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Fixing the workforce

David Eccleston, Head of Modernising Scientific Careers at Liverpool Clinical Laboratories, and colleagues outline their programme to secure a more stable workforce. 

Liverpool is located in the North West of England and is the fourth most deprived local authority area in England. The City of Liverpool and Merseyside Region has felt the impact over the last two decades of a loss of traditional apprenticeship and workforce supply routes with a consequential decline in vocational qualifications, which would have been made available to those in the 16-24 age range.

The challenge

The Liverpool City Region has seen increasing unemployment with a subsequent increase in school leavers claiming job seeker’s allowance within this age range. As well as the regional economic impact this has, there is also a marked increase in anxiety, depression and other mental health issues associated with loss of self-esteem and social unacceptability. Increases in unemployment, particularly among the young, are likely to create or exacerbate cycles of intergenerational unemployment and inequality; education and employment are key mitigating factors in reducing inequality.

Liverpool Clinical Laboratories (LCL) is a multidisciplinary NHS pathology service, jointly owned by the Royal Liverpool and Broadgreen University Hospitals and University Hospitals Aintree .

Alongside the social challenges of the region, there has been a tendency within LCL to appoint biomedical science graduates in to support worker roles. These staff are keen and enthusiastic, but are generally looking for a pathway into becoming registered as biomedical scientists, which means that they are a transient workforce, representing a poor return on the investment of recruitment and training.

What are the solutions?

Create a sustainable workforce for the future by creating traineeships within LCL  

  • Target Liverpool residents, including young people; those from black and racial minority communities; inner city schools; and others who are disadvantaged in the labour market  
  • Improve retention in the support roles by employing local young people, who can grow through the traineeship then apprenticeship routes, and because of their community ties are more likely to stay with the laboratories.

“Departments are now seeing the benefit of appointing the traineeship students and the number of post-grads being employed into support roles has reduced”


Implementation of the project to date has specifically targeted young people from Black, Asian and Chinese communities and young people who would not otherwise have considered traditional routes to further education for a range of reasons and personal issues. Further consideration for participation in the programme included students from low socio-economic groups, attending schools of low progression and those living in low-participation neighbourhoods who would be the first generation to consider higher education.

Liverpool in Work is Liverpool City Council’s employment services department and puts out expressions of interest on LCL’s behalf to job centres and other agencies. It also undertakes an employer engagement role, as well as supporting local residents and communities.

Customers are unemployed Liverpool residents and the service is funded through the Liverpool Ways to Work programme, which is part-funded by the European Social Fund and the Youth Employment Initiative.

Following expressions of interest, the potential candidates attend an open day explaining the course and the nature of LCL, their expectations and the benefits/opportunities available to them. Those who wish to be considered then submit an application, CV and two references. Relatively informal interviews are held, appropriate to the experience and age of a lot of the applicants, exploring their qualifications, current situation and reasons for considering the course. Provided they meet the criteria and are successful at interview, they are signed up by the college (to complete the course application), Liverpool in Work (to receive a travel pass and uniform) and the hospital HR team (honorary contracts) on the day of interview. Those who are suitable but who have not attained the standard required for maths and English receive extra tuition in these subjects.

Upon completion, the candidates get a Certificate of Achievement for completing the course from LCL, and Level 1 and 2 qualifications in employability skills and potential, Introduction to First Aid in the Workplace and a Level 2 IOSH award from Wirral Metropolitan College.


Liverpool in Work offers support through the Ways to Work programme, which targets unemployed residents in the city and city region, and has particular focus on those furthest from the labour market; young people aged 16-29; and long-term unemployed residents. The Ways to Work programme offers one-to-one support for customers, including access to a personalised budget for removal of barriers to work, or to help sustain employment. Typical examples of this support include funding for travel, childcare, training, equipment, DBS checks, etc. For unemployed people aged 16-29 there is a £500 personalised budget to remove such barriers to work.

Although training time is invested in the trainees by departments, the financial burden has not been calculated. The scheme is seen as a potential investment for future staffing and allows the organisation to get a feel for the student and their potential suitability for the role, which cannot be quantified financially.


  • To ensure full support of students with learning difficulties, LCL mentors and training officers undertook a development session delivered by the college’s Adult Learning Support Team. The development prepares them around highlighting and giving guidance to support students with learning difficulties and/or disabilities and what aids can be put in place.  
  • The programme has been shared with other health organisations, to not only involve communities in healthcare, but also in health education. This also includes a project being considered in Queensland, Australia.
  • It has won three awards: NHS Healthcare Science Awards 2017. Chief Scientific Officer’s Equality and Diversity Leadership Award; Health Education England NHS. Learning Matters Health and Care Awards 2017. North West Winner in the category Widening Participation in Health and Care; Health Education England NHS National Widening Participation Awards Work Exposure. 2019, Liverpool City Council, Partner Organisations that have made a significant contribution to the outcomes of employment and skills.  
  • Another local hospital has approached LCL to start the traineeship programme, and have said they will give those who have previously attended the programme priority as they shortlist for their own assistant practitioner posts. This will greatly increase the numbers gaining full-time employment in the clinical laboratories sector.  
  • Departments are now seeing the benefit of appointing the traineeship students and the number of post-grads being employed into support roles has reduced.  

