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The NHS Graduate Management Training Scheme (GMTS) is a salaried leadership training route into NHS management. Official recruitment materials on graduates.nhs.uk describe a strengths-focused process: your degree subject and university brand are not the main message; passion and potential to become a future NHS leader are.

GMTS is not the Civil Service Fast Stream, the NHS Scientist Training Programme, or Public Health Specialty Training ST1. Application windows and start dates change by cohort. As of July 2026, official apply guidance stated that applications for 2026 entry were closed and that applications for 2027 scheme entry would open in September 2026, with successful 2026-entry candidates joining in early September 2026. Always check the live Apply page for the cohort you are targeting.

As published for recent intakes, the live process has included registration and application, then:

  1. Stage 1 Future Potential Assessment (online) - about 45 minutes, not time limited, with practice for each question type before you start, and feedback for candidates.
  2. Stage 2 NHS GMTS Alignment Assessment - about 60 minutes, including video responses; only video questions are timed; practice available; feedback after completion. Video responses are reviewed manually (the scheme states it does not use AI for that review).
  3. Stage 3 Virtual Assessment Centre (VAC) - half-day interactive exercises with feedback regardless of outcome, then offer, reserve list or unsuccessful outcomes, followed by placement allocation for successful candidates.

Commercial candidate guides often discuss Cappfinity-style adaptive ability and strengths assessments for Stage 1. The official apply pages emphasise strengths, onboard practice tests and equipment checks rather than naming a single publisher in the public summary. Treat your candidate account materials as controlling.

This page does not use nursing dose-calculation drills. Practice items are leadership-trainee numeracy (service metrics, budgets, ratios) plus situational judgement and strengths-style reflection.

The 30 questions below are original educational exercises for graduate leadership selection themes. They are not official NHS Leadership Academy, graduates.nhs.uk, Cappfinity, SHL or JobTestPrep items, and they do not reproduce confidential live assessments.

Key Takeaways

  • NHS GMTS is distinct from the Civil Service Fast Stream and from NHS STP clinical scientist recruitment.
  • Stages and timings are cohort-specific. Confirm the live graduates.nhs.uk Apply page for your year.
  • Official practice materials appear in your candidate account after you apply.
  • Strengths-focused assessment rewards authentic answers; do not try to game a profile.
  • Commercial packs are third-party supplements and cannot guarantee a VAC invitation or scheme offer.

Quick facts

NHS Graduate Management Training Scheme assessment snapshot
Item Detail
Scheme NHS Graduate Management Training Scheme (GMTS)
Official apply hub graduates.nhs.uk
Stage 1 (published summary) Future Potential Assessment ~45 minutes, not time limited
Stage 2 (published summary) Alignment Assessment ~60 minutes with video responses
Stage 3 Virtual Assessment Centre (half day)
Official practice Preparation materials appear in your account after you apply
Distinct from Civil Service Fast Stream; NHS STP; Public Health ST1; nursing/HCA screens

Official process notes worth remembering

From the public apply guidance reviewed:

  • Recruiters emphasise being yourself; strengths matter more than CV polish alone.
  • Stage 1 and 2 include hints, tips and practice tests in-account; VAC familiarisation and coaching calls have been offered in recent cycles.
  • Reasonable adjustments are encouraged; you only need to share enough information to set adjustments.
  • Feedback reports are described after Stage 1, Stage 2 and the VAC.
  • Allocation to placements comes after success at VAC and is described as matching preferences with available roles, not as a further assessment stage.

For clinical scientist selection instead of management, see NHS STP Assessment. For specialty public-health selection, see Public Health Specialty Assessment.

How to prepare

  1. Read graduates.nhs.uk apply guidance and complete every official practice set in your account.
  2. Practise untimed careful work on tables, percentages and service metrics, then rebuild pace.
  3. For alignment and VAC themes, rehearse clear examples of collaboration, integrity, patient-centred decisions and calm escalation.
  4. Answer strengths-style items honestly. Do not try to game a profile.
  5. Use third-party PrepPacks only after official materials.

Optional third-party practice

Some links on this page are affiliate links. We may earn a commission if you purchase through them, at no additional cost to you. See our Affiliate Disclosure.

If you want additional graduate-scheme style practice after official materials, an independent UK NHS graduate scheme practice pack can help candidates practise comparable ability and judgement formats.

JobTestPrep UK is an independent third-party preparation provider. It is not NHS England, the GMTS administrators or an official publisher. Check the current UK price and access period before purchase. Preparation cannot guarantee a pass, VAC invitation or scheme offer. Official account materials control the live assessments.

Practice questions

Educational exercises only. Not official GMTS, Cappfinity, SHL or JobTestPrep items.

Numerical reasoning (service and leadership metrics)

1. A trust transformation office tracks project spend:

Workstream Spend
Digital £420,000
Estates £280,000
Workforce £140,000

What percentage of the total is Digital?

A. 45% B. 50% C. 55% D. 60%

Correct answer: B

Total = £840,000. Digital = 420,000 / 840,000 = 50%.

