imperative that NMAHPs are appropriately qualified and clinically skilled as well as temperamentally suited to delivering quality care in a collegial and compassionate manner. To address this and so strengthen the personal interview as the preferred selection method, a more structured and consistent approach was required. Questions that identified a candidate’s qualifications, experience and skills as well as his or her attitudes and behaviours (Garcea et al 2011, Bassett et al 2012) would reduce ‘reliance on intuition and subjectivity in employee selection’ (Highhouse 2008). For NMAHPs, codes of conduct are defined by regulatory or national bodies (Nursing and Midwifery Council (NMC) 2008, The Scottish Government 2009, Health and Care Professions Council 2012). The NHS Scotland Quality Strategy espouses three quality ambitions of safety, effectiveness and person-centeredness, and there was local guidance on caring and compassionate practice (NHS Lanarkshire 2010, The Scottish Government 2010a). In 2013, the publication of the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (Francis 2013) highlighted the
importance of effective staff selection in raising and maintaining standards of care. The challenge was to find ways of discerning if an applicant’s responses to interview questions signalled concerns regarding patients and their ability to lead in ways that promoted safe and effective care as well as testing commitment to the values expected from them. The resulting process should not create a burdensome structure and should have potential for further development and use by other staff groups. The initial aims were therefore to refine the personal interview process for all NMAHP posts from band 2 onwards, to maximise the effectiveness and efficiency of interview panels and to design effective support.
The evidence The literature was reviewed to seek an evidence base or, ideally, a ready-made solution to improve the selection interview. Initial searches of business management, HR, medical and NMAHP literature from the previous ten years with a specific focus on the UK and NMAHPs resulted in some support for certain aspects. However, what was absent from the literature and from contacts with others was a solution that could be adapted easily to local needs.
TABLE 1 NHS Lanarkshire organisational values Our values are those things that matter to us individually and together across all parts of NHS Lanarkshire. This means we share a common set of responsibilities in relation to how we provide our services. Fairness Ensuring clear and considered decision making at all levels.
As a team, we are responsible for being consistent and open in making decisions. As an individual, I am responsible for participating in decisions and seeking clarity whenever I am unsure.
Respect Valuing each individual and his or her contribution.
As a team, we are responsible for being courteous and professional in fulfilling our individual and collective roles. As an individual, I am responsible for recognising that we are all different and appreciating the contribution made by myself and by others.
Quality Setting and maintaining standards in everything we do.
As a team, we are responsible for upholding our high standards in every activity, for every person, everywhere. As an individual, I am responsible for ensuring I understand and deliver our standards every time.
Working together Thinking, developing, delivering as a team.
As a team, we are responsible for creating and sustaining an environment that allows team working and collaboration to flourish. As an individual, I am responsible for communicating effectively and working well with others at all times.
By living our values, we all take pride in the important role we have as providers of excellent services to people in Lanarkshire. (NHS Lanarkshire 2013)
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Art & science leading better care series: 2 Business management and HR sectors often use relatively complex selection processes such as assessment centres, multistage interviewing and psychometric testing or screening. We were unable to identify a strong evidence base to indicate how using such complex methods – with associated questions about validity and reliability of scoring and weighting alongside the likely requirement for increased investment of cost and time – would provide greater assurance of how applicants would behave in healthcare practice. At this initial stage, it was felt that the aim was to reorder, structure and unify the current selection interview process rather than to create resource-intensive structures that were the subject of debate and were not well tested in the NMAHP field. Improvement of our selection interviewing would allow us to assess how applicants narrated their thinking and actions, witness interactions with the questioner that could indicate attributes such as defensiveness, openness and curiosity, as well as affording opportunities for applicants to assess for themselves our organisational attitudes and culture. Selection interviewing is about the suitability of the applicant for the organisation and the organisation for the applicant. The dearth of specific literature, especially of published empirical research, was also reported in work conducted in Scotland to identify good practice in recruitment, selection and retention of pre-registration nursing and midwifery students (Scottish Government Health Directorates and NHS Education for Scotland 2010). This was disappointing. However, NHS Lanarkshire already possessed a committed collaborative team of HR, NMAHP and other colleagues from professional and trade unions, augmented by external specialists, to take forward the required work on selection interviews. This work was therefore developed under the auspices of the local LBC programme, an initiative explained more fully by McGuire and Ray (2014).
