Research Article - (2021) Volume 18, Issue 7
Nasreen Ali1*, Erica Cook1, Irtiza Qureshi1, Tamanna Sidika1, Sultan Mahmood2, Muhammad Waqar1 and Gurch Randhawa1
1Institute for Health Research, University of Bedfordshire, Putteridge Bury, Luton Bedfordshire, United Kingdom
2Diverse CT, Luton, Bedfordshire, United Kingdom
Received Date: May 22, 2021; Accepted Date: May 24, 2021; Published Date: May 31, 2021
Background: UK ‘home grown’ (born and/or socialised in Britain) South Asians (Pakistanis, Bangladeshis and Indians) are underrepresented in the NHS nursing and the allied health workforce but there is a dearth of evidence on documented interventions specifically designed for targeted widening participation activity for South Asians. Despite a range of inclusive outreach activities taking place at the University of Bedfordshire (UoB) which has its main campus in Luton, a culturally diverse town located in the South East of England, South Asian prospective students are underrepresented in applications and attendance at the nursing and midwifery summer school. This paper presents the details of the design, delivery and evaluation of the Collaborated Targeted Outreach Programme (CTOP) which is a feasibility intervention aimed at improving the knowledge, perceptions and status of nursing and midwifery among the South Asian community in Luton and increasing numbers of ‘home grown’ South Asian students on nursing and midwifery courses at the UoB.
Methods: The CTOP intervention encompassed a young people’s and community outreach event. The outreach events included break-out discussion workshops designed to de-mystify nursing and midwifery, a debate and a multilingual theatre performance of the barriers and enablers to choosing nursing and midwifery as a course or career option and career journey’ presentations from peer mentors and role models. The outreach events were evaluated.
Results: The design and delivery of the CTOP intervention was effective in meeting the aim of improving the knowledge, perceptions and status of nursing and midwifery among the CTOP participants. All participants had positive views about attending the CTOP outreach events and reported it was a good experience.
Conclusion: The CTOP intervention has demonstrated that there are feasible culturally competent approaches that could be adopted to widening participation in the NHS workforce via the UK’s ‘home grown’ diverse population. In fact, there is no reason not to consider the CTOP approach for other workforce areas within the public sector. What is clear is that CTOP is underpinned by genuine community engagement and empowerment, which requires dedicated skills, time and resources to ensure that diversity and inclusion in the NHS workforce becomes more of a reality rather than rhetoric.
Widening Participation; South Asian (Pakistani, Bangladeshi, and Indian); United Kingdom; Nursing; Midwifery; Intervention
In October 2014, Health Education England (HEE) launched a national programme for widening participation the aim of which is to develop a healthcare workforce that can relate to the communities it serves. HEE provided evidence that links increasing diversity to improvements in cost management, quality of care for patients, and outcomes [1]. It also identified some groups as being under-represented in the NHS workforce: 16-21 year olds, disengaged young people, males (but not in ambulance, medicine, estates and ancillary), Black, Asian and Minority Ethnic groups (Black groups are under-represented in medical and dental, while Asian/Asian British groups are over-represented), and older adults with numeracy and literacy difficulties. One of the key goals of the strategy was to increase the understanding and evidence on what are the specific needs of under-represented groups as they apply, commence and progress on healthcare education programmes and employment.
It is within this context that HEE commissioned the Institute for Health Research (IHR), University of Bedfordshire (UoB) to carry out research ‘building evidence for supporting widening participation for South Asian students: a qualitative study of the East of England and Thames Valley regions’(hereafter referred to as the previous widening participation research) [2]. The Pakistani, Bangladeshi, Indian and Sri-Lankan ethno/national groups are used to define South Asian in the 2011 Census and these groups were included within the South Asian category for the purposes of this research [3]. The term ‘home grown’ refers to those people born or socialised in Britain. Socialisation is referred to as a key construct of identity formation [2,4,5]. The previous widening participation research concluded that a feasibility intervention, the collaborative-targeted outreach programme (CTOP) should be designed to encourage more ‘home grown’ South Asians onto nursing and midwifery courses at the University of Bedfordshire (UoB) and that the intervention should be evaluated. At the time of the CTOP intervention the Access and Outreach Team at the UoB, which has its main campus in Luton, a culturally diverse town located in the South East of England, were carrying out a range of widening participation events and projects to nurture student’s aspirations and demonstrate that UoB is accessible for all. The events they were running included campus visits for year ten health and social care students from local schools and colleges to see the facilitates and learn about careers in nursing, a road safety day where the outreach team, nursing and midwifery academics and the Bedfordshire Fire Service worked together to demystify courses and careers in healthcare and raise awareness of road safety.
