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Career progression opportunities and the retention of health visitors

02 November 2024
Professional
02 November 2024
Volume 1 · Issue 3

Abstract

There is a shortage of health visitors in England and career progression is known to increase staff retention in nursing. Therefore, a systematic search strategy was conducted and four main themes emerged following a reflexive thematic analysis. It found career progression opportunities improve staff retention, while barriers to career progression, including a lack of structured career pathways and progression opportunities, staff shortages, unavailable funding for staff training and gender inequalities, have a negative impact on staff retention. It is concluded that providing structured career pathways could improve the retention of health visitors. Further research examining the influencing factors on health visitor retention is recommended. Structured career pathways should be offered, allocating time during working hours for health visitors to attend courses and work on projects, and ensure that equality, diversity and inclusion policies include specific strategies for female career progression.

The health visiting workforce in England has reduced by approximately 40% since 2015 (Mayes and Cochran, 2022; NHS Digital, 2022) with a shortfall of around 5000 health visitors (Conti and Dow, 2021). Many London NHS Trusts also report struggling to recruit into the specialist community public health nursing (SCPHN) programme (Institute of Health Visiting [iHV], 2023). Both these factors have a detrimental impact on client safety and experience.

The NHS Long Term Workforce Plan promotes staff retention initiatives to support adequate staffing across all areas of healthcare (NHS England, 2023a). As research identifies the strong influence that career progression opportunities have on staff retention, this literature review aimed to investigate the relationship between career progression and the retention of health visitors.

Adequate staffing is crucial for the NHS to deliver a healthcare service that meets the growing needs of the population (NHS England, 2023a). The Health Foundation (2018) reported that between 2017 and 2018 there was minimal growth in workforce numbers in nursing and health visiting at just 0.5% and that there have been no improvements in staff retention since their 2011/2012 report (The Health Foundation et al, 2018). Staff shortages are found to be the strongest driver behind leaving the NHS (Weyman et al, 2019) and for health visitors, staff shortages result in higher caseloads, factors known to negatively affect staff wellbeing (Hochschild, 2003).

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Health visiting
Career progression
Retention
Career pathways
Staff wellbeing