WP Nursing

Widening participation in nurse education

Professor Liz Thomas, Dr Vanessa Heaslip, Dr Vicky Duckworth and Dr Michele Board have been examining widening participation in nurse education.

Context

The nursing profession faces a double dilemma of both recruiting and retaining sufficient nurses from diverse backgrounds to meet the health needs of the population. This challenge has become more complex with the introduction of tuition fees and the UK’s imminent departure from the European Union, especially as the current nurse force is aging and there are many unfilled vacancies. Data from the Universities and Colleges Admissions Service (UCAS) showed that by the 15th January deadline for the 2017 cycle there were 23% fewer applicants to nursing from England, and 25% fewer applicants from the EU (excluding the UK) compared to the same time the previous year. Figures released by UCAS in August 2017 that there was a drop of about 8% in the number of students taking up nursing places. These declines in applicants and enrolments follow changes to the funding of nurse education, particularly the ending of bursaries, to be replaced by student loans, and the introduction of tuition fees. At the time of these changes the government promised an additional 10,000 healthcare professionals over the following five years; at the moment it is difficult to see how these numbers will be achieved. Increasing the recruitment and retention of nurses is essential to fill the large number of vacancies for nurses and healthcare professionals more generally.This can be understood as a perfect storm that if not addressed could have catastrophic implications for those needing nursing care.

Research to date

We have undertaken:

• A review of literature which found that there is a lack of conceptualisation and focus regarding mechanisms to encourage and support wider diversity of entrant to the profession.
• Interviews with 70 students and recent graduates from NHS-funded programmes.
• A review of institutional strategies to widen participation in health.
• A survey of 806 registered nurses responded to the online survey which sought to explore attitudes towards diversity.
In summary our research has discovered:
• A lack of clarity about what diversity and WP mean in nurse education context, including identification of target groups, recognition of intersectionality, and looking beyond access across the student lifecycle. Tendency to address at a generic level or to focus on a single aspect of diversity, such as race or age.
• A stronger focus on access, and less focus on retention and success in higher education, and progression into and retention in the workplace.
• Limited evidence base about how to expand participation and increase diversity and success, and existing research and interventions focus on what students lack, rather than the richness of what they bring to nurse education.
• Concern amongst existing students and workforce that funding changes will reduce diversity, and particular concern with regards to some WP groups.
• The importance of staff diversity for patient care and wellbeing.

Outputs

Literature review:  Widening participation in nurse education: An integrative literature review
Literature review: Literature Review on approaches and impact of interventions to facilitate Widening Participation in Healthcare Programmes

Research report: NHS funded healthcare education programmes. Building the evidence for supporting widening participation
Download Here

Working paper 1: Persistent passion: Implications for policy and practice in widening access and success in healthcare education... Download Here
Working paper 2: to be made available shortly
Catalyst event report: to be made available shortly
Slides from the Catalyst event  Download Here

Next steps

Our work to date points to the need for further research about how to secure a diverse workforce to mirror and care for a diverse population. We have identified the following areas of potential future inquiry:
i. Who is going to look after the ageing population?
ii. How do we make the nursing workforce reflect the communities they care for?
iii. What is the impact of changes in student funding on who enters nurse education?
iv. How can completion rates in nursing be maximised to secure a sufficiently large and diverse workforce to care for a diverse population?
v. How can nurses from disadvantaged and diverse backgrounds be enabled to be successful in the workplace?
vi. What is the contribution of nurse education social mobility and social justice in the UK?
vii. How can we promote better collaboration between the health and education sectors to secure a diverse nursing workforce?