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 17-20 undergraduate students p.a.
 Recruitment mainly from local area
Approximately
93% of
applicants
from 20072011 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 wasn’t an option for me to leave the island
for 3 years of study.
I hadn’t studied in over a decade...I wasn’t a particularly
high achiever. However, I discovered that with a bit of
determination and commitment, it’s 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 wouldn’t 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 student’s 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 didn’t do
well – I see the investment
that is made for me and that
makes you invest in yourself”
(3rd year student)
The student’s 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”
(3rd year student nurse)
“They [mentors]
want you to
succeed”
(3rd year student nurse)
“The learning environment is
good. The clinical network is
used to give students the best
experience”
(3rd year student nurse)
The student’s 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
– http://www.youtube.com/watch?v=qD9VtFMGA4Y
• 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
KNOWLEDGE & SERVICE EXCHANGE NETWORK BETWEEN NHS
WESTERN ISLES & UNIVERSITY OF STIRLING
NES
NHSWI
Head of clinical
governance and
practice
development team
Policies and Procedures
MPT reviews
NMAHP Education forum
Honorary contracts
Designated teachers
Clinical Strategy
Support & advice
UoS WI campus staff
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
opportunities
challenges
 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