Can I use a colleague instead of my line manager for an NHS reference?

It is highly unlikely. Most NHS trusts have a strict policy that at least one reference must come from your current or most recent line manager. If you have a difficult relationship with your manager, you should raise this with the recruiting manager as soon as you receive a conditional offer to discuss potential alternatives.

Will a bad reference stop me from getting an NHS job?

A negative or unenthusiastic reference can certainly be a concern for recruiters, as it may raise questions about your performance or conduct. However, all references must be factual and justifiable. If a reference contains unexpected negative information, the recruiter may contact you or the referee to seek clarification before making a final decision.

How long does the NHS reference check take?

The time it takes depends entirely on how quickly your referee responds to the request. Most trusts send automated reminders, but it can take anywhere from a day to a couple of weeks. This is just one part of the overall pre-employment screening, which typically takes 6-12 weeks from offer to start date.

Can my manager refuse to give me a reference?

While there is no absolute legal obligation for an employer to provide a reference, it is standard professional practice and an expectation within the NHS. An outright refusal could be problematic and is very rare. This is why it is essential to ask someone for their permission before listing them as a referee.

What if I'm a student or have been out of work?

If you are a recent graduate with no employment history, you should use an academic referee, such as a university tutor or course leader who knows you well. If you have a gap in your employment, you may be asked for a character reference from someone who has known you in a professional capacity. Be open and honest with the recruiter about your circumstances.

Does the NHS contact referees by phone?

It is very uncommon for the initial reference request. The vast majority are handled through secure online portals. However, a recruiter might make a follow-up phone call if the written reference is vague, contains contradictory information, or if they need to verify a specific detail urgently.

NHS reference request templates: guide for applicants & managers

An NHS reference request is a formal part of the pre-employment checking process for virtually all roles in the health service. After you receive a conditional job offer, the recruiting trust will contact the referees you listed on your application to verify your employment history and gather information about your performance, conduct, and suitability for the role. This guide explains exactly what referees are asked, how to write a strong reference, and how to manage the process as an applicant.

Understanding the NHS reference process

References are a crucial step in NHS recruitment, designed to safeguard patients and ensure the right people are hired. They are typically requested after a conditional offer of employment has been made and must be completed satisfactorily before a final, unconditional offer is issued.

The entire process from interview to your first day can take between 6 and 12 weeks, as it also includes other essential checks like a Disclosure and Barring Service (DBS) check, occupational health screening, and verification of your identity and right to work in the UK.

Key things to know about the process include:

Timescale: Most NHS employers require references covering your last three years of continuous employment or activity.
Who to ask: You will almost always need to provide details for your current or most recent line manager. Other referees can include previous managers or, for recent graduates, academic tutors.
Format: Forget simple, informal letters. The majority of NHS trusts now use secure online recruitment systems (like Trac, NHS Jobs, or Jobtrain) that send referees a link to a structured form. This standardises the information they receive.
Factual Basis: UK law requires references to be fair, accurate, and not misleading. This is why NHS reference forms focus on factual information and evidence-based assessments rather than vague personal opinions.

What information does the NHS ask for?

While the exact form varies between trusts, most NHS reference requests cover the same core areas. Referees will be asked to confirm factual details and provide an assessment of your professional capabilities. Expect the form to be divided into several sections.

Factual Employment Details

This part is for verification. Your referee will be asked to confirm:

Your job title and the band you were on.
Your start and end dates of employment.
The type of contract you had (e.g., permanent, fixed-term, bank).
A brief description of your main duties and responsibilities.
Your reason for leaving the post.
Whether they would be happy to re-employ you.

Sickness Absence and Disciplinary Record

These are standard but sensitive questions.

Sickness Absence: Referees may be asked to provide details of your sickness absence. In some trusts, this requires your explicit consent. The information should be factual, often presented as the number of days and instances of absence over a 12-month period. Some managers prefer to give a qualitative answer, such as 'low' or 'in line with the team average'.
Disciplinary Record: The form will ask if you were subject to any formal disciplinary procedures during your employment and, if so, to provide details. This refers to formal warnings, not informal chats or development conversations.

Performance and Competency Ratings

This is the most detailed section and where a good reference can make a real difference. Referees are often asked to rate the applicant on a scale (e.g., Excellent, Good, Satisfactory, Poor, Unable to Comment) across a range of criteria based on the NHS Constitution values and the specific demands of the job.

Common areas for assessment include:

Teamwork and collaboration
Communication skills (with patients and colleagues)
Commitment to quality of care
Compassion and respect
Reliability and timekeeping
Clinical skills and knowledge (for clinical roles)
Leadership and management skills (for senior roles)

The form usually includes a free-text box for the referee to add any further comments to support their ratings.

A guide for referees: how to write a great NHS reference

If you've been asked to provide a reference for a colleague, your input is incredibly valuable. Your goal is to provide a fair, accurate, and helpful assessment. Here’s how to approach it.

