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Welcome !“Promoting ethnic diversity in paramedic education and

the profession”

Harminder BainsEducation Transformation Manager – Health

Education East Midlands

www.hee.nhs.ukHousekeeping

Here to helpHere to help

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The journey so far…

• Young Carer• Recent experience • Different sector similar challenges• Paramedic Lead for HEEM

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A bit about today

Expert Individuals

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Three ask

1. Share2. Recommend3. Accountable

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#ParamedicDiversity@EastMidsLETB

@HEEM_EduComms

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Strategic Overview - Paramedic Evidence based

EducationProject (PEEP)

David FarrellyLocal Director

Health Education East Midlands

29th July 2015

9

Paramedic Evidence Based Education Report

• Commissioned by DH’s National Allied Health Professional Advisory Board - funded by the College of Paramedics, reporting in October 2013 and passed over to HEE in autumn 2013

• Provides an evidence base to progress the strategic direction of the standardisation of education and training

• Various education and funding models in place across the UK - PEEP seeks to address these issues

• Delivery lies with Health Education England (HEE), the College of Paramedics and the Association of Ambulance Service Chief Executives

• HEE asked College of Paramedics to co-chair an oversight national steering committee including devolved nations invited to be active participants to deliver UK solution

10

PEEP Report• In 2013 the PEEP report identified that The paramedic profession as the only Allied

Health Profession:o With no single education level entry route to registration with HCPC o No clearly nationally defined or aligned career structure leaving inconsistency

in titles, scope of practice and purpose– Advanced prescribing necessitates both to be agreed and in place before the non-

medical prescribing board will consider a business case from the profession– The outcomes of Keogh’s urgent and emergency care review – have a direct

influence on the future work force plan as well as the role paramedics will play in providing services to the public, through the urgent care commissioning framework

11

Steering Group - Key Recommendations

• There should be a nationally agreed approach to the commissioning and funding of paramedic education

• Models of pre-registration education and training should align with other non medical professions and lead to an all graduate profession

• The standards of proficiency and Standards of Education and Training are both HCPC documents and were reviewed by them and updated in 2014. The College of Paramedics Curricula Guidance and Competency Framework were submitted for independent Educational reviewing to confirm the standards of education at BSc (Hons) HE level 6

• Evaluate education and development opportunities for the existing workforce and embed a whole systems approach to enhance the learning environment for the student paramedic

• There should be an enhancement of clinical skills and clinical decision making developed through the College of Paramedics curricula

12

Project Structure

Education & Training Steering Group

Ways of Working /Scope

of Practice

PEEP Report Recommendation Sub Group Leading

Education Models

Clinical Models

Urgent Care Steering Group

Workforce Planning

1.0 Standardised approach to education and training

Scope of Practice and Ways of Working

1. Nationally agreed approach to commissioning and funding

Finance

1.2 Access to bursary funding Finance

Finance Commissioning

2.0 Pre-registration education development model leading to an all graduate profession


3.0 Models of pre-registration education and training


Clinical Standards

3.1 Knowledge and skills enhancement Scope of Practice and Ways of Working

Communication and Engaged

3.2 Content Scope of Practice and Ways of Working

3.3 Clinical Decision Making Scope of Practice and Ways of Working

4.0 Partnership Model Workforce Planning

5.0 Paramedic leadership for England Scope of Practice and Ways of Working

6.0 Standardised approach to identification Communications

14

Where are we now?• A managed phased transition to a 3 year BSc (Hons) programme

for all direct entry students, achieved by the 2019 intake.• Continued growth in demand, as measured by total calls to switchboard

in AmbSYS data, consistent with the average for the last three years.• Continued progress to achieving a 40% ‘See & Treat’ share of activity,

supported entirely by Paramedics, including 15% at a post-registration qualified level, by 2021 at the latest.

• Changes to the education pathways arising from the PEEP project, i.e. a move to a standard 3 year BSc (Hons) Paramedic Science degree programme;

• Underlying demand pressures in the face of changing urgent care systems at a local level;

• An increase in ‘see and treat’ responses that reduced conveyance to hospital, supported by an enhanced skill mix.

15

Work in progressDevelopment of a transition implementation plan, to include:

• Education and development opportunities for the existing workforce• An engagement programme with all stakeholders to be delivered from a

national platform to have the necessary influence, supported by local delivery plans

• The development of the infrastructure to deliver the education and training model with service

• HEE to pilot pre-degree paramedic programme in four geographies with a particular aim in widening participation/BME inclusion agendas.

