Research study exploring the barriers and enablers for progression to Health and Social Care careers for disadvantaged/ underrepresented Health and Social Care students studying in Further Education Colleges
Overview
This report describes a unique qualitative study, which is the output of collaboration between Further Education (FE), Higher Education (HE) and National Health Service (NHS) employers. This study is unique because of the triumvirate approach between these key stakeholders. The study shows there is a clear requirement for deeper collaborative working between FE colleges, Health and Social Care (HSC) employers and Higher Education Institutions (HEIs) to support the progression of FE students into HSC careers and HEI-related study, preventing them from falling between the organisational ‘gaps’. The study recommendations are pertinent to the FE, HE and healthcare sectors. These recommendations are based on prima facie evidence from FE HSC current and former students, employers and insights and knowledge obtained from the collaboration between FE, HE and employers.
Study Aims and Objectives
• To ascertain the barriers that disadvantaged/underrepresented HSC students in FE colleges encounter when accessing HSC careers/ HEI programmes.
• To ascertain the enablers that support disadvantaged/under-represented HSC students to pursue HSC careers/HEI programmes.
• To explore with employers what they could do to mitigate barriers and enable HSC disadvantaged/ underrepresented FE students to access opportunities and pursue careers in HSC.
Methodology
This is a qualitative study, which incorporated 5 FE student focus groups and individual interviews with alumni and employers from North and West London local Hospital Trusts. There were 45 participants in total.
Findings
Themes and sub-themes from student Focus Groups and alumni
1. Motivation and influence on study Health and Social care
1.1 Self-motivation, determination and innate feelings/qualities
1.2 External influences 1.3 Personal experiences that influence motivation
2. Academic expectations
2.1 Grade boundaries 2.2 The pressures and barriers of studying 2.3 Knowledge of higher education route, supports and other career options
3. Academic and personal support in FE colleges
3.1 Support from teachers 3.2 Other support services
4. Perceptions of Health and Social care careers 4.1 Financial implications 4.2 Stressors, pressure and burnout
Themes and sub-themes individual interviews with healthcare providers
1. Employment and Training Qualifications
1.1 HSC courses 1.2 Development Strategies 1.3 Recruitment and Retention 2. HSC Career Pathways
2. 2.1 Identification of career pathways 2.2 Enablers of career progression 2.3 Barriers to career progression
3. 3. Networking and Collaboration 3.1 Partnerships
Limitations of the Study
This study was limited to colleges and HSC providers in the North and West London regions. It may be beneficial to extend this study to other regions, however it is likely that the findings are broadly representative. The study findings may be enriched through interviewing students who had completed HSC programmes, but pursued other professions/ HE programmes.
Recommendations
FE Colleges
1. Training and support needs to be available for careers advisors to enable them to comprehensively advise students on HSC careers including: course choice; breadth of career options (including terms and conditions) and entry requirements. This training needs to be undertaken in collaboration with FE colleges, employers and HEIs.
2. As part of FE enrolment/induction, students must be given the opportunity to meet HSC providers/HEI representatives to obtain information on available healthcare pathways. Following these sessions each student must be given an opportunity to map their career options so that they can be supported with the right information to inform their progression.
3. Students should be provided with relevant and high-quality HSC clinical insight placement opportunities. When placement capacity is unavailable, high quality replacement simulation opportunities must be provided for all learners.
4. HSC students should have a minimum entitlement to access care suite facilities. A review of care suite facilities must be undertaken by FE providers to ensure that the minimum entitlement is available to all learners to ensure equity.
5. FE colleges, in partnership with HSC providers, must ensure that adequate pastoral support is available for students on placements. Students must be offered opportunities for debriefing when they complete the placements.
6. Further training of FE staff must occur to support them in recognising mental health concerns for HSC students, utilising the available pastoral policies, for example mental health, student wellbeing and safeguarding. A review of the learner voice policies will further enable the strengthening of student feedback.
7. FE colleges must provide students with comprehensive information on the financial assistance available to them including those that have caring or childcare responsibilities. This information must be delivered to students during the induction period.
8. FE colleges must work in collaboration with HEIs and employers to ensure a strategic oversight for placement capacity to offer T-Level students the requisite 45 day placement, for the Employer Set Project to be achievable.
