Following on the heels of the Francis Report in 2013 – which called for measures to improve compassionate and committed care and encourage a culture of openness and transparency in the  NHS – recruiting for values is increasingly seen as a priority by many healthcare providers today. Employers aren’t just hiring people for their skills and competence, but also looking at how their values align with those of the organisation.  

Eight years on, this report has never been timelier for mental health care. A study on openness in the NHS by BMC Health Services Research released last September suggests the Francis Report may have had a positive impact on physical healthcare, but such improvements have not been seen in mental health.

According to BMC’s Mental Health Survey, patients feel less listened to, believe they are not given  enough time to discuss their care, and feel treated with less respect and dignity compared to previous years. These findings indicate applying values like openness and transparency may be more challenging in mental health settings. 

Recruitment and retention statistics for this workforce look worrying. The Mental Health Workforce Plan for England has reported the NHS is losing more than 10,000 mental health staff each year. As a  result, the shortage is affecting staff workload, well-being, morale, and the ability to provide quality care. 

Despite these factors, demand for mental health services is rising and there’s a genuine consensus that mental health matters as much as physical health. A recent survey by Public Health England shows almost half of UK adults feel the pandemic has negatively affected their mental health. 

To support the nation’s mental health during this time, the Government has launched the Every Mind Matters programme and announced new funding for a recruitment drive to help 10,000 people living with serious mental illness. The funding boost will help recruit and train 480 new mental health social workers, forming a vital part of the response to the pandemic. 

There has never been a more important time to invest and attract the right staff to this sector. It’s  not just about having the right numbers of staff, it’s also about having a motivated and values-driven workforce in place to care for patients in a sector that’s notoriously demanding. 

Staff hired for values perform better 

Combined with different interviewing methods, values-based recruitment can help mental health care providers recruit better staff. Investing in recruitment processes that focus on candidate values and behaviours, rather than skills and experience, has been shown to be effective in improving  performance. Skills for Care reports 72% of employers agree that staff recruited for values perform better than those recruited using traditional methods. 

Putting values into action and action into values 

Part of this process involves asking interviewees to give real-life examples of behaviours in their previous roles, or personal lives, which demonstrate values in action. Before employers can assess interviewees on their values, they have to know what their own values are as an organisation and  how this would be reflected by staff in the role.

All candidates should experience the same interview process and be asked the same questions so  that answers can be compared. Asking behavioural and situational questions will help identify  whether the values of the interviewee are similar to those of the organisation. Lead questions  should focus on past behaviour (‘Tell me about a time when you…’) and then followed up with probing questions to get beneath the surface of the particular situation. 

Value-based interview questions 

To demonstrate the kinds of values supported by health and care organisations, here are a few examples of value-based interview questions from Health Education England and National Skills Academy for Social Care. With each value, there are effective and ineffective behaviours showing  what the value does or doesn’t look like. 

Integrity 

Please give an example of a situation where you’ve spoken up because you had concerns, or tell me  about a time when you had to address a difficult situation with a colleague. Why was it important to  address this situation? What was the outcome? How did you perceive your colleague’s reaction? 

• Positive: The person is proactive in identifying and addressing issues, is sensitive and tactful in raising difficult issues, or is aware of the risks associated with inaction.  
• Negative: The person passes responsibility to others, jumps to conclusions, or seeks to blame others. 

Compassion 

Tell me about a situation when you had to break some difficult news to someone, or had to handle an  upset or confused client? What was the outcome? How did the other person respond or react? How  did you feel in that situation and what did you learn from it? 

• Positive: Shows sensitivity and helping behaviour to the needs of others in discomfort, or acts to alleviate  and prevent suffering in others.  
• Negative: Is inattentive to distress signals in others, shows a lack of empathy, or demonstrates avoidance. 

Commitment 

Tell me about a time when you have “gone the extra mile” at work. What was the task? Why did you  do that? What was the outcome? 

• Positive: Takes ownership of problems and challenges, or carries out a plan, task or action to completion in  spite of difficulty. 
• Negative: Blames others for not being able to make commitments, or shows a lack of interest in being  involved with the role and organisation. 

Collaboration 

Describe a time where it was important for you to develop an effective working relationship with  someone. Why was this relationship significant? What did you learn from this experience? How did  you react or feel about developing this relationship?  

• Positive: Considers the needs and perspectives of others, talks about the benefits of working together, or  shows willingness to cooperate with others.
• Negative: Is dismissive of the views and perspectives of others, makes inappropriate assumptions about  others, or demonstrates a negative attitude towards working with others. 

The Francis Effect: Making the invisible visible 

Like delving below the tip of the iceberg, value-based interviews can help reveal the less visible  attributes of a person. Values and behaviours make up a significant part of us and are as important as the skills and knowledge that mental health care workers need to have.  

When common values are identified at the recruitment stage, and behaviours understood,  employers are more likely to find and keep a more engaged and committed workforce. In an open  and transparent culture, staff will naturally know what it takes to deliver high-quality, attentive care in often challenging working conditions. 

To level out the inequalities between physical and mental health services, investment in finding the  right staff is a key step towards building compassionate, modern mental health services, and truly realising the ‘Francis Effect’. 

Reena Sidar is the founder and CEO of hirestaff, a specialist consultancy offering a  values-based approach to recruitment for healthcare.