Interview structure In the UK, the current NHS Knowledge and Skills Framework (KSF) applies to all NMAHP posts (Department of Health (DH) 2004), so it was appropriate to make use of this. External specialists commissioned locally to support our work advocated the adoption of competency or behavioural-based approaches that use past or observed behaviours as predictors of future performance in selection interviews (Main et al 2011). Both initiatives dovetailed with local work to help in developing a values and competency framework. This framework could then be used to
formulate interview questions, providing a consistent basis for personal interviews. Interview questions previously used prospective questioning, which meant that answers were derived from a hypothetical scenario. Competency-based approaches use retrospective and reflective reporting on situations experienced and chosen by candidates to exemplify their actions and intentions. This enables interviewers to gain an enhanced perspective on how the applicant expresses his or her internal values through action, reaction, responses, omissions and post hoc learning in situations that are self-selected to illustrate a particular competence. This is based on self-reporting rather than validated testimony. However, it provides structure to the process and generates responses on which the interviewer could make judgements and decisions in a way that engagement in hypothetical questioning cannot. In the current version of the NHS Lanarkshire Values and Competency Framework, content is based on the six core dimensions of the NHS KSF – communication; personal and people development; health, safety and security; service improvement; quality; and equality and diversity – as these applied to all posts (DH 2004). Two additional competencies – care and compassion, and technical/role specific skills – were added to address temperament and clinical skills in more detail. In addition, for posts at band 6 and above, where formal leadership is required, further work was undertaken. Again this was based on previous work begun locally to form questions that reflect a further eight dimensions from the document Delivering Quality through Leadership: NHS Scotland Leadership Development Strategy (The Scottish Government 2010b). Table 2 provides an overview of the NHS Lanarkshire Values and Competency Framework. Within the Values and Competency Framework, each of the 16 values and competencies has associated questions. These questions were designed to reflect each dimension at one of four levels, aligned to the Agenda for Change pay band of the post as follows: Level 1 questions = bands 2-4. Level 2 questions = band 5. Level 3 questions = bands 6 and 7. Level 4 questions = band 8. For any post, interviewers are expected to select a maximum of eight competency-based questions, agreed by the panel beforehand as most relevant to the post, ensuring consistency for all candidates. This number may be lower if a question covers more than one competency, and interviewers have guidance available on formulating other competency-based questions to reduce the risk of
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rigidity within this structured approach. Rigidity is further avoided by the use of probing questions, which addresses the need for dynamism, a point highlighted by Martin and Pope (2008). Guidance on which part of the Values and Competency Framework questions should be used is: Bands 2-4: up to eight level 1 questions from competencies 1-8. Band 5: up to eight level 2 questions from competencies 1-8. Band 6: up to seven level 3 questions from competencies 1-8; one competency from 9-16. Band 7: up to seven level 3 questions from competencies 1-8; two competencies from 9-16. Band 8: up to five level 3 questions from competencies 1-8; three competencies from 9-16. Evocative of the assessment centre approach advocated originally by Vernon and Parry (1949), but not true to it, we recognised that, for more senior posts (band 6 and above), supplemental techniques to an interview would be useful. This reflected some of the active skill sets required of those taking up these more senior leadership positions and included presentation, writing and problem-solving skills. Guidance on and exemplars of how to apply these additional techniques were created for use in the Values and Competency Framework and the selection interview. A simple scoring system (0 does not meet the required standard, 1 meets the required standard, 2 exceeds the required standard) was used for all assessment measures. Written guidance on recognising weak, acceptable and strong responses was produced.
Interview panels Membership of the NMAHP selection panel was agreed and standardised (Table 3). While work related to lay membership is currently in progress, it was agreed that senior
NMAHP professional leadership was crucial to ensure consistent support for line managers on the interview panels. The creation of senior NMAHPs as panel chairs, who are prepared and equipped appropriately to lead and manage the selection process would further strengthen the process. In addition, this would allow education and development to be focused on those who would most frequently use these skills.
Preparation of and support for panel chairs
A one-day training programme, in conjunction with external specialists, was designed. The use of external recruitment specialists provided assurance that the planned approaches fitted with professional and health policies as well as being contemporary and legally compliant. To date, just over 60 people have been formally prepared, each being supported with an internal, newly created Panel Chairs’ Guide. Arrangements are in place for this guide to be reviewed periodically and redistributed to the panel chairs. HR and practice development staff have also been identified as providers of ongoing support. From the delivery of the preparation programme, it was recognised that the new selection process, particularly for posts at band 6 and above, will take marginally longer than the previous system to conduct. It became crucial therefore to address more rigorous screening of applications to ensure that only the best applicants were invited for interview. Those preparing as panel chairs identified that two further supportive resources would be helpful: improved person specifications to accompany standardised job descriptions, which were not being changed, and other supplemental techniques such as presentations, written exercises and problem-based scenarios, which could be used in the selection interview. There was also recognition of the need to make relevant information available for potential candidates for NMAHP
TABLE 2 NHS Lanarkshire Values and Competency Framework General Competency 1: care and compassion. Competency 2: technical and/or role-specific skills. Competency 3: communication. Competency 4: person and people development. Competency 5: health, safety and security. Competency 6: service development. Competency 7: quality. Competency 8: equality and diversity.
Agenda for Change bands 6-8 Competency 9: setting direction – intellectual flexibility. Competency 10: setting direction – drive for results. Competency 11: personal qualities – self-belief. Competency 12: personal qualities – drive for improvement. Competency 13: personal qualities – personal integrity. Competency 14: delivering the service – leading change through people. Competency 15: delivering the service – effective and strategic influencing. Competency 16: technical/role-specific leadership skills.
