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Case Study – Central London Community Healthcare NHS Trust

Speeding up employment checks in Central London using factual references as outlined in NHS Employers’ Employment Check Standards to grow the healthcare workforce at pace and allow new staff to start their healthcare careers more quickly

As the first NHS Trust to fully implement the use of factual references, as outlined in the updated NHS Employers‘ Employment Check Standards, Central London Community Healthcare NHS Trust has seen significant results. The length of time needed to gather references has fallen from five weeks to two weeks, allowing new recruits to begin work much faster.

Central London Community Healthcare NHS Trust (CLCH) is a community healthcare provider in the boroughs of Barnet, Hammersmith and Fulham, Kensington and Chelsea, and Westminster. It employs 3,000 health professionals and support staff who provide community and in-patient services to almost one million people across London. CLCH is one of two London-based NHS trusts that exclusively deliver out-of-hospital, community-based NHS healthcare services.

CLCH was one of 11 London trusts involved in the initial Streamlining Programme recruitment managers workgroup that reviewed the NHS Employers Employment Checks Standards to identify ways in which they could be improved. Several meetings, held on different days and of varying durations, took place with the purpose of redrafting guidance notes and producing Standard Operating Procedures that would ensure that good policy resulted in best practice. CLCH piloted the new processes, including the collection of factual references from previous employers or from the current employer, if the applicant was currently employed by another NHS trust. This means that line managers are no longer pestered for references for staff that are about to leave or left some time ago – instead, the recruitment team can instead provide a factual reference on their behalf.

The new process is simpler, requires substantially less administration, and reduced the time it takes to hire new staff. CLCH now wants to see it implemented in trusts across England so that everyone can benefit from a quicker and safer recruitment process.

CLCH worked with the programme to lobby for changes to national policies. New trust policies were drafted in line with the new national standards and the case for change was presented to the Executive Leadership Team. A risk assessment was completed through the Workforce Committee and the changes were approved with executive support.

Implementation was phased to reduce the impact on day-to-day work. First, CLCH set up an email address for incoming reference requests. As new vacancy requests were received, the recruiting managers were informed of the new process. Gradually more recruiting managers got used to the new process and their questions were answered increasingly quickly. After about two to three months the questions peaked and slowed down as the new process began to embed into the organisation.

In parallel, line managers were invited to send their incoming reference requests directly to the new email address so that CLCH could issue factual references with faster turnaround times. The volume increased as managers realised the benefit of not having to fill out the references themselves and the importance of them being factually accurate.


  • The length of time required to gather references has fallen from five weeks to two weeks
  • References from other trusts are now handled systematically and centrally
  • New recruits to the trust no longer need to wait for such a long time to complete pre-employment checks. The result is that they are enthusiastic and ready to start, rather than frustrated and despondent when they take up their new post
  • CLCH is now less exposed to receiving or issuing discriminatory and/or fraudulent references, reducing the legal risk to the trust
  • The transition from the old-style subjective references to the new style factual references needs careful handling, with relevant teams being kept informed of upcoming changes
  • Explain the reasons and benefits of the changes to the trust board and senior management team early in the process to ensure senior-level buy-in
  • Prepare a good communications plan to ensure those line managers and can have all their questions about the new process answered
  • Start slowly, phase the implementation and the use and popularity of the new system will quickly grow