Development and delivery of education assurance framework:

The assurance framework has been developed by HEE in partnership with the Education Modelling sub group and National Ambulance Service HR Directors Group.

16

Managing Transition

Education Development

Employment Issues

Workforce Planning

17

College Developments• Agreed Scope of Practice at point of registration• Revised Paramedic Curriculum Guidance• Developed competency framework • Developed Paramedic Post Registration - Career

Framework• Developing the Post-Graduate Curriculum for Specialist

and Advanced Paramedics• Reviewing the QAA Paramedic Science Benchmark

Statement in Partnership with the QAA.

18

Next Steps and Opportunities• Financial viability to be fully assessed and a suitable commissioning model to be

determined• Workforce plan to be confirmed and the education delivery model to be approved • Communications strategy to be developed • New Implementation Steering group and transition plan to be supported• Growth in Paramedic Workforce, working in new settings and in new networks in

the Primary Care Commission report and the new urgent care vanguards• Pre degree and access opportunities to develop the BME workforce in all areas• Final report to be submitted HEE in September - use the proposed

commissioning numbers and pre degree pilots as an opportunity for addressing underrepresentation of BME groups

• Outputs from today will inform our narrative preferred approach with sponsorship from HEE

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The role of leadership - Jagtar Singh

“We are the change we have been waiting for”

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Paul Deemer – NHS Employers

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Tea break

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What the research suggest ?West Midlands Ambulance ServiceEquality Challenge Unit

Promoting ethnic diversity in paramedic

education and the profession

Barbara Kozlowska, Head of Organisational DevelopmentMaria Watson, Senior HR Manager

Activity to date:•June 2013: WMAS CEO established HEI Deans group•HEI Consortium•University of Worcester led on research•Positive Imagery•Positive Action•Engaging with Young People•Co-mentoring Pilot•Next steps

Activity to date:•June 2013: WMAS CEO established HEI Deans group

Activity to date:•June 2013: WMAS CEO established HEI Deans group•HEI Consortium

Activity to date:•June 2013: WMAS CEO established HEI Deans group•HEI Consortium•University of Worcester led on research

West Midlands Ambulance Service NHS Foundation TrustOrganisational Development: Driving positive change through consulting and influencing

Purpose: To gain an understanding of how BME groups respond to information about paramedic courses, their experience of the enrolment processes and their experience of paramedic training.

What barriers to paramedic education exist for BME groups?

- a joint research project between WMAS and the University of Worcester


Methodology: Questionnaires were distributed to BME and non-BME qualified paramedics and student paramedics within the West Midlands. Telephone interviews were conducted with qualified paramedics and student paramedics from BME groups.




Findings:•Questionnaire results revealed significant differences between BME and non-BME groups for the accessibility and understanding of information on paramedic education

•Results produced no significant differences in the way that specific sources of information influenced career choice for BME or non-BME respondents (e.g. internet, newspapers, television, etc.)

•No significant difference between BME and non-BME respondents for factors relating to; prior knowledge of the profession, experiences of recruitment processes, recommending the profession to others, influence from family/friends, and sharing information on the profession with others.

•Interviews suggest a lack of information in preparation for paramedic courses and on the job training, causing unrealistic expectations. A lack of diversity in the student population, incidences of racial offence (unconscious or conscious), and also a lack of visibility of BME staff in the ambulance service as well as in the wider community were identified.




Practical implications: The results produced from this evaluation may contribute towards a series of recommendations in order to better inform practice to increase the diversity of students entering into paramedic science and in order to avoid issues such as student attrition.



Activity to date:•June 2013: WMAS CEO established HEI Deans group•HEI Consortium•University of Worcester led on research•Positive Imagery

Activity to date:•June 2013: WMAS CEO established HEI Deans group•HEI Consortium•University of Worcester led on research•Positive Imagery•Positive Action

West Midlands Ambulance Service Positive Action

The Beginning

• Audit data analysis• Positive Action Paper• Board Buy in and vision• Recruitment analysis• Changing the image• Community engagement• Raising the profile

• Audit data analysis• Positive Action Paper• Board Buy in and vision• Recruitment analysis• Changing the image• Community engagement• Raising the profile

Positive Action Imagery

• Leaflets• Flyers• Advertisements• Positive Action Statement• Social media• Careers brochure

• Leaflets• Flyers• Advertisements• Positive Action Statement• Social media• Careers brochure