Academics from the School of Healthcare Practice were also delivering talks at local colleagues, nursing academics attended careers fairs for secondary schools and a year twelve nursing and midwifery residential summer school was organised.These events were inclusive but not targeted at ‘home grown’ South Asian prospective students. Despite a large local South Asian population living in the town, South Asian prospective students were under represented in applications and attendance at the nursing and midwifery summer school. Evidence shows that existing interventions for under-represented groups are small scale, isolated and specific to the needs of different disadvantaged population groups [6]. During a search of the literature we did not find any documented interventions specifically targeted at widening participation for South Asians in the UK [5]. Therefore based on the low numbers of prospective South Asian students attending UoB widening participation activities, recommendations from the previous widening participation research and the search of the existing evidence base we aimed to design, deliver and evaluate a feasibility CTOP intervention to improve the knowledge, perceptions and status of nursing and midwifery among the South Asian community in Luton and increase numbers of ‘home grown’ South Asian students on nursing and midwifery courses at the UoB.
The design of the CTOP intervention was driven by established community engagement approaches which are recognised to improve adherence to the aims of the intervention and the methodology and findings from the previous widening participation research which showed the need for co-design and culturally competent interventions. The CTOP intervention was developed, delivered and evaluated from 1 February 2017-31 March 2017 and consisted of a young people’s outreach event and a community outreach event intended to improve the knowledge perceptions and status of nursing among the South Asians in Luton.
The young people’s outreach event
For the young people’s outreach event we worked with the UoB Access and Outreach Team, to carry out outreach events at the UoB targeted at South Asian young people. We liaised with and invited South Asian and mixed heritage students from five local schools and colleges. These schools were selected because they have a high proportion of students from South Asian ethnic backgrounds. The head teachers and careers advisors at these schools were contacted for access and attendance of their pupils at the young peoples outreach event. The UoB Access and Outreach Team have an established relationship with schools in Luton which helped with the access and recruitment of the young people. The young people's outreach event however coincided with some student year groups taking exams so students from two local schools attended the outreach event.
The young people's outreach event included break-out discussion workshops ‘demystifying’ nursing and midwifery, a debate on barriers and enablers to choosing nursing and midwifery as a course or career option, career journey’presentations from peer mentors and role models (current South Asian UoB nursing and midwifery student/s and nurse/s working at the Luton and Dunstable University Hospital NHS Foundation Trust and the East London NHS Foundation Trust). a discussion with nursing teaching staff and admissions staff at the UoB to discuss entry requirements and processes for nursing and midwifery courses, a tour of the University and lunch and networking with nurses, midwives and UoB nursing and research staff. The workshops were video recorded (after permission) with the view to using young people’s narrative extracts to focus some discussion at the community outreach event and for disseminating at widening participation conferences/events and Personal, Social, Health and Economic Education (PHSE) sessions in schools.
The community event
An ethnographic approach was used to invite the South Asian community (parents, young people, and religious teachers, community figures) to the community outreach event, in other words using community organisations and informal community networks such as personal community contacts, Facebook, WhatsApp groups, Snapchat and Instagram to snowball information about the outreach event using CTOP publicity materials designed specifically for the CTOP intervention. Publicity materials were circulated for a four week period leading up to the community outreach event. The publicity materials were developed because the previous widening participation research highlighted that young people felt invisible because they were not visually represented on University websites, careers fairs and media. The CTOP publicity was also intended to ‘brand’ the CTOP intervention so that it is easily recognisable as well as being representative of the South Asian community. All publicity materials were reviewed and approved by the then Widening Participation Lead at HEE.