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Art & science leading better care series: 2 posts. Five brief documents were prepared, and these can be viewed on the organisation’s website at www.nhslanarkshire.org.uk/Careers/ Pages/NMAHP.aspx
Progress to date The changes described remain at an early stage and have been developed in an iterative manner, influenced by the experience of those involved. The panel chairs’ enthusiasm to use the new approach in selection interviews was such that implementation began in summer 2013 ahead of the formal commencement planned for January 2014. This provided positive feedback and reassurance that the materials, preparation and processes are fit for purpose. In taking this work forward it was identified that improving the interview structure and the construction of interview panels was only part of the process. Other elements had to be considered. For example, HR staff had to become familiar with the new process, supporting paperwork had to be designed and different arrangements made for NMAHP selection interviews because they would take longer. Each had to be chaired by a designated panel chair and new documentation was required. Further, although being professionally led from an NMAHP perspective, service and general manager colleagues needed to be appraised of the changes; panel chairs had to plan their
time in advance to honour their commitments to the selection processes and to their work; and communication to and from NMAHP senior leaders, staff side partners and others needed to be maintained because the work was being developed incrementally. As this work was being conducted under the auspices of LBC, the local LBC programme board (McGuire and Ray 2014) had also to be updated so that the work would be underpinned by local evaluation. The approach taken has been an iterative process, reflective of quality improvement or action research methodology. Elements were: agreed and designed, drawing on evidence where this existed; tested in practice; evaluated and reviewed; and alterations were repeated as required. One example of a formal evaluation performed was an electronic survey, which was conducted after the panel chair preparation was completed. This was done to identify the extent to which the preparation was effective and the new approach resonated with participants’ expectations of selection by interview. Further formal evaluation was then conducted after three months when some participants had put their preparation into practice. These initial evaluations indicated highly positive responses for the approach being taken and the effectiveness of the preparation programme. Improvements in the quality of feedback available for successful and unsuccessful candidates, alongside has improved reflection
TABLE 3 Selection panel membership for nurses, midwives and allied health professionals Pay band
Core members
Lay member (in progress)
Band 8
Nurse/AHP director*. Associate nurse director/AHP. Professional lead/deputy director PDC. General or service manager.
Local public partnership forum member or designate.
Band 7
Associate nurse director/AHP. Professional lead/deputy director PDC*. Senior nurse/AHP team leader/NMAHP consultant. Service manager.
Volunteer/member from the local advocacy services/local public partnership forum member or designate.
Band 6
Senior nurse/AHP team leader/NMAHP consultant*. Senior charge nurse/senior AHP practitioner.
Volunteer/member from the local advocacy services.
Band 5
Senior nurse/AHP team leader/NMAHP consultant*. Senior charge nurse/deputy charge nurse/senior AHP practitioner.
Bands 2-4
Senior nurse/AHP team leader/NMAHP consultant. Senior charge nurse/deputy charge nurse/senior AHP practitioner. Registered practitioner.
All panels included the line manager for the post. *Designated panel chair. AHP = allied health professional, NMAHP = nursing, midwifery and allied health professional, PDC = NMAHP practice development centre
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by each panel on its own performance, were also identified. Future formal evaluation will ensue with the same broad intentions: to see if the practice is becoming embedded, and to highlight successes or identify any gaps. Recent focus groups indicate ongoing successful implementation and the need for a few other areas, such as the further development of the bank of questions, to be addressed. A full report is in preparation. While current evaluation is helpful in strengthening approaches, it has not yet addressed outcomes: was the best person selected for the job? This is an area where there is little evidence to draw
on other than that related to selection for training programmes, where follow up has been conducted reaffirming the success of a competency-based approach (for example, Crawford 2005, Daiches and Amor 2006). At present some consideration is being given to case study work to follow through a sample of those selected, preferably on a longitudinal basis. While challenging to conduct, it is felt that, without creating this first step forward, the empirical evidence to support progress or to assure the public or others that this new approach ensures better selection will remain elusive. Although experiential evidence to date indicates that the new approach has improved
References Attree M (2001) Patients and relatives experience and perspectives of ‘Good’ and ‘Not so Good’ quality care. Journal of Advanced Nursing. 33, 4, 456-466.
Daiches A, Amor C (2006) The journey towards competency-based selection at the Lancaster doctorate in clinical psychology. Clinical Psychology Forum. 167, 24-27.
Bassett ML, Ramsay WP, Chan CA (2012) Improving medical personnel selection and appointment processes. International Journal of Health Care Quality Assurance. 25, 5, 442-452.
Department of Health (2004) The NHS Knowledge and Skills Framework (NHS KSF) and the Development Review Process. tinyurl.com/nkkef68 (Last accessed: October 3 2014.)
Crawford ME (2005) Reassuring evidence on competency based selection: commentary. British Medical Journal. 330, 7493, 714.
Francis R (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Enquiry. The Stationery Office, London.
Garcea N, Isherwood S, Linley A (2011) Do strengths measure up? Strategic HR Review. 10, 2, 5-11. Health and Care Professions Council (2012) Standards of Care, Performance and Ethics. tinyurl. com/n5rwkkb (Last accessed: October 3 2014.) Highhouse S (2008) Stubborn reliance on intuition and subjectivity in employee selection. Industrial and Organizational Psychology. 1, 333-342.
Main P, Curtis A, Irish B (2011) How was it for you? Competency-based selection of general practice educators. Education for Primary Care. 22, 6, 450-452. Martin PD, Pope J (2008) Competency-based interviewing: has it gone too far? Industrial and Commercial Training. 40, 2, 81-86. McGuire C, Ray D (2014) Developing leadership roles in nursing and midwifery. Nursing Standard. 29, 9, 43-49.
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Art & science leading better care series: 2 processes, a full examination of the outcomes is necessary. At present, this is accepted as a limitation of, rather than a barrier to, this new approach. Another limitation is that some of these approaches may be commonplace elsewhere while being new locally. Given the enthusiasm with which they have been welcomed locally, it seems fitting to share them more widely.
