Quym Greaves, OD Specialist at NHS Arden & GEM, shares key findings from her research into talent management practices within the NHS, as part of a Senior People Professional Degree Apprenticeship at the University of Exeter.
Within my Senior People Professional Degree Apprenticeship at the University of Exeter, we are encouraged to not only develop our knowledge but also our mindset – combining discipline, evidence, strategic thinking and lived experience. In a system as vital as the NHS, this integrated approach is not merely beneficial, it is essential. I brought this methodology to my research into successful talent management practices with an equality, diversity and inclusion (EDI) lens. As a result, my investigation was centred upon not just what works in talent management, but what works in a publicly funded system under sustained cost pressure that relies on people for their competitive advantage.
NHS Arden & GEM is an employer, like many others in the public sector, that operates under resource constraints yet is dependent on qualified committed employees. As scholars including Malcolm Higgs1 (2004) argue, such public sector organisations must compete as employers of ‘values’, by attracting and retaining people because of purpose, meaning and integrity – rather than financial incentives alone.
In order to investigate talent management practices and their link with EDI, I analysed several sources including WRES, WDES and gender pay gap data. While the organisation’s equality indicators rank favourably compared to other NHS organisations, there was a recognition that there is always more that can be done to ensure equal access to career opportunities.
When good intentions aren’t enough
Through both academic theory and reflective practice, I began to see a pattern across cases: people falling through the cracks in systems, despite good intentions. Some of the cases highlighted included:
- Managers stepping into leadership roles without adequate preparation
- Besieged people processes where policy exists on paper but lacks clarity in practice
- Staff unsure of how – or whether it is safe – to speak up when something feels wrong.
The audit involved mapping breakdowns that occur across recruitment, induction, capability, wellbeing and performance processes. This process showcased that in a high-pressure environment, more cases occur, with the most vulnerable colleagues more likely to be affected, including disabled staff, internationally recruited colleagues, or those new to the organisation. This systems lens, grounded in evidence-based practice, shifted my approach from reactive casework to preventative design.
Psychological safety as a strategic lever
A key insight emerging from the audit highlights the centrality of psychological safety and organisational trust. While well documented in theory, achieving this in practice requires deliberate organisational framing that enables individuals to raise concerns, seek support and challenge practice without fear of negative consequences.
At Arden & GEM, this learning has informed the design of interventions that prioritise strengthening managerial confidence and capability. Rather than relying solely on written guidance, development programmes are being shaped to:
- Equip managers with practical skills that strengthen relational trust – including courageous conversations, inclusive leadership and consistent application of policy – helping create environments where employees feel able to speak openly about concerns.
- Embed reflective supervision and peer learning through structured forums where managers can discuss complex people issues, test decision-making and learn from colleagues. These spaces reinforce shared accountability while modelling psychologically safe behaviours that managers can replicate within their own teams.
- Clarify accountability within people processes to reduce ambiguity and improve consistency in decision-making. Clearer roles increase perceptions of fairness and transparency, strengthening trust in organisational processes.
- Reinforce early intervention rather than escalation by equipping managers to recognise emerging issues and initiate supportive conversations sooner. Early intervention enables employees to raise concerns before problems escalate, reducing the perceived risk of speaking up.
The aim is not to introduce additional policy, but to strengthen system coherence so fewer colleagues fall through organisational gaps and staff feel confident that concerns will be addressed constructively.
Lessons for similar organisations
Organisations working under comparable constraints including high demand, limited financial flexibility and specialist workforce requirements may benefit from a similar approach of:
- Conducting an in-depth examination of the organisational system
- Avoiding assumptions that policy equates to practice, and map the lived experience
- Identifying friction points and strengthening the capability of those closest to staff experience including managers and staff voice leads
- Anchoring interventions in organisational values rather than relying on compliance alone.
Safeguarding organisational value
Within publicly funded systems, inefficiency carries both financial and human costs. When managers feel unprepared, sickness absence rises. When processes are poorly executed, grievances escalate. When staff do not feel safe to share concerns, innovation is impeded. Strengthening psychological safety and managerial capability therefore does more than improve culture; it safeguards organisational value by reducing avoidable escalation and enabling more effective workforce management.
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1. Higgs, M. (2004).‘Future Trends in HRM’ cited in Taylor, S. and Woodhams, C. (2012) Managing People and Organisations, London, CIPD