Figure 1: Talking point postcards developed for CTOP branding and publicity.
Figure 2: Posters developed showing South Asian nurses and midwife role models working in the National Health service (NHS).
The community outreach event took place at a well-known community venue located in ‘Bury Park’ which is the name given to a commercial area near Luton town centre which also has a large South Asian settlement. The outreach event for the South Asian community included a drama performance of the key findings from the previous research. We used an applied theatre approach at the UoB. [7-9] and collaborated with the School of Media and Performance and a Masters of Dance Science student from the School developed a script based on the findings from the previous widening participation research and directed the drama. The drama performance focussed on the barriers to choosing nursing courses and careers within the South Asian community identified in the previous widening participation research and was performed by UoB, MSc Public Health Students in a combination of English, Punjabi and Urdu. An audience discussion took place after the drama performance focussing on breaking down barriers related to nursing and midwifery courses and careers within the South Asian community, viewing a video recording of the young people’s debate and discussion about the views young people expressed and barriers and enablers to choosing nursing and midwifery as a course and career, a break-out discussion activity ‘demystifying’ nursing and midwifery and ‘career journey’ presentations from peer mentors and role models [10,11] peer mentors and role models included those that took part in the young people's outreach event). Issues discussed included young people's and community cultural and religious concerns related to choosing a nursing or midwifery course and careers. Bi-lingual speakers and facilitators were available during the event. The participants at the community outreach event were grouped by spoken languages and seated on tables with up to three bi-lingual facilitators. The speakers were also bi-lingual and were therefore able to understand and respond to questions in participant’s vernacular if required.
We carried out a an evaluation of the CTOP intervention at the end of each outreach event by asking participants to complete a short quantitative survey and qualitative comments. The results are presented in the section below.
The survey
We requested quantitative participant feedback using 'Response ware' software with clickers or mobile devices. This was a useful tool for the outreach event as it allowed us to obtain responses from non-English speakers using bi-lingual facilitators in groups rather than one to one support to complete evaluation forms.
The evaluation focussed on the following outcomes: views on the CTOP outreach events and impact on perceptions and acceptability of choosing nursing and midwifery courses and careers. The results for the outreach event are presented in the sections below.
The young people’s outreach event: Participants were asked about their general views towards nursing and midwifery both before and following the event (Table 3). Following the event, more participants agreed (+13.64%) and strongly agreed (+29.32%) that nursing is a relatively well-paid profession. The findings revealed there was some uncertainty about the pay salaries for midwives as compared to nurses form midwifery as compared to nursing at the beginning of the outreach event, which was less evident following the event. There was also an increase in those who agreed (+3.6%) and strongly agreed (+9.32%) that society needs more midwives.
Participants were asked their views and level of confidence in promoting nursing and midwifery before and after the event (Table 4). The findings confirmed that 57.14% and 44.12% would consider a career in nursing and midwifery respectively. There was a slight change found for nursing (+5.36%) and midwifery (+2.94%) following the event. The findings also revealed that more participants felt confident in promoting nursing (+8.82%) and midwifery (+48.49%) as a career to another person following the event. Most participants stated that the event had also changed their views towards both nursing (93.75%) and midwifery (85.71%) respectively. In addition, the event was viewed enjoyable to many of the participants who took part (95.65%).
The community outreach event: Perceptions of nursing and midwifery changed when before and after results were compared. The data captured is described below.
Participants were asked about the general views towards nursing and midwifery both before and following the event (Table 1). Following the event, more participants (n=3) strongly disagreed that nursing is a female occupation. The findings also confirmed that more participants strongly agreed (n=11) that nursing is a relatively well-paid profession. The findings revealed there was some uncertainty about midwifery compared to nursing salaries at the beginning of the outreach event, which was less evident following the event with more participants who disagreed (n=7) or strongly disagreed (n=9) that there was a difference. More participants agreed and strongly agreed that society needs more midwives following the event (+6.34%).