Conclusion In our Leading Better Care programme, we have taken steps to improve our NMAHP selection
Mitchell M, Strube P, Vaux A, West N, Auditore A (2013) Right person, right skills, right job: the contribution of objective structured clinical examinations in advancing staff nurse experts. Journal of Nursing Administration. 43, 10, 543-548. NHS Lanarkshire (2010) Caring and Compassionate Practice. tinyurl. com/qcnxcyx (Last accessed: October 3 2014.) NHS Lanarkshire (2013) Values in action framework (Unpublished document). NHS Lanarkshire, Glasgow.
Nursing and Midwifery Council (2008) The Code: Standards of Conduct, Performance and Ethics for Nursing and Midwifery. NMC, London. Nursing Standard (2013) Values-based recruitment and robust training cuts trust’s HCA turnover. Nursing Standard. 27, 46, 6. Roberts G (1997) Recruitment and Selection: A Competency Approach. Chartered Institute of Personnel and Development, London. Scottish Government Health Directorates and NHS Education for Scotland (2010) Good Practice
processes, we are identifying areas for ongoing development and are actively considering further robust evaluation. This work has been undertaken to ensure the best person is selected for every NMAHP post NS Acknowledgement Nursing Standard would like to thank Dr Kathleen Duffy, NHS Education for Scotland nursing and midwifery practice educator, Practice Development Centre, NHS Lanarkshire, for developing and co-ordinating the Leading Better Care series of articles.
in Recruitment, Selection and Retention of Pre-Registration Nursing and Midwifery Students. tinyurl.com/qcltte7 (Last accessed: October 3 2014.)
The Scottish Government (2010a) The Healthcare Quality Strategy for NHSScotland. tinyurl. com/ctqr54o (Last accessed: October 3 2014.)
The Scottish Government (2008) Leading Better Care. Report of the Senior Charge Nurse Review and Clinical Quality Indicators Project. tinyurl.com/yl94e38 (Last accessed: October 3 2014.)
The Scottish Government (2010b) Delivering Quality Through Leadership: NHSScotland Leadership Development Strategy. tinyurl.com/ mqy3nbk (Last accessed: October 3 2014.)
The Scottish Government (2009) Code of Conduct for Healthcare Support Workers. tinyurl. com/nnh7gmx (Last accessed: October 3 2014.)
Vernon PE, Parry JB (1949) Personnel Selection in the British Forces. University of London, London.
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If you would like to contribute to the Art & science section, email [email protected] or @NSclinicalEd
The synthesis of art and science is lived by the nurse in the nursing act
Josephine G Paterson
Improving staff selection processes Cerinus M, Shannon M (2014) Improving staff selection processes. Nursing Standard. 29, 10, 37-44. Date of submission: March 24 2014; date of acceptance: May 30 2014.
Abstract This article, the second in a series of articles on Leading Better Care, describes the actions undertaken in recent years in NHS Lanarkshire to improve selection processes for nursing, midwifery and allied health professional (NMAHP) posts. This is an area of significant interest to these professions, management colleagues and patients given the pivotal importance of NMAHPs to patient care and experience. In recent times the importance of selecting staff not only with the right qualifications but also with the right attributes has been highlighted to ensure patients are well cared for in a safe, effective and compassionate manner. The article focuses on NMAHP selection processes, tracking local, collaborative development work undertaken to date. It presents an overview of some of the work being implemented, highlights a range of important factors, outlines how evaluation is progressing and concludes by recommending further empirical research.
Authors Marie Cerinus Director, NMAHP Practice Development Centre, NHS Lanarkshire, Hamilton, Scotland. Marina Shannon Practice development practitioner, NMAHP Practice Development Centre, NHS Lanarkshire, Hamilton, Scotland. Correspondence to: [email protected]
Keywords Collaboration, evaluation, midwifery, nursing, recruitment, selection, training and information, values and competencies
Review All articles are subject to external double-blind peer review and checked for plagiarism using automated software.
Online For related articles visit the archive and search using the keywords above. Guidelines on writing for publication are available at: rcnpublishing.com/r/author-guidelines
RECRUITMENT AND SELECTION of high-quality staff is crucial to the success of any organisation. NHS Lanarkshire, in common with most if not all health boards and trusts, is a major local employer responsible for employing a wide range of professional and support staff in significant numbers. Nurses, midwives and allied health professionals (NMAHPs) and their support workers constitute the largest proportion of these staff in terms of numbers and turnover and, given their importance to care delivery, form a critical staff group for recruitment and selection. The Scottish Government (2008) launched Leading Better Care (LBC) a policy that initially supported the role and development of senior charge nurses and team leaders in nursing and midwifery. Nationally, it has evolved since its launch to focus on how these roles affect patient care and experience directly. Locally in NHS Lanarkshire, allied health profession (AHP) team leaders have been included in its implementation. As part of the local implementation of LBC, the recruitment and selection of NMAHPs was identified as an area that would benefit from developing greater rigour. Initial local discussion focused on the selection of staff for the pivotal position of senior charge nurse or team leader but it became apparent that this was too limiting and that, to develop leadership capacity and continue to deliver high-quality care, consideration should be given to all levels of NMAHP selection (band 2 and above). This article presents the main impetus for change in NMAHP selection, discusses what was changed, and highlights areas that require further development.
