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Breaking the cycle

Gareth Richardson, a Laboratory Medicine Training Officer, outlines an innovative approach to recruitment of support staff.

The Division of Laboratory Medicine (DLM) at Manchester University NHS Foundation Trust (MFT), like many pathology services across the country, has always struggled with a high staff turnover in support roles, particularly medical laboratory assistants (MLAs). This is mainly due to these MLA positions being filled with graduates who are looking for a start in their careers in pathology, rather than wanting to stay in the role. Although this is beneficial for creating a pipeline of future potential biomedical scientists, it does make for a constant cycle of advertising, shortlisting, recruiting, and training for these roles. This cycle is not only costly in staff time, but also puts pressure on the training capacity of the service. With this in mind we decided to see what we could do differently in our recruitment strategy to break the cycle.

Aim of the programme

The Pre-Employment Programme is an initiative that has been run at MFT for a number of years by the trust’s Widening Participation Team, and the labs at MFT have always supported this initiative. However, during the COVID-19 pandemic we decided to see if we could expand on this existing programme to resolve some of our own recruitment issues.

The Pre-Employment Programme is a collaborative effort between the trust and the local division of the Department of Work and Pensions (DWP). It is aimed at individuals who are unemployed and on Universal Credit, to give them a short placement to try to get back into employment. The programme advertises the opportunities in local Job Centres and candidates must complete an expression of interest. Those who are successful then complete a two to four-week college course in which they are taught employability skills, and also undertake their ID checks and the relevant trust mandatory training. At the end of the college course they are then put on a five-week, 30-hour-per-week placement in a department within the trust. During the college element of the programme and the five-week placement, the candidates are not paid by the trust and are still eligible to claim Universal Credit. Historically, the labs at MFT had only taken a couple of placements per year, but in response to the COVID pandemic and the need for more support staff we decided to change our approach and see if we could do something that would support our local community, which had been hit with unemployment.

Case study: Amir Jenab

MLA Central Specimen Reception

The programme helped get me into employment in the NHS by introducing me to the lab environment and gave me the opportunity to gain experience. It gave me the chance to have enough appeal so when I submitted my application, it would be considered.

I had never considered a job in a laboratory or the NHS until the programme advertised the opportunities. My past job experience and education background is in other fields outside of healthcare, but because of my situation it was extremely hard for me to find work in this field.

Now that I am working in the labs, I like it a lot; it is a friendly and nice place to work, and I feel like I am helping others in this role.

The five-week placement gave me the opportunity to find out what kind of environment I was going to be in, having never been inside a laboratory. It helped me to understand the values of the trust and what I could expect from this job and what is expected of me.

I was successful in obtaining a medical laboratory assistant position right at the end of the placement and now, after a year, I have been chosen for the team leader position in Central Specimen Reception.


Case study: Bethany Branthwaite

MLA Mycology

The pre-employment programme gave me the confidence to join a career that previously I would not have considered. My background is in retail, and I haven’t participated in much education, besides GCSEs. So, with no degree I thought that becoming part of a laboratory team would not be possible for me.  

I always thought about a career in the NHS, but was unsure where I would fit in to the organisation. I thought it would be impossible without formal training.

During the five-week placement I was able to experience a lab environment and I realised quickly that this was the career for me going forward. I got a chance to see many sides of how a lab works and the different people in it. It gave me time to build a rapport and trust with the colleagues that were in the lab.

I was approached early on in my placement to apply for the MLA position that was just about to go live. I then had an interview a few months later and obtained the job. Now I am working full-time in the lab and have just started, and hope to complete my Level 4 apprenticeship in healthcare science. I then want to go on to complete a degree in biomedical science and become a biomedical scientist in the mycology department.

What we did

In late 2020, working closely with the trust’s Widening Participation Team, we held our first virtual open-day event and advertised placement opportunities for MLA posts. We had an amazing response to the opportunities, with a lot of people saying that they wanted to help the NHS during the troubling times. Due to classroom restrictions and not wanting to over-saturate our training teams, three cohorts were recruited, with 14 individuals in total passing the entry requirements and progressing to placement. As we moved into 2021, we started planning further intakes throughout the year. At the same time, the Government announced the Kickstart initiative to support under-25s at risk of long-term unemployment. The trust was successful in obtaining funding for Kickstart posts and we decided to use the existing Pre-Employment Programme as a way of recruiting to these. Between February 2021 and January 2022, we provided MLA placements for 51 individuals. In addition to this, we supported 12 business and administration placements to support our secretarial and administration teams. 

“We decided to change our approach and see if we could do something that would support our local community”

Challenges and obstacles

There were a few challenges and obstacles as we started to increase placement numbers. Enthusiasm for the programme and placement opportunities increased once departments realised the benefits that recruiting support staff in this manner had following the successful first cohort. Another major challenge was the training capacity in the labs. To alleviate this, we incorporated some basic knowledge, such as specimen acceptance, into the college element of the programme. This meant those coming through the programme had a basic understanding of lab processes before coming on to placement. COVID also created a few challenges, with the college having a limit on classroom size. We overcame this by splitting cohorts into smaller groups and delivering the college element in a blended learning format. The splitting of the groups into smaller cohorts naturally created a staggered flow on to placement, which also helped remove some of the pressure on the training in the laboratories. We quickly realised many people in our communities did not have access to computers. Therefore, we had to work closely with the college and DWP to ensure everyone was well supported and had access to computers and the internet to complete the college element.

Outcomes of scheme so far

By using the Pre-Employment Programme as one of our primary recruitment strategies for support staff in the labs we have seen increased staff retention. This approach has allowed for an equal, diverse and inclusive recruitment strategy, which supports the NHS People Plan to increase local recruitment and support the local population getting into work. In the period from November 2020 to January 2022, we have supported 55 individuals on placement in MLA roles, with more than 30 of these being offered full-time positions, Kickstart-funded posts or onboarded on to the NHS professionals bank. By onboarding those who we did not have full-time posts for on to the bank system, we have created a pool of bank staff that all departments can pull from to cover any COVID-related absences or other sicknesses. For those who we could not offer any roles to, most of them have found full-time employment outside the NHS after their initial placement, with many of them citing the experience and skills they learned on placement as the key factor in them finding full-time employment. We have observed a very low dropout rate during this pilot period, with only five individuals withdrawing, due to personal circumstances. For those that have come into full-time posts, we have started supporting their further career development, with some beginning the IBMS Certificate of Achievement and a few also successfully enrolling in the Level 4 Healthcare Science Associate Apprenticeship. All departments in the DLM have now really embraced the programme and provide fantastic training and support to these individuals.


Following this successful pilot, we have now embedded the Pre-Employment Programme into the DLM as a primary recruitment strategy for support staff.

We are now looking at expanding the programme across the rest of Greater Manchester and working with other organisations’ widening participation teams to increase the opportunities we can create across different areas of Greater Manchester. We have also started working with a local charity, Pure Innovations, which supports people with disabilities and disadvantaged groups to get into work. We are using the pre-employment framework as the route to allow these individuals the opportunity to work in the NHS.


My advice to anyone who is looking at setting up something similar at their trust or network is to engage with your trust widening participation or employability teams. Their input and connections to the wider systems are essential to create a good and robust programme.  

Gareth Richardson is the Greater Manchester Pathology Network Workforce Development Lead and Training Officer for the Division of Laboratory Medicine at Manchester University NHS Foundation Trust

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Image credit | iStock

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