Participants were asked about their views and confidence in promoting nursing and midwifery before and after the event (Table 2). The findings confirmed that 55.56% and 33.90% would consider a career in nursing and midwifery respectively. An increase was found for both nursing (+6.2%) and more notably midwifery following the event (+25.07%). The results also found that more participants stated that they would want their children to study nursing (+34.35%) and midwifery (+37.36%) at University following the event. There were more participants who felt confident in promoting nursing (+37.39%) and midwifery (+58.88%) as a career to another person following the event with participants stating that the event had changed their views towards both nursing (94.87%) and midwifery (87.80%) respectively. The event was also well received and viewed enjoyable to most of the participants who took part (97.37%).
The qualitative comments
We also recorded qualitative views about the outreach events and activities by asking participants to comment using Twitter, Snapchat and post-it notes at the end of the event. Participants were asked to answer three questions: (1) what did you find most enjoyable about the CTOP outreach event? (2) What could be done to improve the CTOP outreach event? (3) Anything else you would like to tell us?
Young people’s views about the outreach event: The main themes emerging from the young people’s views and verbatim comments are presented in Table 5 and the main themes emerging from the views of the community are presented in Table 6. Participants at the community outreach event who were unable to speak and/or write English relied on the bilingual facilitators to translate and note down their views.
| Strongly agree | Agree | undecided | Disagree | Strongly disagree | ||
|---|---|---|---|---|---|---|
| Nursing is a female occupation | Pre | 5.45% (3) | 21.82% (12) | 3.64% (2) | 30.91% (17) | 38.18% (21) |
| Post | 8.33% (3) | 5.56% (2) | 0% (0) | 19.44% (7) | 66.67% (24) | |
| Nursing is a relatively well-paid profession | Pre | 5.08% (3) | 35.59% (21) | 15.25% (9) | 25.42% (15) | 18.64% (11) |
| Post | 35.90% (14) | 53.85% (21) | 0% (0) | 2.56% (1) | 7.69% (3) | |
| Midwifery is better paid than nursing | Pre | 18.75% (12) | 35.94% (23) | 29.69% (19) | 12.50% (8) | 3.13% (2) |
| Post | 10.53% (4) | 7.89% (3) | 13.16% (5) | 39.47 (15) | 28.95% (11) | |
| Society needs more midwives | Pre | 52.46% (32) | 36.07% (22) | 3.28% (2) | 6.56% (4) | 1.64% (1) |
| Post | 71.79% (28) | 23.08% (9) | 2.56% (1) | 0% (0) | 2.56% (1) |
*The numbers who took part in the evaluation differ by question and time point.
Table 1: Community event results.
| Yes % (n) |
No % (n) |
||
|---|---|---|---|
| Would you consider a career in nursing? | Pre | 55.56% (30) | 44.44% (24) |
| Post | 61.76% (21) | 38.24% (13) | |
| Would you consider a career in midwifery? | Pre | 33.90% (20) | 66.10% (39) |
| Post | 58.97% (23) | 41.02% (16) | |
| Would you want your children to take up a career in midwifery? | Pre | 52.50% (21) | 47.50% (19) |
| Post | 82.86% (29) | 17.14% (6) | |
| Would you consider going to university to study nursing? | Pre | 44.44% (24) | 55.56% (30) |
| Post | 78.79% (26) | 21.21% (7) | |
| Would you consider going to university to study midwifery? | Pre | 29.31% (17) | 70.69% (41) |
| Post | 66.67% (22) | 33.33% (11) | |
| Do you feel confident in promoting nursing as a career to another person? | Pre | 50.98% (26) | 49.02% (25) |
| Post | 88.37% (38) | 11.63% (5) | |
| Do you feel confident in promoting midwifery as a career to another person? | Pre | 28.30% (15) | 71.70% (38) |
| Post | 87.18% (34) | 12.82% (5) | |
| Has the event changed your view of nursing? | Pre | NA | NA |
| Post | 94.87% (37) | 0% (0) | |
| Has the event changed your view of midwifery? | Pre | NA | NA |
| Post | 87.80% (36) | 4.88% (2) | |
| Have you found today enjoyable overall? | Pre | NA | NA |
| Post | 97.37% (37) | 2.63% (1) |
*The numbers who took part in the evaluation differ by question and time point.
