Career advice

COVID-19: how we transformed our recruitment process at the height of the pandemic

Recruiting nurses more quickly enabled us to cope with the surge in patient numbers 
Papworth Hospital

Recruiting nurses more quickly enabled us to cope with the surge in patient numbers 

Critical care at Royal Papworth Hospital. Picture: PA

COVID-19 is the biggest health challenge the NHS has ever faced. At Royal Papworth Hospital in Cambridge, the pandemic meant urgently revising many of our established practices, including nurse recruitment.

Royal Papworth Hospital, Cambridge
Picture: PA

Due to our respiratory expertise, the Royal Papworth was identified as a ‘surge hospital’. This meant expanding our critical care capacity from 47 beds so we could potentially take up to 200 critical care patients. It was clear we would need more nurses.

Before the pandemic, we had been successfully recruiting registered nurses and healthcare support workers through a monthly selection day of shortlisted candidates. Now, not only could we no longer meet candidates face to face, but we also needed nurses faster than this process allowed.

We needed to recruit clinical staff for the new essential care teams (ECTs), working in our critical care unit under supervision from experienced critical care staff, and caring for the most seriously ill COVID-19 patients from the East of England.

Transforming the recruitment process during the pandemic

We started by creating an emergency recruitment advert based on feedback that showed what had attracted candidates to the trust in the past. We were inundated with applicants and immediately started shortlisting.

The usual process of having two senior nurses shortlisting was continued to maintain standards, and we started shortlisting candidates every day. This sped up the process, improving our time to hire, and if candidates had applied to several hospitals, the fast pace of the process gave us a competitive edge.

After shortlisting, we booked interviews with candidates directly. Rather than the previous 30-day timeframe, interviews were booked within 24 to 48 hours of the initial phone call and we interviewed every day.

Most of the interviews were carried out by me and another lead nurse for recruitment. Ward sisters or charge nurses would normally be part of this process, but as the candidates were working in our ECTs rather than the wards, it wasn’t imperative that they were present. This also freed up their time to concentrate on clinical duties.

Remote interviews and a shorter induction process 

The interviews were carried out remotely – over the phone and via Skype. Using Skype was new to us, so we had to get to grips with the technology, but it was safe and felt as personal as it could under the circumstances.

Candidates were informed of the outcome of their interview immediately, meaning they were not kept waiting and we could move them on to the next stage of the process quickly.

‘The time taken to hire staff was reduced from three months before the pandemic to an average of ten days’

Cora McKeown, lead nurse for nurse recruitment at Royal Papworth Hospital NHS Foundation Trust in Cambridge

New checking processes were created in line with government guidelines, with successful candidates asked to scan photographic identity and evidence of their address, and the temporary service offered by the Disclosure and Barring Service (DBS) during the pandemic meant staff could be safely recruited in advance of receiving full DBS clearance.

Potential employees also underwent a risk assessment to ensure it was safe for them to work at the trust. If they failed the risk assessment, we would not proceed with their application, to ensure their safety.

Before the pandemic, inductions for new staff were carried out every month and the process lasted a week. Under the new recruitment strategy, the process for ‘on boarding’ new staff was changed to three times a week, with 15-minute one-to-one appointments throughout the day where staff confirmed their identity, signed paperwork and were provided with trust access badges.

Clinical induction and IT training were arranged with limited numbers to ensure social distancing, and talks from speakers – including the chief executive and chief nurse – were videoed and uploaded to a new ‘on boarding’ website.

The candidate’s view: Sally-Jane Papworth

Sally-Jane Papworth using personal
protective equipment

Sally-Jane Papworth was recruited to the trust as a band 5 staff nurse in April, working mostly in critical care to support the essential care teams

‘The streamlined shortlisting and interview process was very efficient – it seemed to reduce a lot of the administration and was much quicker than jobs I have applied for previously, which have taken up to four months to get started.