Authors
Professor Karen Buckwell-Nutt (Buckinghamshire New University)
Dr Karen Harrison-White (Brunel University London)
Suba Dickerson, Assistant Principal, Harrow College and Uxbridge College
Associate Professor Margaret Rioga (Buckinghamshire New University)
Acknowledgements
This project was funded by the College Collaboration Fund (CCF) and Health Education England (HEE).
We would like to thank the Further Education Colleges who supported this project. We would additionally like to thank the students and alumni and NHS employers, for their valued contributions.
1. HEIs must form strategic partnerships with FE colleges and HSC providers to promote operational collaboration on curriculum design and progression pathways.
2. HEIs must have a strategic objective which is specially targeted at strengthening the liaison between FE colleges, HEIs and HSC providers to promote the recruitment and retention of disadvantaged and underrepresented students.
3. HEIs must strengthen their work with their outreach/widening participation teams to ensure that subject experts link with HSC students to provide information on HEI study, course options and pathways, the entry level requirements and associated funding arrangements.
4. HEIs must engage with and provide the following information to FE college career advisors: programme options; breadth of career options (including terms and conditions) and entry requirements.
5. HEIs, FE colleges and HSC providers must have strategic oversight of placement capacity across the sector to enable quality placement opportunities for all learners (eg. T-Levels, multi-professional groups, HSC students).
6. HEIs should work in collaboration with FE colleges and HSC providers to inform and develop a simulation strategy, for example, including human factors.
HSC Providers
1. HSC providers must have early engagement with HSC FE students to provide career information and pathways available within HSC. Specific case studies must be given by employers to illustrate career progression opportunities for all HSC students, but specifically for disadvantaged and under-represented students.
2. All HSC providers must consistently engage with FE Colleges to ensure they understand the requirements of HSC qualifications.
3. HSC providers must work in partnership with FE colleges and HEIs to ensure there is strategic oversight to maximise placement capacity. This may require specific ringfencing of work experience opportunities.
4. HSC providers should work in collaboration with FE colleges and HEIs to inform and develop a simulation strategy. This strategy will include the use of virtual reality and simulation to deliver the required knowledge, skills and behaviours within occupational Standards.
5. A diverse and inclusive HSC workforce must engage with HSC students to enable them to effectively role model and breakdown ‘glass ceiling’ perceptions, particularly with BAME communities, but also including other disadvantaged groups.
6. HSC providers must engage with HSC students to promote a positive professional image to mitigate the influence of negative media reports.
7. All HSC providers must work with FE Colleges to develop clear career progression pathways for employment, for example from T level to employment opportunity (including apprenticeships).
8. HSC providers must train staff to understand how to engender a sense of learner belongingness, through careful work experience orientation, assignment of a mentor/ buddy and through debrief. To achieve this there needs to be a practice-based education infrastructure specifically to support these more vulnerable learners.
9. HSC providers must ensure that equality, diversity and inclusion related barriers to career progression are eradicated; this will enable a full representation of all communities at senior level. Students, for example, from BAME or disadvantaged backgrounds, will be inspired to undertake careers in HSC if they can see representative role models in senior positions.
Future research
It is recommended that future research should be conducted as a follow-up study with participants from FE colleges, HSC employers and HEIs to explore the impact of the recommendations outlined in this report.
Conclusion
In reviewing the findings of this study and evidence from the extant literature, it is apparent that students on HSC programmes provide an important employment pipeline for healthcare providers to close the current healthcare workforce gap. Although students have a clear motivation to enrol on HSC FE programmes, many do not subsequently follow HSC careers or further related HE study. Students from disadvantaged and under-represented groups are particularly vulnerable to deviating from their chosen career choice due to a number of pervasive and complex disadvantaging issues including: financial pressures; poor physical and mental health; conflicting caring responsibilities; lack of timely academic and career related information and support; peer and family pressures; negative media images and the perception that there are few representative role models in senior positions. Clinical insight placements are highlighted as supporting students to gain an important awareness into HSC and understanding of available career opportunities. However, limited placement capacity can lead to inequity in gaining this experience. This study makes several important recommendations to enhance progression opportunities into HSC careers, with a particular focus on those from disadvantaged and under-represented groups.