Table 2: Community event results-Participants Opinion.
| Strongly agree | Agree | undecided | Disagree | Strongly disagree | ||
|---|---|---|---|---|---|---|
| Nursing is a female occupation | Pre | % 0 (0) | 2.86% (1) | 14.29% (5) | 34.29% (12) | 48.57% (17) |
| Post | 5.71% (2) | 5.71% (0) | 0% (0) | 5.71% (2) | 82.26% (29) | |
| Nursing is a relatively well-paid profession | Pre | 3.03% (1) | 36.36% (12) | 30.30% (10) | 27.27% (9) | 3.03% (1) |
| Post | 32.35% (11) | 50% (17) | 5.88% (2) | 2.94% (1) | 8.82% (3) | |
| Midwifery is better paid than nursing | Pre | 8.57% (3) | 8.57% (3) | 62.86% (22) | 11.43% (4) | 8.57% (3) |
| Post | 5.88% (2) | 8.82% (3) | 44.12% (15) | 17.65% (6) | 23.53% (8) | |
| Society needs more midwives | Pre | 32.35% (11) | 35.29% (12) | 29.41% (10) | 2.94% (1) | 0% (0) |
| Post | 41.67% (15) | 38.89% (14) | 8.33% (3) | 0% (0) | 11.11% (4) |
*The numbers who took part in the evaluation differ by question and time point.
Table 3: Young people’s event results
| Yes % (n) |
No % (n) |
||
|---|---|---|---|
| Would you consider a career in nursing? | Pre | 57.14% (20) | 42.86% (15) |
| Post | 62.50% (20) | 37.50% (12) | |
| Would you consider a career in midwifery? | Pre | 44.12% (15) | 55.88% (19) |
| Post | 47.06% (16) | 52.94% (18) | |
| Would you want your parents/carers to take up a career in midwifery? | Pre | 51.43% (18) | 48.57% (17) |
| Post | 59.38% (19) | 40.63% (13) | |
| Do you feel confident in promoting nursing as a career to another person? | Pre | 70.59% (24) | 29.41% (10) |
| Post | 79.41% (27) | 20.59% (7) | |
| Do you feel confident in promoting midwifery as a career to another person? | Pre | 27.27% (9) | 72.73% (24) |
| Post | 75.76% (25) | 24.24% (8) | |
| Has the event changed your view of nursing? | Pre | NA | NA |
| Post | 93.75% (30) | 6.25% (2) | |
| Has the event changed your view of midwifery? | Pre | NA | NA |
| Post | 85.71% (30) | 14.29% (5) | |
| Have you found today enjoyable overall? | Pre | NA | NA |
| Post | 95.65% (22) | 4.35% (1) |
*The numbers who took part in the evaluation differ by question and time point.
Table 4: Young people’s event results-Participants Opinion.
