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TRANSFORMING THE NHS
AT THE ROYAL UNITED HOSPITALS BATH
NHS FOUNDATION TRUST (RUH)
A holistic, digital talent strategy to create a great place to work and an employer of choice, delivering efficiencies, better employee experiences and over £20 million in cost savings
Contents
1. Background
2. The Brief
3. Discovery Findings
4. Vision & Opportunity
5. Approach & Methodology
6. Programme Workstreams & Goals
7. High-Impact HR Principles
8. The Journey
9. New Ways of Working
10. Results
11. Takeaway Tips
12. Thank you
13. Testimonial
"Sonia has been a phenomenal support in transforming the way we acquire talent. She has created a passion for excellence and customer focus that has truly set us apart"
Alfredo Thompson
Chief People Officer - Royal United Bath Hospital NHS Foundation Trust
1. About the RUH
The RUH aspire to being one of the leading Trusts in the UK
Launched in 1948 the NHS is the National Health Service of the UK. Employing over 1.5 million people, the NHS sits within the top five largest workforces in the world.
Royal United Hospitals Bath NHS Foundation Trust (RUH) provides acute treatment and care for around 500,000 people in Bath, and the surrounding areas. Services provided include medicine and surgery, services for women and children, accident and emergency and diagnostic and clinical support services.
The RUH aspire to being one of the leading Trusts in the UK and are proud to put people at the heart of everything they do, striving to create an environment where everyone matters.
2. The Brief
"Break it apart and put it back together again"
The RUH People leadership team approached me with a problem - they had significant challenges with their recruitment. However, they weren’t sure of the root cause, and they didn’t know where to start.
I shaped a detailed discovery phase to work with their teams mapping out end-to-end processes to identify risk, waste, pain points, the impact on candidate and manager experience and Trust outcomes. I’d gather all available data and have conversations with Recruitment teams, HR, IT, stakeholders, cross functional teams, hiring managers and new employees.
From here I’d analyse findings, provide an overview of the current landscape, the root cause of the problem, practical quick fixes along with key priorities and a longer-term plan. In line with their aspiration to be a leading Trust I asked if they’d be open to a blank piece of paper approach - to harness opportunity and for me to shape a vision for the future. The People Leadership team agreed confirming “break it apart and put it back together again in a way this is simple and customer focused. And help us build capability in our teams”.
The discovery phase then kicked off followed by a further project to take forward the new vision.
3. Discovery Findings
A leading NHS Trust must be enabled by an exceptional HR function with inclusive, effective recruitment and onboarding practices
My discovery and analysis revealed a disconnected structure with recruitment managed across different teams. The teams were, in the main, providing a recruitment administration service with much of the recruitment process sitting with hiring managers, many in clinical roles.
Processes were complex and completely manual, managed through spreadsheets alongside the NHS job website. Duplication, waste, legacy ways of working and silos were creating huge delays and re-work within the system.
There was an absence of an inclusive recruitment strategy and practices, despite this being a key objective for the Trust. The experience for candidates and hiring managers was impacted through often lengthy processes, confusion and frustration. As a result, 24% of new hires were leaving within their first year costing an estimated £2.8 million annually.
To realise their aspiration of becoming a leading NHS Trust, the RUH needed an exceptional HR function with inclusive and effective recruitment and onboarding practices. An integrated approach to collaboration and digitalisation was required.The opportunity to transform was significant, to deliver efficiencies, great experiences for candidates and hiring managers, and the best outcomes for RUH people, the Trust, and Patients.
4. The Vision & Opportunity
A holistic, digital talent strategy to create a great place to work and an employer of choice
I believe the greater the challenge, the greater the opportunity. In line with the RUH's aspiration to be a leading employer, I shaped a new vision for a seamless, digital, engaging and inclusive employee experience. Helping people to be at their best and enabling managers to focus on their core roles, delivering exceptional outcomes for their people, the Trust, and Patients.
5. Transformation Approach & Methodology
Simplify - Digitalise - Innovate - Collaborate
At the core of the transformation approach were my High-Impact HR principles to create a fast-moving programme driven by excellence and customer value.
Changing perceptions, driving innovation, and collaboration whilst leveraging technology. Creating streamlined, effective, inclusive and consistent solutions with the employee experience at the core.
