1. Values Based Recruitment – The story so far
To help ensure excellent patient care and a positive experience for staff and trainees,
Health Education England (HEE) has embarked on the Values Based Recruitment (VBR)
programme. This document presents the story of VBR, from key drivers to evidence-
informed progress on the key programme deliverables.
Why VBR?
There has been an increasing focus on the NHS Constitution values across the NHS, in part due to the
report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (Francis, 2013) which
highlighted the critical role the workforce plays in ensuring the provision of high quality and safe
healthcare services and, in particular, the significance of staff values and behaviours on the level of care
and patient experience. Other significant reports which emphasised the importance of values include:
 The outcomes of the review by Professor Sir Bruce Keogh (2013) into the quality of care and
treatment provided by those NHS trusts and NHS foundation trusts that were persistent outliers
on mortality indicators.
 The Berwick Report (2013), which states: “Place the quality of patient care, especially patient
safety, above all other aims. Engage, empower, and hear patients and carers at all times. Foster
whole-heartedly the growth and development of all staff, including their ability and support to
improve the processes in which they work. Embrace transparency unequivocally and everywhere,
in the service of accountability, trust, and the growth of knowledge.”
When HEE was established on 1 April 2013, the following was included in the Health
Education England Directions 2013: The Secretary of State directs that HEE
must exercise its functions under the HEE Directions with a view to ensuring
that education and training for healthcare workers is provided in a way which
promotes the NHS Constitution (paragraph 2.4).
Furthermore, VBR was identified as a key deliverable in the Mandate (April 2013 – March 2015) to HEE
from the Department of Health: HEE will oversee delivery of a national values based recruitment
framework and associated tools and resources by October 2014 and ensure that selection into all
new NHS funded training posts incorporates testing of values based recruitment by March 2015
(page 25).
Historically, undergraduate courses in healthcare have tended to select primarily on academic
ability, whereas selection for employment focuses more on job-fit. Furthermore, it cannot be
assumed that those with high academic ability alone can be turned into effective clinicians via
education and training – other attributes and qualities, and the right values need to be present
from the start.
Page 25, Evaluation of values based recruitment (VBR) in the NHS, 2014.

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It is important to recognise that testing of values will be just one part of assessing a candidate’s suitability
for training or employment within the NHS; the candidate’s aptitude must also be taken into account. The
VBR programme intends for testing of values to sit alongside the assessing of aptitude and skills,
enhancing rather than replacing current recruitment processes. The importance of this was highlighted in
initial scoping meetings with stakeholders.
Stakeholder scoping events: What you told us
In 2013 HEE held a number of stakeholder events in order to help determine the scope of the VBR
programme.
The general outcomes and discussions from the event with VBR leads from the Local Education and
Training Boards (LETBs), which included some providers and Higher Education Institutions (HEIs), were
as follows:
 Want to gain experience and ideas from other providers through case studies and best practice;
 The need for consistent and evaluated tools;
 The importance of student perspective and their involvement in developing the framework
 The importance of patient involvement in developing the framework;
 How testing values is only one part of the recruitment process and must be looked at in
conjunction with skills and aptitude;
 The importance of training assessors who are assessing for values; and
 That recruitment is only one part of the process and the need to link to the culture of the
organisation and HR processes (i.e. values based employment).
Outcomes and discussions from the events held with NHS Employers and attended by Trusts were as
follows:
 Providers keen for us to recognise existing good practice;
 Providers keen for us to recognise that they have their own organisational values which may not
be the same as the NHS Constitution;
 Many providers were already recruiting for the values but those who were not, were keen for
support and guidance and to learn from other organisations; and
 There was an appetite for an online assessment tool which was linked to NHS jobs.
These key pieces of feedback from stakeholders are included throughout the document in blue boxes.
Link to HEE Strategic Framework
VBR is a key lever for delivering Framework 15, HEE’s Strategic Framework for the next 15 years. Whilst
we may not be able to predict exactly what the NHS will look like in the future, we do know that the core
values around which the NHS is built, such as respect and dignity and compassion, will never change.
This is why it so important that all students who begin NHS funded training programmes, and all
candidates who want to work in the NHS, are recruited for values to help ensure a culture which
embodies the key values set out in the NHS Constitution to ensure excellent patient care and a positive
experience for staff and trainees.

