Role of Human Resources in Healthcare: A Practical Guide to HR in Hospitals

The role of human resources in healthcare goes beyond administration. In a hospital, HR is a patient safety function, because an unchecked registration, a professional working beyond their privileges or a ward that is chronically short of nurses all put patients at risk. This guide covers the core HR functions in an Indian hospital and what the NABH 6th edition hospital standards expect from each.

HR functions and the NABH standards

In NABH’s 6th edition hospital standards, effective 1 January 2025, Human Resource Management (HRM) is chapter 9. It has 13 standards and 76 objective elements. Its intent statement opens with: “The most important resource of the organisation is its human resource.”

The chapter applies to all “staff”, which NABH defines as everyone working in the organisation: employees, “fee for service” medical professionals, part-time workers, contractual personnel and volunteers. Induction also covers outsourced staff, students and trainees. The table maps each HR function to its standard.

Staff well-being sits in a different chapter: it moved from HRM to the sustainability standard ROM.3 in the 6th edition. For the other chapters, see our guide to the NABH 6th edition standards.

Workforce planning and staffing

Planning starts from the services the hospital offers and the patients it expects. Under HRM.1, the hospital must:

• maintain an adequate number and mix of staff for patients’ care, treatment and service needs (a Core element);
• plan for future needs as well as current ones;
• keep contingency plans for long-term, short-term and unplanned shortages;
• define a job specification, job description and reporting relationship for each category of staff;
• run background checks on new staff;
• conduct exit interviews and use them to improve HR practice.

In practice, base staffing on bed numbers, occupancy, patient acuity and the shift pattern, unit by unit, and build in a reserve for leave and training days. Contract and agency staff count towards the staffing plan and must meet the same standards. Public hospitals can use the staffing norms in the Indian Public Health Standards as a reference.

Recruitment and credential verification

HRM.2 requires written guidance for recruitment and a code of conduct for staff (both Core), a pre-employment medical examination, and documented HR administrative procedures. The step that matters most for patient safety is checking that every clinician is qualified and registered to practise.

Doctors

A doctor needs a valid registration with a state medical council or the National Medical Commission (NMC), which replaced the Medical Council of India in 2020. Check the registration number and status with the council that issued it, and on the NMC’s National Medical Register portal, launched in August 2024. Confirm that postgraduate qualifications are recorded, and keep copies of degrees and registration in the personal file.

Nurses and midwives

Nurses and midwives register with their state nursing council. Verify the registration with that council and check that it is current. The Indian Nursing Council also runs the Nurses Registration and Tracking System (NRTS), a national database of nursing personnel.

Pharmacists, dentists and allied health professionals

• Pharmacists register with their state pharmacy council under the Pharmacy Act, 1948.
• Dentists register with their state dental council.
• Allied and healthcare professionals, such as laboratory, radiography and operation theatre technologists and physiotherapists, come under the National Commission for Allied and Healthcare Professions Act, 2021. The Act provides for state councils that maintain live state registers. Where your state’s register is not yet running, verify qualifications directly with the issuing institution.

For an overview of who regulates which profession, see our guide to the regulators and councils in Indian healthcare.

Credentialing and privileging

Credentialing is collecting and verifying a professional’s education, registration, training and experience. Privileging is the decision, based on those credentials, about what that person may do in your hospital: which patients they may admit, which procedures they may perform and which services they may provide without supervision.

NABH sets out the same process for medical professionals (HRM.11), nursing staff (HRM.12) and para-clinical professionals (HRM.13) who are permitted to work without supervision. The hospital must:

1. identify who is permitted by law, regulation and the hospital to provide care without supervision (Core);
2. document their education, registration, training and experience, and update it periodically;
3. verify the information where possible;
4. grant privileges in line with qualification, training, experience and registration (Core);
5. make sure the professional and the relevant departments know what services each person is privileged to provide;
6. check that people work within their privileges.

A credentialing and privileging committee with clear procedure lists makes this workable. Review privileges at a fixed interval and whenever someone starts a new procedure or the hospital brings in new equipment, and share the current lists with the operation theatre, ICU and scheduling teams.

Induction and training

Induction

Every new member of staff gets induction training (HRM.3.a, Core). NABH lists what it must include:

• the hospital’s vision, mission and values;
• staff rights and responsibilities, and patient rights and responsibilities;
• safety, including the hospital’s emergency codes;
• cardio-pulmonary resuscitation (CPR);
• infection prevention and control;
• service standards, administrative procedures, and department policies and procedures;
• information systems, information security and information use, a new element in the 6th edition.