2. Outpatient clinic DNA rates for four months: 9%, 11%, 8%, 12%. What is the mean DNA rate?

A. 9% B. 10% C. 11% D. 12%

Correct answer: B

Sum = 40. Mean = 40 / 4 = 10%.

3. Two directorates share efficiency savings in the ratio 5 : 3. Total savings are £640,000. How much does the larger directorate deliver?

A. £240,000 B. £320,000 C. £400,000 D. £480,000

Correct answer: C

Parts = 8. One part = £80,000. Larger = 5 × £80,000 = £400,000.

4. Staff survey response counts rise from 1,250 to 1,500. What is the percentage increase?

A. 15% B. 18% C. 20% D. 25%

Correct answer: C

Increase = 250. Percentage = 250 / 1,250 = 20%.

5. A waiting-list initiative clears 3,600 pathways in 12 weeks at constant pace. How many pathways per week is that?

A. 250 B. 280 C. 300 D. 320

Correct answer: C

3,600 / 12 = 300.

6. Quarterly leadership development budgets (£000s): 45, 52, 48, 55. What is the range?

A. 8 B. 10 C. 12 D. 15

Correct answer: B

55 - 45 = 10 (£000s).

7. Agency spend falls from £2.0 million to £1.7 million. What is the percentage reduction?

A. 10% B. 12% C. 15% D. 20%

Correct answer: C

Reduction = £0.3m. Percentage = 0.3 / 2.0 = 15%.

8. Three ICBs compare same-day urgent care contacts (thousands): 18, 24, 21. What is the mean?

A. 20 B. 21 C. 22 D. 23

Correct answer: B

Sum = 63. Mean = 21.

9. A business case splits benefits 2 : 3 : 7 across prevention, productivity and elective recovery. If prevention is valued at £120,000, what is elective recovery worth?

A. £300,000 B. £360,000 C. £420,000 D. £480,000

Correct answer: C

One part = £120,000 / 2 = £60,000. Elective = 7 × £60,000 = £420,000.

10. Board pack pages: 64 of 80 pages are completed before the deadline. What fraction remains unfinished in lowest terms?

A. 1/4 B. 1/5 C. 1/6 D. 1/8

Correct answer: B

Remaining = 16. Fraction = 16 / 80 = 1/5.

11. Training cohorts fill at 92% of a 250-place cap. How many places are filled?

A. 220 B. 225 C. 230 D. 235

Correct answer: C

0.92 × 250 = 230.

12. Project milestones complete in 18 days with a team of 6 at constant load. Using simple educational inverse proportion, how many days would 9 people need for the same load?

A. 10 B. 12 C. 14 D. 15

Correct answer: B

Person-days = 6 × 18 = 108. With 9 people: 108 / 9 = 12 days.

Verbal / strengths comprehension

Passage A (questions 13-16)

GMTS Buddy Note (educational extract) Trainees must escalate patient-safety concerns immediately to the placement supervisor even if a senior manager later wants a polished report. Informal messages on personal phones must not include identifiable patient details. Shadowing clinically led meetings is encouraged when invited, but trainees must not present themselves as clinical decision-makers. Travel claims require receipt images uploaded within 10 working days.

13. When should patient-safety concerns be escalated?

A. After polishing a board slide B. Immediately to the placement supervisor C. Only at the end of the scheme D. Via public social media

Correct answer: B

Immediate escalation is required.

14. Identifiable patient details on personal phone messages:

A. Are encouraged for speed B. Must not be included C. Are fine if deleted later D. Are required for claims

Correct answer: B

Forbidden by the extract.

15. May trainees present themselves as clinical decision-makers?

A. Yes during shadowing B. No C. Only at weekends D. Only if invited to the canteen

Correct answer: B

They must not.

16. Travel claims need receipt images within:

A. 2 working days B. 5 working days C. 10 working days D. 30 working days

Correct answer: C

Within 10 working days.

Situational judgement (leadership trainee)

For each scenario, choose the Most and Least effective response.

17. A colleague asks you to hide a data-quality error in a slide pack for a senior meeting because “everyone is busy”.

A. Quietly delete the error and say nothing. B. Correct the figure, flag the issue early to your supervisor, and adjust the narrative honestly. C. Post the error on social media to force action. D. Refuse to attend the meeting without explanation.

Most effective: B Least effective: A

B protects integrity and service decisions. A conceals risk.

18. During a VAC-style group exercise you notice quieter candidates are cut off repeatedly.

A. Dominate the talking time to “rescue” the score. B. Invite quieter colleagues in with a concise question and keep the discussion balanced. C. Stay silent for the whole exercise. D. Mock the louder participants.

Most effective: B Least effective: D

B shows inclusive leadership. D damages collaboration.

19. Your placement mentor is delayed and a ward clerk asks you to countersign a clinically worded form usually signed by clinicians.

A. Sign it to be helpful. B. Decline politely, explain you are not authorised, and help find the right clinician. C. Ask another trainee to forge a signature. D. Take the form home overnight.