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Programme set up
The VBR programme is a priority for HEE aiming to deliver a system to support recruitment for values for
NHS funded training posts and NHS employees, which promotes quality care and positive patient, staff
and trainee experience by March 2015.
The VBR programme comprises three interdependent projects:
 Project 1 – Recruiting for values in all NHS funded training posts
 Project 2 – Recruiting for values in to NHS employment (in partnership with NHS Employers)
 Project 3 – Measuring the impact of recruiting for values
The scope of Project 2 was developed in direct response to the feedback from providers at the initial
scoping events.
Nicki Latham, HEE Chief Operating Officer, is the Senior Reporting Officer for the programme, and
governance is ensured by the VBR Programme Board, which includes student representation. The VBR
Stakeholder Advisory Group (VSAG) has also been established with an advisory capacity and members
act as advocates for the VBR programme. Organisations represented on the VSAG are HEE’s key
partners including; NHS England, Public Health England, CQC, Monitor, NHS Trust Development
Agency, NHS Leadership Academy and NHS Employers. This helps to ensure cross-system working
recognising that HEE cannot successfully implement VBR alone.
Programme Deliverables
By October 2014, the VBR programme will deliver a national values based recruitment framework
and suite of associated tools and resources.
Other deliverables include:
 Common working definition of values based activity
 Evidence to support employers and higher education institutions in recruiting for values
 Tool to support NHS organisations in testing and mapping their locally agreed values to those of
the NHS Constitution
 Access to values based interview and assessment training
 Good practice resources and networks across higher education institutions and NHS employers
 Methodology for measurement of long term impact and benefits
Whilst HEE is mandated by Government to ensure that recruitment into HEIs incorporates testing of
values by March 2015, in terms of recruitment into employment, the framework will have a much more
supportive role providing tools and resources which can be used by NHS employing organisations at
their discretion.
The next section of the story will talk about developing the framework and the
deliverables, along with identifying the evidence which has informed the decisions taken
being shown in orange and the initial feedback from stakeholders during the scoping
stage included in blue.

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Developing the Framework and deliverables
1. Why a framework?
If there is a need to assess values in order to make selection decisions (either at screening or
interview stage) then a single tool is unlikely to be appropriate. The research evidence suggests
that a tailored approach is more likely to accurately assess the diverse requirements of different
job roles across the NHS.
Page 16, Evaluation of values based recruitment (VBR) in the NHS, 2014.
Given that the NHS is a large, complex organisation encompassing a wide range of clinical and non-
clinical roles, it is unlikely that a single-tool approach to VBR will be appropriate.
The VBR Stakeholder Advisory Group felt that a “single framework for a single system” would be
more preferable than a single tool, however it was acknowledged that a VBR tool could be useful for a
specific cohort of workers or students and HEE is working on options to address this.
What stakeholders told us:
The importance of student perspective and their involvement in developing the framework;
The importance of patient involvement in developing the framework.
The importance of students’ and patients’ perspectives was highlighted in the initial scoping for the VBR
programme. These groups of stakeholders will be consulted with in the development of the framework:
students via established student groups and are also represented on the VBR Programme Board by the
HEE Clinical Fellows; and patients via the HEE Patients Advisory Forum. NHS employing organisations
have also fed back on expectations of staff and patients via the VBR partner network coordinated by
NHS Employers.
2. Common working definition of values based activity
What stakeholders told us:
Recruitment is only one part of the process and the need to link to the culture of the organisation
and HR processes (i.e. values based employment).
The first deliverable of the VBR programme was to establish a common working definition of values
based activity so all stakeholders were clear about what is meant by VBR and indeed the scope of the
programme.
Values Based Recruitment is an approach which attracts and selects students, trainees or
employees on the basis that their individual values and behaviours align with the values of the
NHS Constitution.
The purpose of VBR is to ensure that the future and current NHS workforce is selected against
the values of the NHS Constitution so that we recruit for the right workforce not only with the
right skills and in the right numbers but with the right values to support effective team working in
delivering excellent patient care and experience.

5. 5
VBR can be delivered in a number of ways: through pre-screening assessments, to values based
interviewing techniques, role play, written responses to scenarios, and assessment centre
approaches amongst others. Any VBR techniques, assessments or processes used should be
equality assessed and assured.
This definition reflects the narrow scope of values based recruitment as set out in HEE’s Mandate and
does not attempt to define the broader definition of values based employment as this falls outside the
scope of the programme. However, it is recognised that successful implementation of VBR must not be
conducted in isolation of the values based employment journey. The diagram below illustrates this
distinction in terms of where VBR is placed as part of the broader values based employment agenda.
The scope of the VBR programme is denoted in orange.
With partners, HEE has developed a map showing related programmes of work across the employment
spectrum in the stages described above and will be maintaining strong links with organisations including
NHS England, NHS Leadership Academy and NHS Employers on the work they are doing to help embed
values across the system.
Figure 1: The NHS Employment Journey – A Continuum of Values Based Employment