Impetus for change To implement LBC in a meaningful way 12 key areas for development were identified, as shown in
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Art & science leading better care series: 2 Box 1. Each of these areas was deemed important in the work of senior charge nurses or team leaders and their teams. Engaging high-quality staff is essential to maintain and improve care standards as well as clinical leadership capacity. However, there were issues about consistency and rigour. The current personal selection interview did not conform to clear or consistent standards, and there was also a lack of appetite for onerous assessment centre activities or engagement in multilayered psychometric testing. While the way in which the personal interview was conducted was criticised for its limitations, it was nonetheless valued. If conducted better, applicants could exemplify their actions, reactions and responses, and the interview could uncover deeply held values and opinions that reflected their personal attitudes. Another facet in the selection interview we considered was related to the composition of interview panels and whether staff were well prepared to conduct interviews. Line managers were tasked with involvement in the selection interview for vacant posts, but many stated that they had never received formal preparation. The question of how best to address selection knowledge and skills also emerged. The outcomes of these early discussions reflected the findings of previous exploratory work – undertaken by NHS Lanarkshire’s NMAHP practice development centre in 2010/11 in conjunction with human resource (HR) colleagues – which showed that selection relied on a relatively unstructured personal interview. Although this interview was always conducted by at least two interviewers and an administrative process was in place, it was not clear who should be involved and the preparation and questions used lacked consistency. In addition, the scoring system for evaluating an applicant’s interview performance and the decision of whether to appoint was not robust, objective or focused. Therefore it was
BOX 1 Key areas for development (work packages) Human resource recruitment and selection process. Workforce integration. Line manager development. Care documentation. Research and evaluation. General ward nursing dashboard. Support worker development. Band 5 development. Band 6 development. Band 7 development. Leading Better Care communications. Programme management and administration.
challenging to reconcile selection processes with espoused organisational values (Table 1). Such unstructured processes did not provide assurance about the appointment of the ‘right’ person – that is, the one with the right values, attributes, behaviours and skills – even though that was the intention. The time for change was ideal: clear need had been identified, policy opportunity existed and there was an enthusiasm to address NMAHP selection.
Local context In NHS Lanarkshire, NMAHPs constitute about 70% of the total workforce, approximately 7,500 people, with an average annual turnover of 6.5%. Recruitment activity represents a significant investment where the majority of NMAHPs have a lifetime career of 40-plus years until retirement. Attree (2001) identified that an inappropriately selected employee can harm the quality of care provided, patient and carer experience, staff relationships and organisational reputation. In addition, it takes much time and effort to improve his or her practice or to terminate employment equitably. Inappropriate selection is to be avoided, where possible. In 2012/13, NHS Lanarkshire advertised 695 nursing and midwifery posts, generating 7,326 applications, accounting for 50.73% of all recruitment activity and indicating that the process of selection was important. While at times some positions are difficult to fill, many vacancies are well or over-subscribed, demonstrating that attracting potential recruits is not an issue. The challenge lies in ensuring that posts are offered not only to the ‘right’ applicant – those possessing appropriate skills, qualifications and personal attributes – but to the ‘best’ applicant – those who can demonstrate value-added attributes or potential to develop further, given the career-long retention of most NMAHPs selected. These considerations further reinforced the need to reshape local selection processes.
Selection considerations Selecting the best candidate involves a collection of tangible and more elusive assessment methods. Qualifications and demonstrable clinical skills, while important, are insufficient, a point made by Roberts (1997) and highlighted by Mitchell et al (2013). The importance of values-based recruitment has been emphasised in respect of healthcare assistants (Nursing Standard 2013). For selection processes, the more challenging
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assessment lies in ensuring that each new appointee is an effective, competent, caring practitioner able to provide patient-centred and continually updated care. It is imperative that NMAHPs are appropriately qualified and clinically skilled as well as temperamentally suited to delivering quality care in a collegial and compassionate manner. To address this and so strengthen the personal interview as the preferred selection method, a more structured and consistent approach was required. Questions that identified a candidate’s qualifications, experience and skills as well as his or her attitudes and behaviours (Garcea et al 2011, Bassett et al 2012) would reduce ‘reliance on intuition and subjectivity in employee selection’ (Highhouse 2008). For NMAHPs, codes of conduct are defined by regulatory or national bodies (Nursing and Midwifery Council (NMC) 2008, The Scottish Government 2009, Health and Care Professions Council 2012). The NHS Scotland Quality Strategy espouses three quality ambitions of safety, effectiveness and person-centeredness, and there was local guidance on caring and compassionate practice (NHS Lanarkshire 2010, The Scottish Government 2010a). In 2013, the publication of the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (Francis 2013) highlighted the
importance of effective staff selection in raising and maintaining standards of care. The challenge was to find ways of discerning if an applicant’s responses to interview questions signalled concerns regarding patients and their ability to lead in ways that promoted safe and effective care as well as testing commitment to the values expected from them. The resulting process should not create a burdensome structure and should have potential for further development and use by other staff groups. The initial aims were therefore to refine the personal interview process for all NMAHP posts from band 2 onwards, to maximise the effectiveness and efficiency of interview panels and to design effective support.
The evidence The literature was reviewed to seek an evidence base or, ideally, a ready-made solution to improve the selection interview. Initial searches of business management, HR, medical and NMAHP literature from the previous ten years with a specific focus on the UK and NMAHPs resulted in some support for certain aspects. However, what was absent from the literature and from contacts with others was a solution that could be adapted easily to local needs.
TABLE 1 NHS Lanarkshire organisational values Our values are those things that matter to us individually and together across all parts of NHS Lanarkshire. This means we share a common set of responsibilities in relation to how we provide our services. Fairness Ensuring clear and considered decision making at all levels.
As a team, we are responsible for being consistent and open in making decisions. As an individual, I am responsible for participating in decisions and seeking clarity whenever I am unsure.