| What did you find most enjoyable about the CTOP outreach event? | |
| Theme | Verbatim comments |
| Enjoyable debate exercise | ‘The debate’. ‘I enjoyed the debated because I was able to hear and project different views’. ‘I love the debate and personal panel. It gave me the confidence to go into paediatric nursing’. ‘Debate…’ ‘The debate was the best’. ‘I enjoyed the debate because we were able to tackle stereotypes’. ‘The debate was enjoyable as we were able to challenge stereotypes and the speakers’. ‘The debate was fun’. ‘Debate and group work’. ‘The debate about midwifery’. |
| Personal stories/interacting with nurses & midwives | ‘I liked the environment and how the speakers were friendly and answered our questions’. ‘Very interactive, informative and the personal stories’. ‘…and listening to people and their stories’. ‘…and panel stories’. ‘Learning about midwifery and what they do and how they deal with it’. ‘I found it useful that real life midwives and nurses talked to us about their jobs and experience’. ‘Learning how midwives and nurses change and help lives’. ‘The speakers are a good form of individual’s experiences and role models’. ‘Hearing the stories about midwifery and nursing’. ‘Panel of speakers’. ‘Nurse stories were very interesting’. …personal stories about nursing and midwifery which was very interesting…’ ‘… and hearing personal experiences’. |
| Interactive discussion and group work | ‘I enjoyed how interactive the organisation was and made us think’. |
| University tour | ‘I enjoyed the tour…’ ‘The tour…’ ‘I like the dinner room’. ‘I enjoyed the tour of the university’. ‘Tour and debate’. ‘Campus tour…I’ve not seen inside a university before.’ |
| Overall learning | ‘That fact that it was very helpful and inspiring’. ‘Learning more about nursing and midwifery’. ‘It showed me how beneficial and engaging the service is towards both genders’. |
| Completing the evaluation survey | ‘…and questionnaire as I got to see everyone’s views and the university environment’. ‘The quiz’. |
| What could be done to improve the CTOP outreach event? | |
| More/longer breaks | ‘Longer breaks’. ‘Break times could be longer’. |
| The University tour | ‘…and give us more information on the tour’. ‘Make the tour more fun’. ‘Allow us to interact more with more than one school and allow us to have a longer tour of the university’. |
| Improvements to content | ‘Use younger people (our age)’. ‘More events to be held e.g. broadcasted on TV’. ‘Practical work’. ‘More interactive activities’. ‘Maybe something more interactive’. ‘More speakers (different professions)’. ‘Show videos and real life experiences’. To improve, the speakers could have used more visual images and videos to make their speeches more interactive. More information about different career paths and qualifications needs’. ‘The debate could be longer’. ‘Give us as much information as possible’. ‘Less speakers, more presentations’. ‘More time on debates’. ‘Make it more interactive’. ‘More active, not just sitting down’. ‘Less talking from speakers’. |
| Food wasn't nice and give more information on the tour | |
| More schools attending the CTOP outreach event | ‘More schools coming to the university’. ‘More schools’. |
| Anything else you would like to tell us? | |
| How to improve the CTOP outreach event. | ‘Have the event run more often to inform more people’. ‘Thank you for talking to us. Now I know which career path I would like to follow in nursing’. Nothing - everything was good’. ‘Nothing-it was amazing’. ‘Nothing’. ‘No suggestions’. It was very good - thanks! ‘Good job! You really inspired me’. ‘The people here are amazing, especially the man’ [male nurse]’. We would like to meet and talk to the people in the University’. |
| Food | ‘Food was good’. ‘The buffet was nice’. ‘The food was nice’. ‘The food was amazing’. ‘The food was amazing and all round great event’. |
| Further suggestions | ‘Hold more events like this please’. To have more visits like this as it helped give a better understanding. ‘More workshops’. ‘I need to know what subject to take to be a nurse’ |
Table 5: Young people’s views about the outreach event.