Lessons learned  

  • Students were unaware of when substantive posts were advertised – alerts are now sent to their mobile devices direct from NHS Jobs as soon as jobs are advertised.  
  • All substantive staff need to be able to communicate with the students at the appropriate level.  
  • A small number of students have had serious issues with respect to time-keeping, attendance and commitment. LCL has worked with the college to implement a strategy to ensure these issues are now promptly addressed.  
  • There has been some turnover (around 15%) in the programme, due to extremely complex and distressing personal issues among candidates. Where possible, extra support has been provided but given the background of the candidates, sometimes they are unable to complete the course.  
  • The greatest challenge has been the integration of these students. A recent merger means that the influx of more students had been received with some scepticism and a little resentment by those staff who believed their own developmental needs were suffering during this time of major transition.  
  • The programme is about investing in community to achieve sustainability. Aligning the programme to the drivers for change issued by the government and the Department of Health have allowed staff to come fully on board.  
  • Programme participants have provided feedback, which evidences the contribution and input into their learning by all LCL staff but also by departments who initially had not wished to take on a trainee via the traineeship; the departments are coming forward requesting a student from the next cohort which demonstrates a significant shift in culture and commitment. Students from this programme are now entering our Apprenticeship programmes.

Key strategies

Organisational The programme has been aligned to the drivers for change published by the government and Department of Health, meaning that leaders and other staff have been able to quickly engage with the aims.

A key communication and leadership theme has been highlighting the advantages of developing local communities to become future staff and ensuring inclusivity of all staff in the development and delivery of the traineeship students.

Should any healthcare scientist assistant posts become vacant while they are undertaking the traineeship, participants will be guaranteed an interview should they wish to apply for the post.

Students are automatically placed into the casual staff pool once they have completed their course.

By completing an information session, recruitment process and administrative onboarding in one day, LCL maximises time efficiency sourcing and hiring.

Successful candidates receive an honorary contract from human resources prior to the commencement of the programme, which stipulates that they are under the same conditions of service and support as a permanent member of staff, and the expectations are required.


The programme was developed with the help and assistance of the Royal Liverpool University Hospital NHS Trust Operational Department and Education Department, Liverpool in Work, Job Centres, Schools, Colleges and community groups with which close working relationships have been developed. Liverpool in Work provides the employer engagement functions.

Wirral Metropolitan College provides the classroom-based training aspect of the traineeship.

Recruitment of candidates happens via a wide range of established networks, including Job Centre Plus, Career Connect, Childrens Centre, black and minority ethnic community organisations, Housing Associations, youth organisations, and self-referrals.

Programme design

It is a 13-week course, delivered in partnership with Wirral Metropolitan College, combining classroom-based learning and on-the-job training.

Five weeks of taught sessions are delivered by Wirral Metropolitan College and eight weeks of work experience are delivered within the pathology departments of LCL.

Students work across departments, providing a greater breadth of experience and a clearer understanding of the healthcare system, patient and care pathways. Students are given the skills and experience that could help them to apply for a job as a healthcare science assistant, including clinical and employability skills.

Development of a traineeship training and competency log allows for consistency and standardisation across the placement departments and a clear requirement of what is expected from both the student and training officer(s), which helps to manage the expectations of scope of practice for the trainees.

The project has been developed to ensure it is fully inclusive of the local community and one cohort is specifically dedicated to young people in the local community with learning difficulties.

To support continued delivery, a champions groups was formed within LCL that enables information concerning the programme, and the opportunities it provides, to be disseminated widely across the region reaching further into the community.

David Eccleston is Head of Modernising Scientific Careers at LCL, Jane Harrison-Williams is Interim Head of Quality Management at LCL, Emma Donaldson is Recruitment Advisor for Employment and Skills for Children and Young People’s Services at Liverpool City Council, Annette Pollitt is Learning and Development Lead at Royal Liverpool and Broadgreen University Hospital Trust, Michelle Woodward is an Employability Lecturer at Wirral Metropolitan College, Emma Robinson is a Workforce Consultant for Health and Aged Care Workforce Services in Queensland, Australia, Jenny Lloyd is Haematology Manager at LCL.

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Image credit | iStock

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