Respect Valuing each individual and his or her contribution.
As a team, we are responsible for being courteous and professional in fulfilling our individual and collective roles. As an individual, I am responsible for recognising that we are all different and appreciating the contribution made by myself and by others.
Quality Setting and maintaining standards in everything we do.
As a team, we are responsible for upholding our high standards in every activity, for every person, everywhere. As an individual, I am responsible for ensuring I understand and deliver our standards every time.
Working together Thinking, developing, delivering as a team.
As a team, we are responsible for creating and sustaining an environment that allows team working and collaboration to flourish. As an individual, I am responsible for communicating effectively and working well with others at all times.
By living our values, we all take pride in the important role we have as providers of excellent services to people in Lanarkshire. (NHS Lanarkshire 2013)
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Art & science leading better care series: 2 Business management and HR sectors often use relatively complex selection processes such as assessment centres, multistage interviewing and psychometric testing or screening. We were unable to identify a strong evidence base to indicate how using such complex methods – with associated questions about validity and reliability of scoring and weighting alongside the likely requirement for increased investment of cost and time – would provide greater assurance of how applicants would behave in healthcare practice. At this initial stage, it was felt that the aim was to reorder, structure and unify the current selection interview process rather than to create resource-intensive structures that were the subject of debate and were not well tested in the NMAHP field. Improvement of our selection interviewing would allow us to assess how applicants narrated their thinking and actions, witness interactions with the questioner that could indicate attributes such as defensiveness, openness and curiosity, as well as affording opportunities for applicants to assess for themselves our organisational attitudes and culture. Selection interviewing is about the suitability of the applicant for the organisation and the organisation for the applicant. The dearth of specific literature, especially of published empirical research, was also reported in work conducted in Scotland to identify good practice in recruitment, selection and retention of pre-registration nursing and midwifery students (Scottish Government Health Directorates and NHS Education for Scotland 2010). This was disappointing. However, NHS Lanarkshire already possessed a committed collaborative team of HR, NMAHP and other colleagues from professional and trade unions, augmented by external specialists, to take forward the required work on selection interviews. This work was therefore developed under the auspices of the local LBC programme, an initiative explained more fully by McGuire and Ray (2014).
Interview structure In the UK, the current NHS Knowledge and Skills Framework (KSF) applies to all NMAHP posts (Department of Health (DH) 2004), so it was appropriate to make use of this. External specialists commissioned locally to support our work advocated the adoption of competency or behavioural-based approaches that use past or observed behaviours as predictors of future performance in selection interviews (Main et al 2011). Both initiatives dovetailed with local work to help in developing a values and competency framework. This framework could then be used to
formulate interview questions, providing a consistent basis for personal interviews. Interview questions previously used prospective questioning, which meant that answers were derived from a hypothetical scenario. Competency-based approaches use retrospective and reflective reporting on situations experienced and chosen by candidates to exemplify their actions and intentions. This enables interviewers to gain an enhanced perspective on how the applicant expresses his or her internal values through action, reaction, responses, omissions and post hoc learning in situations that are self-selected to illustrate a particular competence. This is based on self-reporting rather than validated testimony. However, it provides structure to the process and generates responses on which the interviewer could make judgements and decisions in a way that engagement in hypothetical questioning cannot. In the current version of the NHS Lanarkshire Values and Competency Framework, content is based on the six core dimensions of the NHS KSF – communication; personal and people development; health, safety and security; service improvement; quality; and equality and diversity – as these applied to all posts (DH 2004). Two additional competencies – care and compassion, and technical/role specific skills – were added to address temperament and clinical skills in more detail. In addition, for posts at band 6 and above, where formal leadership is required, further work was undertaken. Again this was based on previous work begun locally to form questions that reflect a further eight dimensions from the document Delivering Quality through Leadership: NHS Scotland Leadership Development Strategy (The Scottish Government 2010b). Table 2 provides an overview of the NHS Lanarkshire Values and Competency Framework. Within the Values and Competency Framework, each of the 16 values and competencies has associated questions. These questions were designed to reflect each dimension at one of four levels, aligned to the Agenda for Change pay band of the post as follows: Level 1 questions = bands 2-4. Level 2 questions = band 5. Level 3 questions = bands 6 and 7. Level 4 questions = band 8. For any post, interviewers are expected to select a maximum of eight competency-based questions, agreed by the panel beforehand as most relevant to the post, ensuring consistency for all candidates. This number may be lower if a question covers more than one competency, and interviewers have guidance available on formulating other competency-based questions to reduce the risk of
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rigidity within this structured approach. Rigidity is further avoided by the use of probing questions, which addresses the need for dynamism, a point highlighted by Martin and Pope (2008). Guidance on which part of the Values and Competency Framework questions should be used is: Bands 2-4: up to eight level 1 questions from competencies 1-8. Band 5: up to eight level 2 questions from competencies 1-8. Band 6: up to seven level 3 questions from competencies 1-8; one competency from 9-16. Band 7: up to seven level 3 questions from competencies 1-8; two competencies from 9-16. Band 8: up to five level 3 questions from competencies 1-8; three competencies from 9-16. Evocative of the assessment centre approach advocated originally by Vernon and Parry (1949), but not true to it, we recognised that, for more senior posts (band 6 and above), supplemental techniques to an interview would be useful. This reflected some of the active skill sets required of those taking up these more senior leadership positions and included presentation, writing and problem-solving skills. Guidance on and exemplars of how to apply these additional techniques were created for use in the Values and Competency Framework and the selection interview. A simple scoring system (0 does not meet the required standard, 1 meets the required standard, 2 exceeds the required standard) was used for all assessment measures. Written guidance on recognising weak, acceptable and strong responses was produced.