1. Be Factual and Honest: Your primary duty is to be truthful. A misleadingly positive reference could cause problems for the new employer, while a demonstrably unfair negative one could lead to complaints. Stick to what you know and can evidence from their time working with you.

2. Ask for the Person Specification: Ask the applicant to send you the job description and person specification for the role they’ve applied for. This is vital. It allows you to tailor your comments to the essential and desirable criteria the new employer is looking for, making your reference far more powerful.

3. Use Specific Examples: When commenting on their skills, avoid generic praise. Instead, use specific examples to illustrate their competence. Think about a time they demonstrated a key skill. For example, instead of saying "She has good communication skills," you could write, "She is skilled at de-escalating difficult situations with anxious relatives, using active listening and empathy to resolve conflicts calmly and effectively."

4. Check Your Local Policy: Before you start, check your own trust's HR policy on providing references. It may have specific rules about what you can and cannot include, particularly regarding sickness absence or disciplinary issues. When in doubt, speak to your HR department.

Reference templates and worked examples

Although most references are completed via an online form, you can prepare your answers in advance. Here are some examples of how to structure your comments.

Example 1: Answering a competency question

Let's say the form asks: "Please comment on the applicant’s ability to work effectively within a team."

A good answer:

"Yes, they were a reliable and supportive team member who always worked well with their colleagues and contributed positively to team goals."

A better, more detailed answer:

"They were an integral member of our ward team. They consistently demonstrated a collaborative approach, actively participating in multidisciplinary team meetings and ensuring a thorough handover to colleagues. For instance, during a recent CQC inspection, they took the initiative to coordinate the team to ensure all documentation was prepared, which contributed directly to our positive outcome. They are respected by their peers for their willingness to help and support junior staff."

Example 2: General suitability statement

Many forms have a final box for general comments. This is your chance to provide a powerful summary.

Template structure:

"I was [Applicant's Name]'s line manager for [Number] years in their role as [Job Title]. During this time, I found them to be a [Positive Adjective 1] and [Positive Adjective 2] member of staff. Their key strengths are [Skill 1] and [Skill 2], which they demonstrated when they [provide a brief, specific example]. They have a genuine commitment to [mention an NHS value, e.g., patient-centred care] and I have no hesitation in recommending them for the post of [New Job Title]. I confirm that I would happily re-employ them."

A realistic scenario: the Band 5 nurse

Imagine a Band 5 nurse working 30 hours a week on a busy surgical ward is applying for a Band 6 Deputy Ward Manager position in another trust. They have asked their current Ward Manager for a reference.

The recruiting trust sends the Ward Manager a link to their online reference form. The form asks for confirmation of employment dates, current role, and reason for leaving ('career progression'). It also includes a section on sickness absence, which the nurse has consented to share.

The core of the form contains questions rating the nurse's clinical skills, patient communication, and leadership potential. The Ward Manager, having been given the Band 6 person specification by the nurse, focuses their comments on these areas. In the free-text box for leadership, they write: "Although their current role is at Band 5, they have consistently sought out opportunities to develop leadership skills. They have successfully mentored three new student nurses, providing excellent pastoral and clinical support. Furthermore, they recently led a small audit on falls prevention, presenting their findings confidently to the senior nursing team. They are ready to take the next step in their career."

This detailed, evidence-based comment directly addresses the requirements of the Band 6 role and gives the recruiter confidence in the applicant's potential.

Tips for applicants: choosing and briefing your referees

As the applicant, you have a key role to play in ensuring the reference process goes smoothly. Don't leave it to chance.

Choose the Right People: Your first referee must almost always be your current or most recent line manager. Choose someone who has managed you directly and can comment on your work in detail. If you have a difficult relationship with your manager, you may need to have a sensitive conversation with the recruiter about alternatives, but this should be a last resort.
Always Ask Permission: It is basic professional courtesy to ask someone before listing them as a referee. This gives them a chance to decline if they don't feel comfortable, and it ensures they are prepared when the request arrives.
Brief Your Referees Thoroughly: This is the most important step. Once they’ve agreed, send your referees an email containing:
- The job description and person specification for the role you're going for.
- A copy of your updated CV (our Pro CV builder can help with this) or the supporting statement you submitted.
- A polite reminder of the key skills and experiences you'd like them to highlight that are relevant to the new role.
Keep Them in the Loop: Let them know when they can expect to receive the request (usually shortly after your interview). Send a polite follow-up if you know it's been sent but not completed, and always remember to thank them for their time once it's done.

Key takeaways

NHS references are a formal, mandatory part of pre-employment checks, usually requested after a conditional job offer is made.
They typically cover the last three years of employment and require at least one reference from your current or most recent line manager.
Most trusts use structured online forms that ask for factual employment data, sickness and disciplinary records, and ratings against key competencies.
If you are asked to be a referee, be factual, honest, and use specific examples. Always align your comments with the person specification for the new role.
As an applicant, you must ask for permission and brief your referees thoroughly by providing them with the job details and your application materials.
A well-managed reference process can significantly strengthen your job application and speed up your journey to starting your new NHS role.

NHS reference request templates: guidance for securing your role