6. The Programme Workstreams & Goals
Six workstreams each with their own goals, designed to work collaboratively and together enable the overall vision
The Digital Talent Programme was launched, co-sponsored by the Chief People Officer and Chief Digital Officer, with a cross functional team and six work-streams, each with their own individual goals, designed to work collaboratively, and together enable the overall vision:
Talent Acquisition & Onboarding
The goal: a fast, effective, inclusive talent acquisition and on-boarding experience creating high engagement, promoting us as an employer of choice.
Technology & Data
The goal: an automated, efficient, reliable and data driven recruitment and onboarding experience creating efficiencies, and enabling resources to be re-invested into value adding activities.
EVP & Attraction
The goal: an authentic and compelling EVP and attraction strategy to drive talent attraction, engagement and retention, positioning the RUH as an employer of choice.
Diversity, Equity & Inclusion
The goal: inclusive and equitable recruitment, on-boarding and progression practices with transparent and real time data, building and sustaining diversity in the workforce.
Talent Management & Retention
The goal: inclusive and equitable development and progression practices with transparent and real time data, creating an environment where everyone matters.
Comms & Engagement
The goal: authentic, compelling communications to involve, engage and inform RUH people and bring them on the journey.
7. Enabling the Journey - My High-Impact HR Principles
New ways of thinking and working to drive real impact
I introduced the teams to my High-Impact HR principles with easily understandable and actionable concepts:
The 12 Transformation Principles
1. Business Value First
Make the shift from a focus on completed activities, to measuring success by the value and return on investment delivered for the organisation.
2. Simplification – a Skillset and Mindset
Successful transformation is as much about what you remove, as what you create.
3. Keep Your People at the Centre
Keep your people at the centre of every programme, project, process and perspective.
4. A Networked Organisation
Play on the same team and build cross-functional collaboration, optimising diversity of technical expertise, background, experience and thought.
5. Data and Insight Driven
Use data, insights and the voice of your people to shape your path to sustainable success.
6. Tech Enabled Transformation
Utilise technology as the enabler to create people centred, data driven, tech enabled solutions.
7. Deliver Early, Often and Incrementally
Releasing improvements in stages and using data and feedback to continually review progress, delivers results quickly and frequently.
8. High Impact Leadership
Aligning people, purpose and performance for successful transformation and lasting impact.
9. Building Transformation Capability
Consciously creating the conditions for successful, sustainable change, building capability from the ground up.
10. Inspiring Change vs Enforcing Change
Harnessing the power of inspiring, inclusive change.
11. Measuring Business Impact
What differentiates successful transformation is value - and measurement is key.
12. The Mindset for Success
The essential ingredient for transformation success.
This jargon free approach enabled the teams to quickly start thinking differently and operating in new ways to create sustainable impact as we worked together in real time.
8. The Journey
Think big, start small - test, learn, iterate
A fast-moving programme of work designed to build capability and deliver value as soon as possible. Co-creating successful, buildable, sustainable solutions that will grow with the RUH as their organisation, and the world around them evolves.
Discovery
•Process mapping
•Baseline data and feedback sources in place
•Risks, issues and root cause identified
•Future vision shaped
Transformation Begins
•HR and IT Partnership launched
•Cross functional project team assembled
•Strategy, plan and operating rhythm shaped
•Co-creation approach launched
Data Driven
•Quarterly customer surveys providing actionable insights
•KPI’s built with transparent processes and sharing of data
•Dashboards and heatmaps developed
•From reactive to proactive, and eventually predictive
Simplification
•Building a simplification mindset
•Removing non-value-add activity
•Removing duplication end-to-end
•Streamlining legacy complexity
Digitalisation
•Digital first mindset developed
•HR and IT co-creating the future
•Moving from manual to digital solutions
•Automation to maximise resources
Onboarding
•Onboarding strategy and messaging shaped
•“Join the RUH" onboarding experience launched
•Tools for hiring managers and buddies
•New employee guidebook and checklist
Diversity, Equity & Inclusion
•Inclusive Recruitment e-learning design & build
•De-biasing the recruitment process underway
•Candidate attrition reporting with a DEI lens
•Reasonable adjustments process re-design
EVP
•HR and Comms partnership created
•EVP External Partner appointed
•Discovery, narrative & pillars shaped
•Creative and messaging build & test
9. New Ways of Working
Key Foundations Built
Strong foundations have been built to ultimately deliver more value with less work, re-investing critical resources back into value-adding activities.