Interview panels Membership of the NMAHP selection panel was agreed and standardised (Table 3). While work related to lay membership is currently in progress, it was agreed that senior
NMAHP professional leadership was crucial to ensure consistent support for line managers on the interview panels. The creation of senior NMAHPs as panel chairs, who are prepared and equipped appropriately to lead and manage the selection process would further strengthen the process. In addition, this would allow education and development to be focused on those who would most frequently use these skills.
Preparation of and support for panel chairs
A one-day training programme, in conjunction with external specialists, was designed. The use of external recruitment specialists provided assurance that the planned approaches fitted with professional and health policies as well as being contemporary and legally compliant. To date, just over 60 people have been formally prepared, each being supported with an internal, newly created Panel Chairs’ Guide. Arrangements are in place for this guide to be reviewed periodically and redistributed to the panel chairs. HR and practice development staff have also been identified as providers of ongoing support. From the delivery of the preparation programme, it was recognised that the new selection process, particularly for posts at band 6 and above, will take marginally longer than the previous system to conduct. It became crucial therefore to address more rigorous screening of applications to ensure that only the best applicants were invited for interview. Those preparing as panel chairs identified that two further supportive resources would be helpful: improved person specifications to accompany standardised job descriptions, which were not being changed, and other supplemental techniques such as presentations, written exercises and problem-based scenarios, which could be used in the selection interview. There was also recognition of the need to make relevant information available for potential candidates for NMAHP
TABLE 2 NHS Lanarkshire Values and Competency Framework General Competency 1: care and compassion. Competency 2: technical and/or role-specific skills. Competency 3: communication. Competency 4: person and people development. Competency 5: health, safety and security. Competency 6: service development. Competency 7: quality. Competency 8: equality and diversity.
Agenda for Change bands 6-8 Competency 9: setting direction – intellectual flexibility. Competency 10: setting direction – drive for results. Competency 11: personal qualities – self-belief. Competency 12: personal qualities – drive for improvement. Competency 13: personal qualities – personal integrity. Competency 14: delivering the service – leading change through people. Competency 15: delivering the service – effective and strategic influencing. Competency 16: technical/role-specific leadership skills.
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Art & science leading better care series: 2 posts. Five brief documents were prepared, and these can be viewed on the organisation’s website at www.nhslanarkshire.org.uk/Careers/ Pages/NMAHP.aspx
Progress to date The changes described remain at an early stage and have been developed in an iterative manner, influenced by the experience of those involved. The panel chairs’ enthusiasm to use the new approach in selection interviews was such that implementation began in summer 2013 ahead of the formal commencement planned for January 2014. This provided positive feedback and reassurance that the materials, preparation and processes are fit for purpose. In taking this work forward it was identified that improving the interview structure and the construction of interview panels was only part of the process. Other elements had to be considered. For example, HR staff had to become familiar with the new process, supporting paperwork had to be designed and different arrangements made for NMAHP selection interviews because they would take longer. Each had to be chaired by a designated panel chair and new documentation was required. Further, although being professionally led from an NMAHP perspective, service and general manager colleagues needed to be appraised of the changes; panel chairs had to plan their
time in advance to honour their commitments to the selection processes and to their work; and communication to and from NMAHP senior leaders, staff side partners and others needed to be maintained because the work was being developed incrementally. As this work was being conducted under the auspices of LBC, the local LBC programme board (McGuire and Ray 2014) had also to be updated so that the work would be underpinned by local evaluation. The approach taken has been an iterative process, reflective of quality improvement or action research methodology. Elements were: agreed and designed, drawing on evidence where this existed; tested in practice; evaluated and reviewed; and alterations were repeated as required. One example of a formal evaluation performed was an electronic survey, which was conducted after the panel chair preparation was completed. This was done to identify the extent to which the preparation was effective and the new approach resonated with participants’ expectations of selection by interview. Further formal evaluation was then conducted after three months when some participants had put their preparation into practice. These initial evaluations indicated highly positive responses for the approach being taken and the effectiveness of the preparation programme. Improvements in the quality of feedback available for successful and unsuccessful candidates, alongside has improved reflection
TABLE 3 Selection panel membership for nurses, midwives and allied health professionals Pay band
Core members
Lay member (in progress)
Band 8
Nurse/AHP director*. Associate nurse director/AHP. Professional lead/deputy director PDC. General or service manager.
Local public partnership forum member or designate.
Band 7
Associate nurse director/AHP. Professional lead/deputy director PDC*. Senior nurse/AHP team leader/NMAHP consultant. Service manager.
Volunteer/member from the local advocacy services/local public partnership forum member or designate.
Band 6
Senior nurse/AHP team leader/NMAHP consultant*. Senior charge nurse/senior AHP practitioner.
Volunteer/member from the local advocacy services.
Band 5
Senior nurse/AHP team leader/NMAHP consultant*. Senior charge nurse/deputy charge nurse/senior AHP practitioner.
Bands 2-4
Senior nurse/AHP team leader/NMAHP consultant. Senior charge nurse/deputy charge nurse/senior AHP practitioner. Registered practitioner.
