All Aboard the NHS Career Rollercoaster

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Clare Knighton, Training & Development Officer (Restorative Supervision), Herefordshire and Worcestershire ICS, shares how her experiences have taught her that talent opportunities and leadership development shouldn’t be based on banding but rather all skills, values and past work and lived experiences.

“I consider myself lucky to have been employed in the NHS for over 22 years, in a variety of roles. However my most recent appointment has got me reflecting and thinking about career development in the NHS – for me it’s been a real rollercoaster, and so I will share with you some of my experiences, thoughts and viewpoints as I believe there are certain fundamentals that need to change and that we are all capable of doing something to make it better.

My first point to note is that career pathways in the NHS are either very fixed with set hurdles, or they are non-existent. Also there can be a ‘postcode lottery’ depending on where you work, which trust, how linked up they are with others etc. I have experienced both and had to gain certain qualifications to be considered for a role, conversely I have also been in a role where there is no career pathway. The NHS needs a multi-level, joined up, consistent career framework, and when new roles are created, thought is given as to how someone might progress, if they wish.

Secondly, I hear colleagues tell me that they can’t progress their NHS career as their previous or current experiences are not taken into account – some job roles say ‘degree level experience’ but then it’s quite ambiguous as to what that looks like.

Career pathways also don’t seem to link in to NHS wellbeing agendas or recognise periods of illness/disability eg. I went from 8B to band 3, then very difficult to access courses as offer is usually by band. My development required someone to see past my band and look at my skillset, this should be routine in the NHS and it isn’t.

This brings me onto my real NHS pet hate – referring to people by band – “oh she’s a band 7 trainer, he’s our band 4 healthcare worker etc.” Not only is this my pet hate but its depersonalising which then spreads into practice, “has bed 4 been fed yet!?” Additionally, it creates hierarchy that hinders and doesn’t help. I’ll get off my soapbox on that point now!!!

Lastly, people who have had career breaks or who are reduced to a lower band through restructure or other circumstance then find it hard to climb back up and we then lose talent!

 I will share with you that as part of a huge restructure I was made redundant from a high level post and accepted a band 3 post, where I could use my ‘lived experience’ of mental health challenges. However after a few years I began to crave more development. The NHS programmes around at the time that I felt appropriate development were targeting band 7 and above roles. So I simply couldn’t apply.

Fortunately for me I have now been appointed in a role where ALL of my qualifications, skills and lived experience were taken into account following my post being put at risk, so I was able to jump back up!

I believe that NHS career paths should not be rollercoasters, they should be journeys, that you plan yourself, where your experiences are valued, where your banding is just a guide not a gateway, only then can we fully support wellbeing agendas and culture change to make the NHS a great place to work – everywhere, for everyone, no matter what band you are.

Some people are happy to stay in a role long term and that’s fine, but if we want an agile, dynamic and creative workforce, the pay bands should not be the thing that stops you reaching out for growth and development. I have been both lucky and skilful but I would love this to be the case everywhere so that talent is managed on ability or potential and not on pay grade.”


Here in the Midlands Leadership and Lifelong Learning team we try to offer development opportunities to people of all banding, of all experiences, ages, ect and we hope that in doing this we influence others in creating an inclusive and diverse workforce within the Midlands. Follow the links to see our offers and events.

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