‘The idea of being interviewed remotely was stranger than the actual event. I was interviewed via Skype, which was then followed up by a phone call, and it was all very professional. I often get nervous in interviews and don’t always perform at my best, so I actually preferred being interviewed remotely.

‘There was always someone I could call if I had any questions, and I felt supported throughout the process. There was also no time-wasting from point of application to being told my name would be added to the trust’s register of available nurses, and doing the induction online was beneficial.

‘This was a better interview experience than I have had previously. I hope it remains in place beyond the COVID 19 crisis.’


At the height of the pandemic, recruitment more than quadrupled 

Competency packs and numeracy testing for new nurses were also available through the website, with a huge amount of work going into this process to have it up and running within a week.

We received applications from many different routes, including nursing and medical students who opted to support the ECTs, and registered nurses from local NHS trusts who were redeployed to support our status as a regional surge site.

The time taken to hire staff was reduced from three months before the pandemic to an average of ten days. During the critical period of 29 March to 29 May, we recruited 51 registered nurses, 26 healthcare support workers, 38 medical students and 15 nursing students. 

In a normal month, we would recruit about 12 nurses and three healthcare support workers.

As lead nurses for recruitment, we were the candidates’ first port of call, which meant constant communication throughout. Feedback from candidates was positive, with the ‘personal and caring service’ we provided cited as one of the reasons candidates stayed in the process.

Recruiting with such urgency meant we had fully staffed, safe clinical areas during the peak of the pandemic. From our first COVID-19 patient in March to the middle of June, we treated 124 patients with coronavirus, 97 of whom were admitted to critical care. We accepted 77 patient transfers from other hospitals and provided advice on 54 patients remotely. Of our COVID-19 patients, 89 have now been discharged and 13 are undergoing active treatment. 

Our new recruitment processes have seen many benefits for candidates, patients and the trust, and it is unlikely we will go back to a full-week induction or monthly selection days.

Some changes to the interview process will be retained

The daily shortlisting and interviewing will continue, with ward sisters or charge nurses invited to join us for future interviews. We will also continue to build an online presence for training and accessing important documents, with welcome videos from senior staff used as part of the induction process for new starters.

We will do interviews via Skype at times, but as feedback from candidates shows they enjoy attending interviews in person, we will need to find a middle ground as the pace starts to slow down.

Small, manageable interview days, with socially distanced groups, will enable us to give candidates the best experience while also improving our time to hire.

Although we had wanted to re-evaluate our recruitment processes for some time, COVID-19 forced this to happen. It took a lot of hard work from all involved but streamlining our processes has proved to be a positive experience, enabling us to attract the best candidates and deliver the best possible care to our patients.

The candidate’s view: Tracey Wickington

Tracey Wickington is an inspection manager with the Care Quality Commission. She was seconded to the trust during the COVID-19 outbreak to support the essential care teams

‘The interview process was really straightforward and succinct. It worked well and was responsive to the situation while maintaining all the necessary legislation and safety checks.

‘I felt supported throughout, with good email and phone communication, and the process was quicker than other jobs I have applied for.

‘I have had experience of remote interviews, so this was not a complete unknown for me. There was a formalised structure to the interview, with introductions made and the format outlined. The conversation felt open and there was the opportunity for me to ask questions, and next steps were explained before the call was concluded.

‘This was a secondment opportunity enabling me to return to clinical nursing, and was a supportive, two-way process. My previous experience and skill set were taken into account, and I felt listened to and empowered to identify which areas I felt were appropriate for me.

‘I was able to provide my capacity and availability – which were restricted due to my ongoing commitments in my current regulatory role – without feeling that these were seen as issues or limitations that would prohibit my employment.’


Cora McKeown is lead nurse for nurse recruitment at Royal Papworth Hospital NHS Foundation Trust in Cambridge

With special thanks to lead nurse for nurse recruitment Linda Lewis, head of resourcing Lynn Roberts, training and development manager Mike Magowan, essential care team heads Anne White and Pippa Hales, and the clinical education team