All panels included the line manager for the post. *Designated panel chair. AHP = allied health professional, NMAHP = nursing, midwifery and allied health professional, PDC = NMAHP practice development centre
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by each panel on its own performance, were also identified. Future formal evaluation will ensue with the same broad intentions: to see if the practice is becoming embedded, and to highlight successes or identify any gaps. Recent focus groups indicate ongoing successful implementation and the need for a few other areas, such as the further development of the bank of questions, to be addressed. A full report is in preparation. While current evaluation is helpful in strengthening approaches, it has not yet addressed outcomes: was the best person selected for the job? This is an area where there is little evidence to draw
on other than that related to selection for training programmes, where follow up has been conducted reaffirming the success of a competency-based approach (for example, Crawford 2005, Daiches and Amor 2006). At present some consideration is being given to case study work to follow through a sample of those selected, preferably on a longitudinal basis. While challenging to conduct, it is felt that, without creating this first step forward, the empirical evidence to support progress or to assure the public or others that this new approach ensures better selection will remain elusive. Although experiential evidence to date indicates that the new approach has improved
References Attree M (2001) Patients and relatives experience and perspectives of ‘Good’ and ‘Not so Good’ quality care. Journal of Advanced Nursing. 33, 4, 456-466.
Daiches A, Amor C (2006) The journey towards competency-based selection at the Lancaster doctorate in clinical psychology. Clinical Psychology Forum. 167, 24-27.
Bassett ML, Ramsay WP, Chan CA (2012) Improving medical personnel selection and appointment processes. International Journal of Health Care Quality Assurance. 25, 5, 442-452.
Department of Health (2004) The NHS Knowledge and Skills Framework (NHS KSF) and the Development Review Process. tinyurl.com/nkkef68 (Last accessed: October 3 2014.)
Crawford ME (2005) Reassuring evidence on competency based selection: commentary. British Medical Journal. 330, 7493, 714.
Francis R (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Enquiry. The Stationery Office, London.
Garcea N, Isherwood S, Linley A (2011) Do strengths measure up? Strategic HR Review. 10, 2, 5-11. Health and Care Professions Council (2012) Standards of Care, Performance and Ethics. tinyurl. com/n5rwkkb (Last accessed: October 3 2014.) Highhouse S (2008) Stubborn reliance on intuition and subjectivity in employee selection. Industrial and Organizational Psychology. 1, 333-342.
Main P, Curtis A, Irish B (2011) How was it for you? Competency-based selection of general practice educators. Education for Primary Care. 22, 6, 450-452. Martin PD, Pope J (2008) Competency-based interviewing: has it gone too far? Industrial and Commercial Training. 40, 2, 81-86. McGuire C, Ray D (2014) Developing leadership roles in nursing and midwifery. Nursing Standard. 29, 9, 43-49.
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Art & science leading better care series: 2 processes, a full examination of the outcomes is necessary. At present, this is accepted as a limitation of, rather than a barrier to, this new approach. Another limitation is that some of these approaches may be commonplace elsewhere while being new locally. Given the enthusiasm with which they have been welcomed locally, it seems fitting to share them more widely.
Conclusion In our Leading Better Care programme, we have taken steps to improve our NMAHP selection
Mitchell M, Strube P, Vaux A, West N, Auditore A (2013) Right person, right skills, right job: the contribution of objective structured clinical examinations in advancing staff nurse experts. Journal of Nursing Administration. 43, 10, 543-548. NHS Lanarkshire (2010) Caring and Compassionate Practice. tinyurl. com/qcnxcyx (Last accessed: October 3 2014.) NHS Lanarkshire (2013) Values in action framework (Unpublished document). NHS Lanarkshire, Glasgow.
Nursing and Midwifery Council (2008) The Code: Standards of Conduct, Performance and Ethics for Nursing and Midwifery. NMC, London. Nursing Standard (2013) Values-based recruitment and robust training cuts trust’s HCA turnover. Nursing Standard. 27, 46, 6. Roberts G (1997) Recruitment and Selection: A Competency Approach. Chartered Institute of Personnel and Development, London. Scottish Government Health Directorates and NHS Education for Scotland (2010) Good Practice
processes, we are identifying areas for ongoing development and are actively considering further robust evaluation. This work has been undertaken to ensure the best person is selected for every NMAHP post NS Acknowledgement Nursing Standard would like to thank Dr Kathleen Duffy, NHS Education for Scotland nursing and midwifery practice educator, Practice Development Centre, NHS Lanarkshire, for developing and co-ordinating the Leading Better Care series of articles.
in Recruitment, Selection and Retention of Pre-Registration Nursing and Midwifery Students. tinyurl.com/qcltte7 (Last accessed: October 3 2014.)
The Scottish Government (2010a) The Healthcare Quality Strategy for NHSScotland. tinyurl. com/ctqr54o (Last accessed: October 3 2014.)
The Scottish Government (2008) Leading Better Care. Report of the Senior Charge Nurse Review and Clinical Quality Indicators Project. tinyurl.com/yl94e38 (Last accessed: October 3 2014.)
The Scottish Government (2010b) Delivering Quality Through Leadership: NHSScotland Leadership Development Strategy. tinyurl.com/ mqy3nbk (Last accessed: October 3 2014.)
The Scottish Government (2009) Code of Conduct for Healthcare Support Workers. tinyurl. com/nnh7gmx (Last accessed: October 3 2014.)
Vernon PE, Parry JB (1949) Personnel Selection in the British Forces. University of London, London.
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