Ongoing and job-specific training

HRM.4 calls for a written training and development policy (Core), training records, retraining when jobs change or new equipment arrives, feedback on training, and evaluation of its effectiveness. HRM.5 adds job-specific training: handling blood and blood products, caring for vulnerable patients, control and restraint techniques, healthcare communication, infection prevention and control, and periodic CPR for staff in direct patient care (Core).

HRM.6 covers safety and quality: the safety programme, identified risks, what to do after an incident, occupational safety, the quality improvement programme, and two Core elements, the disaster management plan and fire and non-fire emergencies. Staff who handle biomedical waste must also be trained at induction and at least once a year under the Bio-Medical Waste Management Rules, 2016.

Performance appraisal

HRM.7 asks for appraisals of staff at defined intervals, against pre-determined criteria, documented and used as a tool for development. Staff should learn how the appraisal works during induction.

Criteria work best when they fit the role. For nurses, that may mean clinical competence, documentation, infection control compliance and patient feedback; our nurse performance feedback template shows how to collect the patient’s view. For doctors, combine the appraisal with the privileging review. Use the results to plan training, not only to rate people.

Occupational health and staff safety

Hospital staff face infection, needle-stick injuries, radiation, chemicals, violence and long shifts. Under HRM.9, the hospital must:

• take care of staff health problems, including occupational hazards, under a written policy;
• give staff in direct patient care a health check at least once a year and document the results;
• treat staff who are injured at work;
• have measures to prevent and handle workplace violence (a Core element).

The 6th edition’s interpretation also asks for written guidance on physical and mental health, and adds support for the “second victim”, the health worker traumatised after an unanticipated adverse event.

Other duties come from outside NABH. The Bio-Medical Waste Management Rules require hospitals to immunise staff who handle biomedical waste against diseases such as hepatitis B and tetanus, provide protective equipment, and give them a health check at induction and at least once a year. Radiation workers need personal dosimeters, as covered in our AERB guidelines for hospitals. Every hospital also needs a clear process for reporting sharps injuries and starting post-exposure prophylaxis quickly.

Discipline, grievances and staff records

HRM.8 requires written disciplinary and grievance procedures that all staff know about, that follow the principles of natural justice and the law (Core), and that allow appeals in every disciplinary case. Grievances must lead to action.

HRM.10 requires a confidential personal file for each staff member, which may be kept electronically. It holds qualifications, the job description, verification of credentials, health status, training records and appraisal results.

Indian laws HR teams need to track

• Labour codes: the Code on Wages, 2019, the Industrial Relations Code, 2020, the Code on Social Security, 2020 and the Occupational Safety, Health and Working Conditions Code, 2020 came into force on 21 November 2025, replacing 29 central labour laws. Rules under the codes are made separately by the centre and by each state, so check the current rules for your state.
• Prevention of sexual harassment: under the Sexual Harassment of Women at Workplace (Prevention, Prohibition and Redressal) Act, 2013, every workplace with 10 or more employees must form an Internal Committee.
• Personal data: staff records are personal data under the Digital Personal Data Protection Act, 2023. Its rules were notified on 13 November 2025, with most obligations applying after an 18-month phase-in (May 2027). See our guide to health data retention policies in India.
• Professional registration laws: the National Medical Commission Act, 2019, state nursing, pharmacy and dental council laws, and the National Commission for Allied and Healthcare Professions Act, 2021.

Staff feedback, well-being and retention

The foreword to the NABH 6th edition says it “places increased importance on the well-being and satisfaction of healthcare professionals, recognizing their pivotal role in delivering high-quality care.” Standard ROM.3.d asks hospitals to promote staff well-being, HRM.1.g asks for exit interviews, and HRM.4.d asks for feedback on training.

Practical ways to keep good staff:

• Run a short, anonymous staff survey at least once a year, publish what you will change, and report back.
• Make rosters fair and predictable, and watch overtime and consecutive night shifts.
• Offer clear career paths and support for continuing professional development.
• Recognise good work publicly, including feedback from patients.
• Track attrition, vacancies, absenteeism, training hours, appraisal completion and sharps injuries, and review them at management meetings.

Our article on staff feedback and patient feedback in hospitals explains how the two complement each other. For the survey itself, a tool such as LazyMonkey’s survey management system can send survey links by SMS, remind people who have not responded and export the results to Excel or PowerPoint.

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