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Evidence to support employers and higher education institutions in recruiting for values
One of HEE’s aspirations is to become an evidence-based organisation; to ensure that decisions are
informed by evidence. Furthermore, evidence to support employers and higher education institutions in
recruiting for values was identified as another key deliverable for the VBR programme. To this end, HEE
commissioned work to look at evaluating the impact of the VBR programme, including undertaking a
literature review on VBR methods and their suitability of being used to test values. As part of the review,
recommendations were also identified on the way forward for the programme. The expertise of the
evaluators has been valuable in underpinning the work of the other two projects. Key learning points can
be found throughout this document in the orange boxes.
The literature review is available to view on the HEE website.
3. Tool to support NHS organisations in testing and mapping their locally agreed values to
those of the NHS Constitution
What stakeholders told us:
Providers keen for us to recognise that that have their own organisational values which may not
be the same as the NHS Constitution.
When we refer to values as part of the VBR programme, we mean the values included in the NHS
Constitution:
 Working together for patients
 Respect and dignity
 Commitment to quality of care
 Compassion
 Improving lives
 Everyone counts
However, we know that many NHS organisations
have worked hard to establish and embed their
own local values, and we want to ensure that this
work is built on. NHS Employers and HEE have
created a tool to help organisations map their local
values against those within the NHS Constitution.
The new, quick and easy tool is now available to
download from the NHS Employers website.
The values mapping tool has many uses:
 To illustrate how local values map to the values within the NHS Constitution;
 As a guide for NHS organisations who have not yet decided on their values;
 The re-emphasis of values – for organisations who have established their values;
 Print for communication and display around the workplace; and
 As evidence that an organisation is recognising and linking to the values in the NHS Constitution
for staff, patients and the Care Quality Commission (CQC) board.

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4. Access to values based interview and assessment training
What stakeholders told us:
The importance of training assessors who are assessing for values.
On behalf of HEE, NHS Employers is commissioning the design and delivery of training for values based
interviewing techniques for NHS employer organisations to help make interviews more structured as the
evidence suggests that structured (standardised) interviews are effective methods for VBR (see section 6
below). This will be rolled out in a “train the trainer” format, with the aim of those people trained then
training others within their organisation. This opportunity may also be extended to HEIs.
The evidence suggests that recruiters tend to use their own values as a benchmark against which
to measure person-organisation fit during the recruitment process.
Recruiters responsible for making decisions during VBR will have a significant impact on the
outcomes. It is important to ensure that those responsible for recruitment (particularly when
interviewing) represent the values the organisation is seeking to attract.
Page 16, Evaluation of values based recruitment (VBR) in the NHS, 2014.
The evidence suggests that recruiters tend to recruit in line with their own values; if values are sufficiently
embedded in the organisation’s culture with agreement from staff, recruiters’ values will align with these
and will recruit in line with organisational values, which will be linked to the NHS Constitution.
5. Good practice resources and networks across higher education institutions and NHS
employers
What stakeholders told us:
Want to gain experience and ideas from other providers through case studies and best practice;
The need for consistent and evaluated tools;
Providers keen for us to recognise existing good practice;
Many providers were already recruiting for values but those who were not, were keen for support
and guidance and to learn from other organisations.
Approaches and methods are being identified for inclusion in the VBR framework through responses to
the comprehensive national VBR baseline survey which was undertaken in April and May 2014 with HEIs
in England, and also through feedback from NHS employing organisations who are part of the partner
network established by NHS Employers.
The tools, approaches and methods identified will be assessed for their effectiveness of testing for
values using the evaluation criteria outlined overleaf identified by the literature review. Each criterion is
not mutually exclusive and it is possible for some criteria to be at odds with one another.
 Accuracy and effectiveness
Evidence of reliability; evidence of validity; arrangements for on-going validation, evaluation and
development are in place; susceptibility to coaching; fairness, promotes diversity/widening
access; and legality.
 Cost and efficiency
Scalability for high volume recruitment; efficiency; utility; and generality of use.

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 Practicalities and implementation
Practicality (ease of administration/efficiency); expertise required for analysis and interpretation of
information generated by the tool; and ease of interpretation.
 Stakeholder acceptance and feedback
Positive employee, trainee and student perceptions; generates appropriate feedback; and
educational impact/value.
Page 20-21, Evaluation of values based recruitment (VBR) in the NHS, 2014.
The framework and associated resources will be available in October 2014 in the form of an interactive
PDF which will be available for recruiters from HEIs and the NHS to access online.
In practice, recruitment is often managed across two discrete phases; screening which generally
includes the initial activity to narrow down a series of applications into a manageable number, and
selection which involves the identification of suitable candidates to offer a job role or training post to.
Both of these stages are included, along with attraction, within the scope of VBR (figure 1 on page 5).
What stakeholders told us:
How testing values is only one part of the recruitment process and must be looking at in
conjunction with skills and aptitude
Based on the research evidence and the evaluation criteria above, the literature review assessed various
methods for their effectiveness in testing for values at the screening/shortlisting and selection stages of
recruitment. It is important to clarify that the outcomes for the methods below are based only on their
effectiveness in testing for values during recruitment, the methods may be effective at testing for aptitude
or skills but this was outside the scope of this literature review.
Findings can be summarised as follows in Tables 1 and 2 below and overleaf.
Table 1 – Recommendations for implementing screening methods for VBR
Method Recommendation based on research evidence
Personal Statements Not an effective method for VBR as the susceptibility to coaching is
high.
References Not an effective method for VBR as there is little evidence to support
validity or reliability of this method.
Situational Judgement
Tests (SJT)
Can be an effective method for VBR as they show improved validity
over other methods but can be costly.
Personality Tests May be useful at the attraction stage of VBR to help candidates self-
select for roles or careers within the NHS or to help drive more focused
questioning at interview.