| What did you find most enjoyable about the CTOP outreach event? | |
| Personal stories/interacting with nurses & midwives | ‘Meeting nurses and midwives from my community’. ‘Meeting a male nurse’. ‘Good information and the personal stories from the nurses’. ‘Listening to stories of the midwife and nurses’. ‘Good to hear how nurses and the midwife got into job. It is a good job’. ‘What the nurses said was so inspiring, I want my daughter to think about nursing now’. ‘Good information and the personal stories from the nurses’. |
| Drama performance | ‘Drama was very eye opening’. ‘Very informative play’. ‘The drama was excellent’. ‘I learn a lot from the show’. ‘Drama was informative and funny-very good’. ‘Not only good to be a doctor or nurse. Nurse is like doctor and I learn this’. |
| Discussion/feedback sessions and influence of perceptions and status of nursing and midwifery | ‘Discussion was good to hear views of others’. ‘Liked that everyone joined in the discussion and in end I feel it is okay to be a nurse’. ‘Debate was good coz hear views of other people and it has changed my mind now’. ‘Easier to become a midwife’. ‘There is a shortage of midwives and nurses from Muslim backgrounds and like the midwife said we need more Muslim midwives’. ‘Everyone very friendly and helpful and I understand’. |
| Increasing knowledge about nursing and midwifery | I learn a lot about being a nurse and midwife, what I need to do and pay. ‘I did not think my son could do nursing, now I think it is okay’. ‘It is a good job. Important as doctor or dentist’. ‘I want to be a nurse, what can I do?’ |
| Food and venue | I like the hall and the food. Place was lovely. ‘Hall was good’. ‘Very nice food’. ‘Loved the food’. |
| What could be done to improve the CTOP outreach event? | |
| Include more young people and men | ‘You should include young people as well’. ‘My children wanted to come and learn from this’. ‘There should me more men at the event.’ ‘More of these events please for parents with young people so they can discuss together because that is problem’. |
| More personal stories from nurses & midwives | More personal stories. I learn so much. They were inspiring. |
| Length of outreach event and time-keeping | Should be longer event. ‘More time for debate and discussion and not rushing’. ‘Was too rushed’. ‘Not enough time for lunch’. |
| More events | There should be more events, one not enough. |
| More information about nursing and midwifery | More information on how to apply for course. ‘More about how to get qualifications’. ‘I want to be a nurse, am I too old’? |
| University tour | What the University look like that my daughter study in if going to be nurse? |
| Anything else you would like to tell us? | |
| Positive comments | ‘Very inspiring’. ‘Good presentations’. ‘Very friendly people’. |
| Influence on views of nursing and midwifery | I have changed my mind about nursing. I think it is a good job for girls and boys can do it also’. ‘I did not know there are many types of jobs in nursing’. ‘I still think being nurse or midwife not good for a Muslim man’. ‘What subjects will be taught if I want to be a nurse’? |
Table 6: Community views about the outreach event.
Overall the design and delivery of the CTOP intervention was effective in meeting the aim of improving the knowledge, perceptions and status of nursing and midwifery among the South Asian community in Luton. All participants had positive views about attending the CTOP outreach events and said it was a good experience. There were some limitations to our CTOP intervention. We were unable to demonstrate that the increase in numbers of ‘home grown’ South Asian students on nursing and midwifery courses at the UoB is directly attributed to the CTOP intervention. This is because the CTOP intervention was time restricted due to limited resources. It is possible that if the intervention had run for a longer period or more frequently and CTOP was attributed on application forms and reflected on Higher Education Access Tracker (HEAT) data we would be able to report that the increase in the number of students from South Asian backgrounds was due to applicants participation in CTOP outreach events. We also recognise that the CTOP intervention was carried out within a specific community and within a particular geographical location. We would need to build the evidence base to assess the transferability of the CTOP intervention when working with different ethnic communities in different locations.
The CTOP intervention was built on a good collaboration and relationships between the UoB Access and Outreach Team, Luton schools and the South Asian community, The School of Media and Communication and the Institute for Health Research which enabled the design and delivery of the CTOP intervention. The CTOP intervention also highlights that it is feasible to deliver the CTOP intervention to other under-represented groups to increase numbers of ‘home grown’ students on nursing and the allied health courses and careers. Also having more regular CTOP events may improve recruitment to University courses.
In summary, the CTOP intervention has demonstrated that there are feasible culturally competent approaches that could be adopted to widening participation in the NHS workforce via the UK’s ‘home grown’ diverse population. In fact, there is no reason not to consider the CTOP approach for other workforce areas within the public sector. What is clear, is that CTOP is underpinned by genuine community engagement and empowerment, which requires dedicated skills, time and resources to ensure that diversity and inclusion in the NHS workforce becomes more of a reality rather than rhetoric.
