Recruit and Retain: The nursing perspective in the Western Isles of Scotland Strategies for recruiting and retaining health care workers in remote and rural areas 2011 Dr Annetta Smith 11 October 2011

Overview Pre-registration nurse education The start: recruiting The experience: retaining The finish: measures of success Post-registration nursing Recruit, retain, enhance, develop Future perspectives

The Start: Recruitment Background The funding for nursing and midwifery students comes from the Scottish Government's Health budget The NHS commissions the number of nursing and midwifery students using mechanisms calculated to meet the healthcare sector's workforce requirements for the future The NHS and the HEIs collaborate to achieve the best outcomes. A critical measure is that an optimum number of students successfully complete the programmes they embark upon, and subsequently enter the Nursing & Midwifery Council (NMC) Register and enter employment in the healthcare sector At present non means tested bursary is £6578 P.A.

The Start: Recruitment Average recruitment undergraduate students p.a. Recruitment mainly from local area Approximately 93% of applicants from had a local contact address on application

The Start: Recruitment Applications received from: School leavers FE / HEI graduates Mature students Access courses Revision of career aspirations From other employment Re-joining the workforce

Some might say that leaving a good job with prospects and a regular income is risky or even foolish, but I can honestly say that I have never once looked back. I took the plunge to retrain as a nurse and have grown every day since, on both a personal level and a professional level... The campus location was of vital importance to my decision to study nursing. My life is here, my family, my children, my home – it wasnt an option for me to leave the island for 3 years of study. I hadnt studied in over a decade...I wasnt a particularly high achiever. However, I discovered that with a bit of determination and commitment, its amazing what can be achieved. I enjoyed it so much that I completed my degree with Hons, and am now studying at Masters level. If someone had told me a few years ago I would be doing this now, I wouldnt have believed them. Some might say that leaving a good job with prospects and a regular income is risky or even foolish, but I can honestly say that I have never once looked back. I took the plunge to retrain as a nurse and have grown every day since, on both a personal level and a professional level... The campus location was of vital importance to my decision to study nursing. My life is here, my family, my children, my home – it wasnt an option for me to leave the island for 3 years of study. I hadnt studied in over a decade...I wasnt a particularly high achiever. However, I discovered that with a bit of determination and commitment, its amazing what can be achieved. I enjoyed it so much that I completed my degree with Hons, and am now studying at Masters level. If someone had told me a few years ago I would be doing this now, I wouldnt have believed them.

Some unknown impacts Change in number of school leavers Destination of school leavers – local vs. mainland Job security Availability of social/ family support Growing impact of finance on study and careers decisions

The students academic experience Education experience needs to be equitable with students on similar programmes Access to wider network Good grade trajectory I would feel bad if I didnt do well – I see the investment that is made for me and that makes you invest in yourself (3 rd year student)

The students clinical experience The practice placement experience needs to meet NMC requirements NMC review 2011(QA monitoring), e.g. Evidence of effective partnerships between education and service providers, including other education institutions Good rotation of placements and breadth of experience (3 rd year student nurse) They [mentors] want you to succeed (3 rd year student nurse) The learning environment is good. The clinical network is used to give students the best experience (3 rd year student nurse)

The students social experience...

Measures of success: UoS Bomont Prize winners for excellence in clinical practice Rachel Macleod 2006/7 Norma Macleod 2008/9

Measures of success: Completion

Employability and destinations Local / National / UK employers: –NHS –Social care –Private sector –Oil industry International

Post-registration: recruitment Healthy recruitment of Band 5 – 7 Recruitment of specialist nurses can be more challenging Increasing remoteness can impact on recruitment

Post-registration: retain, enhance, develop One year job guarantee / Flying Start Education – pathways – Development opportunities - clinical career structure e.g. –Clinical academic careers (Clinical Academic Fellowships) –Clinical doctorates Access to wider clinical networks Maintaining competence and confidence Job fulfillment Value base

Developing perspectives: Enhancements NES NHSWI Head of clinical governance and practice development team UoS WI campus staff Policies and Procedures MPT reviews NMAHP Education forum Honorary contracts Designated teachers Clinical Strategy Support & advice KNOWLEDGE & SERVICE EXCHANGE NETWORK BETWEEN NHS WESTERN ISLES & UNIVERSITY OF STIRLING University of Stirling and NHSWI has developed a Knowledge and Service exchange network in which mutual and complementary goals are developed and supported between the University of Stirling and NHS Western Isles

Future perspectives Challenges Financial NHS re-design Age profile of workforce Integration agendas Review of nurse education in Scotland Opportunities NHS re-design Integration agendas Review of nurse education in Scotland Better use of simulation / VLE Integrated project with Education / NHS / HEI for hard to recruit areas Research –development of robust evidence base challenges opportunities