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Table 2 – Recommendations for implementing (final stage) selection methods for VBR
Method Recommendation based on research evidence
Traditional (unstructured)
Interviews
Not suitable for VBR as they lack reliability and validity.
Structured Interviews Can be effective for VBR as they use thorough role analysis and
structured/standardised questions and scoring, but resource intensive.
Group Interviews (i.e.
multiple candidates being
assessed together)
Unlikely to be an effective method for VBR as evidence on reliability
and validity is lacking.
Selection Centres Can be an effective method for VBR due to their validity, but can be
costly.
6. Methodology for measurement of long term impact and benefits
Research demonstrates that best practice selection is an iterative process. Results from
evaluation studies should be used to review the original selection criteria and choice of selection
methods. Thus, feedback can be used to continually improve selection systems to enhance
accuracy and fairness.
Page 19, Evaluation of values based recruitment (VBR) in the NHS, 2014.
In order to measure the impact, HEE is working on a methodology for measurement of the long term
impact and benefits of VBR. This will help to determine to what extent the VBR programme has
influenced the way in which values are recruited for, and whether this has improved the quality of patient
care and the patient experience delivered by the NHS workforce as a whole. This will be formative, to
support the timely refresh of the VBR framework and resources which will help ensure accuracy and
fairness. This will also help to reinforce HEE’s aspiration to be an evidence-informed organisation.
Introducing the Framework
The evidence highlights that there are different ways in which VBR could be implemented and the project
team is currently investigating the most sensible approach to take including looking at methods currently
being used not only within HEIs and the NHS, but also in the private sector.
VBR aims to enhance, not replace existing recruitment. For HEIs, the framework will be embedded in a
phased way:
 Phase 1: the framework will be launched in October 2014.
 Phase 2: institutions will be supported to implement VBR by the March 2015 deadline.
 Phase 3: for all new recruitment taking place from April 2015 onwards, HEIs to ensure they are
recruiting for values using an evidence-based approach as included in the national VBR
framework.
NHS employing organisations will be encouraged to recruit for values following the launch of the national
VBR framework in October 2014. However, HEE does not have any levers to ensure this and so
undertaking VBR will be at the discretion of each organisation.

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Beyond Values Based Recruitment
What stakeholders told us:
That recruitment is only one part of the process and the need to link to the culture of the
organisation and HR processes (i.e. values based employment).
In the context of influencing culture and values within an organisation, the evidence clearly
shows the need for a multifaceted approach to organisational values beyond recruitment issues
alone. VBR is only one part of embedding values in the NHS.
Page 13, Evaluation of values based recruitment (VBR) in the NHS, 2014.
Successful implementation of VBR cannot be conducted in isolation of the values based employment
journey; it was recognised both in the initial scoping meetings with stakeholders at the outset of the
programme and also by the VBR Stakeholder Advisory Group that values must be embedded and
nurtured across the system to ensure they are not lost, including within both curricula and organisations.
As shown by figure 1 on page 5, this is, however, outside the scope of HEE’s VBR programme but is
being addressed by the wider system.
In curricula, for example, the Healthcare Scientist degree programme content reflects the rights
(responsibilities) and pledges of the NHS Constitution, placing the patient at the heart of education and
training. Also, behavioural competences (such as respect, dignity and compassion) feature in medical
training curricula but are not specifically referred to as NHS values education however are clearly
comparable to those included within the NHS Constitution.
To help embed values within organisations, NHS Employers is also leading work including: their project
‘Do OD’, a suite of Organisational Development resources for the NHS with a Values, Behaviours and
Culture strand of work, and providing support for NHS organisations to link the NHS Constitution to
performance and appraisal systems. NHS Employers is also working with NHS England on the Care
Makers initiative to champion the 6Cs.
This document has been prepared by the Development Team, Health Education England, in July
2014. For further information on the VBR Programme please contact us on HEE.VBR@nhs.net.