Most effective: B Least effective: C

B respects scope and safety. C is dishonest and unsafe.

20. You disagree with a proposed efficiency cut that you believe will harm accessibility for a vulnerable patient group.

A. Stay quiet to protect your placement score. B. Raise the concern with evidence, listen to constraints, and propose mitigations. C. Leak partial figures to a local newspaper. D. Sabotage the spreadsheet overnight.

Most effective: B Least effective: D

B balances challenge with constructive options. D is misconduct.

21. A peer offers you their completed online practice screenshots so you can copy answers into the live Stage 1 assessment.

A. Accept and copy them. B. Refuse, complete your own assessment, and report the offer through the official channel if required. C. Sell the screenshots to other candidates. D. Ignore ethics because “practice is similar”.

Most effective: B Least effective: A

Integrity first. A is cheating.

22. In a video response you realise mid-answer that you stated an incorrect fact about the NHS.

A. Keep talking and hope assessors miss it. B. Pause, correct yourself clearly, and continue with accurate content. C. Abandon the recording and invent illness to get a new slot without permission. D. Blame your flatmate on camera.

Most effective: B Least effective: C

Corrections show composure. Faking illness abuses process.

23. A finance placement asks you to chase overdue invoices. One supplier alleges bullying by another trainee.

A. Gossip about the supplier on a group chat. B. Log the allegation, escalate to your supervisor, and keep invoice chasing separate from investigation. C. Ignore invoices until HR finishes months later without telling anyone. D. Confront the accused trainee angrily in the corridor.

Most effective: B Least effective: A

B separates operational work from safeguarding process. A spreads risk.

24. You are invited to a clinically sensitive meeting as an observer and are asked for a clinical opinion.

A. Give a confident clinical opinion based on a podcast. B. State you are observing as a management trainee and defer clinical judgement to qualified clinicians. C. Invent experience to sound senior. D. Leave silently without explanation.

Most effective: B Least effective: C

B respects professional boundaries. C invents credentials.

Strengths-style reflection (honesty practice)

These items are educational. Strengths tools on live campaigns may look different. Answer as you would on a real strengths inventory: honestly, not strategically gaming.

25. Which statement best matches a strengths approach to feedback?

A. I only want praise; criticism means the assessor is biased. B. I find specific feedback useful even when it is uncomfortable, because it helps me improve. C. I ignore all feedback from managers. D. I collect compliments only.

Correct answer: B

26. Which statement best matches collaborative leadership potential?

A. I prefer teams where I speak and others only listen. B. I enjoy solving problems with others and making space for different viewpoints. C. I dislike shared credit. D. I avoid meetings entirely.

Correct answer: B

27. Which statement best matches patient-centred purpose in non-clinical leadership?

A. Admin work has no link to patients. B. Operational and people decisions still shape patient experience, so I take that responsibility seriously. C. Only clinicians need NHS values. D. Efficiency always beats access.

Correct answer: B

28. Which statement is least consistent with scheme integrity guidance themes?

A. I would escalate safety concerns promptly. B. I would hide inconvenient data if it helps a polished story. C. I would use official channels for adjustments. D. I would complete assessments myself.

Correct answer: B

Mixed aptitude wrap-up

29. A pilot pathway reduces average wait from 42 days to 35 days. What is the percentage reduction?

A. About 12% B. About 14% C. About 17% D. About 20%

Correct answer: C

Reduction = 7 days. 7 / 42 ≈ 0.1667 ≈ 17%.

30. Programme cohorts of 40 trainees allocate mentors in the ratio 1 mentor : 8 trainees. How many mentors are needed?

A. 4 B. 5 C. 6 D. 8

Correct answer: B

40 / 8 = 5 mentors.

Official resources

FAQ

Is the Future Potential Assessment timed?

Official apply guidance reviewed for recent intakes states Stage 1 takes about 45 minutes but is not time limited. Follow the live candidate instructions for your cohort.

Does the scheme use AI to mark video answers?

Public guidance for the Alignment Assessment states video responses are reviewed manually and that the team does not use artificial intelligence for that process.

Are official practice materials available?

Yes. After you apply, preparation materials, hints and practice tests appear in your account for Stages 1 and 2, with further VAC familiarisation described for later stages.

Is GMTS the same as the Civil Service Fast Stream?

No. GMTS is an NHS leadership scheme. The Civil Service Fast Stream is a separate central-government graduate pathway with its own assessments.

Is GMTS the same as NHS STP?

No. STP trains clinical scientists. GMTS trains future NHS managers and leaders.

Do I need an NHS clinical background?

Official messaging emphasises potential and passion for NHS leadership rather than a single clinical degree. Check the live entry requirements page for your cohort, including rules for in-service NHS employees.

Can paid prep guarantee a GMTS offer?

No. Use independent PrepPacks only as supplemental familiarisation after official materials.

Next steps

Return to the UK Assessment Tests hub for related NHS and graduate leadership guides.