Collaboration
The foundations for a culture of collaboration have been built with a partnership between HR and IT, true cross functional working and the teams co-creating the new solutions.
Visibility
A digital recruitment process is now in place from vacancy approval through to onboarding providing clarity on the process, data, and visibility of the recruitment position for the first time.
Data & Insights
Collaboration and sharing of data sources between HR, IT and external partners has provided the ability to be data driven. Dashboards and heatmaps will enable decision making and better Trust outcomes.
Simplification
Real progress has been made in removing legacy complexity to create simpler, more effective and sustainable solutions. Teams are adopting a simplification mindset, driving continuous improvement.
Employee Experience
A shift is underway from managing transactional processes to focusing on the experience for candidates and managers, building on the aspiration of creating the RUH as an employer of choice.
External Insights
Strong relationships have been established with other NHS Trusts and corporate organisations to share best practice, using learning and insights to help shape the new solutions.
10. The Results
The landscape and mindset across the teams is now unrecognisable. The new ways of working have now been embedded and delivered much more streamlined, digital, data driven and inclusive employee experiences. Significant efficiencies have been realised, and much better employee experiences are in place. A culture of collaboration, continuous improvement and being data driven is paving the way forward and this has translated into impressive Trust outcomes and financial savings. The reduction in new hire attrition saved over £3 million in the first two years, and this work also contributed to a £17 million pay bill reduction.
The transformation won Bronze in the Innovation category at the IHR Awards in 2025, and has been shortlisted for numerous other industry awards. It was also featured on the Josh Bersin What Works podcast.
Discovery Phase – 2022
1. New hire attrition 24% - annual cost £2.85M
2. Customer dissatisfaction, root cause unclear
3. Manual process & spreadsheets
4. Minimal data & targets
5. Workload driven
6. Voice of the customer gap
7. No onboarding solution
8. Separate recruitment teams & silos
9. DE&I gap - no education or support
10. Legacy complexity - e.g. 16 offer letters
11. Functional silos & process black holes
12. Candidates & managers are numbers
13. No EVP to differentiate the organisation
14. Unable to quantify value
Transformed – 2024
1. New hire attrition 2.5% - 2023 + 2024 saving £3M+
2. Clarity, transparency, clear goals & progress
3. Digital end-to-end recruitment process
4. Detailed reporting, KPI’s, surveys & insights
5. Data driven
6. Voice of the customer led
7. “Joining the RUH” onboarding experience - strategy, tools & support
8. One Recruitment team
9. Inclusive Recruitment e-Learning
10. Simplified – e.g. 2 offer letters
11. Cross functional collaboration & co-creation
12. Candidates & managers are customers
13. Authentic, compelling EVP ready for launch
14. Can demonstrate clear ROI
11. My Takeaway Tips
Powerful principles to enable success
Fix the Root Cause
Identify the root cause of problems and shape effective, sustainable solutions.
Simplify Everything
Remove everything holding you back - legacy policy, process, documentation, thinking.
Get Comfortable Being Uncomfortable
If it was easy, everyone would do it. Don’t be afraid to challenge anything that’s not working.
Cross Functional Collaboration is Key
Play on the same team to maximise your resources and co-create the best solutions.
Move From Process to Employee Experience
Make the shift from focusing on your processes, to designing around the employee experience.
Be Data Driven
Use data, insights and the voice of your people to drive your path to sustainable organisational success.
12. Thank You
With thanks to the amazing leaders, teams and people at the Royal United Hospitals Bath NHS Foundation Trust, whose commitment, collaboration and determination enabled this transformation.
You can read the full story of this transformation journey in my book High-Impact HR.
13. Testimonial
"Sonia has been a phenomenal support in transforming the way we acquire talent. She has created a passion for excellence and customer focus that has truly set us apart"
Alfredo Thompson
Chief People Officer at the Royal United Bath Hospital NHS Foundation Trust