Community Engagement

• Diversity Tour Board & Directors

• Community Events• Recruitment events

• Diversity Tour Board & Directors

• Community Events• Recruitment events

Access CourseAccess Course

Activity to date:•June 2013: WMAS CEO established HEI Deans group•HEI Consortium•University of Worcester led on research•Positive Imagery•Positive Action•Engaging with Young People

Activity to date:•June 2013: WMAS CEO established HEI Deans group•HEI Consortium•University of Worcester led on research•Positive Imagery•Positive Action•Engaging with Young People•Co-mentoring Pilot

Activity to date:•June 2013: WMAS CEO established HEI Deans group•HEI Consortium•University of Worcester led on research•Positive Imagery•Positive Action•Engaging with Young People•Co-mentoring Pilot•Next steps

More questions:•What does retention look like?•How do we help with understanding the role, personal characteristics required and progression routes available?•What progression opportunities do people want?•Do universities offer courses that support progression?•How is the profession marketed?

Examining BME underrepresentation in paramedic programmes in the East Midlands

29 July 2015

Szilvia Altorjai and Jennifer Panting

ECU

Outline

= About ECU= The research project= Case for greater ethnic diversity in the paramedic

profession and education= What the data suggests= Recommendations= Next step – stage 2= Questions

Equality Challenge Unit

ECU works to further and support equality and diversity for staff and students in higher education and seeks to ensure that staff and students are not unfairly excluded, marginalised or disadvantaged because of age, disability, gender identity, marital or civil partnership status, pregnancy or maternity status, race, religion or belief, sex, sexual orientation, or through any combination of these characteristics or other unfair treatment.

Equality Challenge Unit

Programme of projects, activities and services

=Research projects=Guidance and best practice publications statistical reports=Conferences and training events=Advice line for universities=Gender and race charter marks (Athena SWAN Charter)=Bespoke services and consultancy

www.ecu.ac.uk

The research

Questions: Why do you think there BME underrepresentation in paramedic courses in the East Midlands?

What can be done to encourage students from a BME background to apply for and accept places on these courses?

Stage 1: Data analysis and literature reviewStage 2: Primary data collection

Scope and case for greater diversity in the paramedic profession and education

= Paramedics’ increasing workload (CfWI, 2012)

= Increasing population and diversity (ONS, 2012b)

= Paramedics care for and treat an increasingly diverse

population

= More diverse student body more confident workforce in

meeting the demand for care (Saha et al., 2008; Whitla et al.,

2003)

Ethnic minority population in the East MidlandsFigure 1. Ethnic minority population aged 16-64 by counties in the East Midlands, 2014

Source: ONS Crown Copyright Reserved [from Nomis on 19 July 2015]

Ethnic composition of students in the UKTable 1. UK domiciled students studying subjects allied to medicine and paramedical science in the UK by ethnic group, 2013/14

Source: HESA Student records 2013/14. Note: 4 digit JACS subject 3.0: (B900) Others in subjects allied to medicine; (B950) Paramedical science. Note: only UK-domicile student included, those whose ethnicity is not known are excluded from the calculation.

Ethnicity

Percent of ethnicities (within others in subjects allied to medicine)

Percent of ethnicities (within paramedical science)

White 73.2% 96.6%

Black 9.7% 0.4%

Asian 13.2% 1.2%

Other (including mixed) 3.9% 1.8%

Total 100.0% 100.0%

Ethnic composition of paramedic completers in the East Midlands

Ethnicity PercentChinese <1%Mixed-White and Asian <1%Mixed-White and Black African <1%Mixed-White and Black Caribbean 2.2Other Asian background <1%Other Mixed background 1.3Other White background <1%White 22.5White-British 71.9Grand Total 100.0

Source: Paramedic completers data – Health Education East Midlands. Note: Those whose ethnicity is not known are excluded from the calculation.

Table 2. Ethnicity composition of paramedic completers in the East Midlands, 2008-2014

BME underrepresentation in paramedic science

Source: Census 2011. Paramedic completers data – Health Education East Midlands. Method: Modood (1993).

Table 3. Comparison of ethnicity composition of paramedic completers (2008-2014) and 0-24 year olds in the East Midlands (2011) by ethnicity.

% of paramedic completers in the East Midlands (2008-2014)

% of 0-24 year olds in the East Midlands (2011)

Level of representation in comparison to population size (%)

White 93.4 81.2 15.1%

Other White background 0.9 3.2 -72.0%

Mixed and other Mixed background 4.8 4.1 17.7%

Asian and other Asian background 0.8 8.5 -90.5%

Black/African/Caribbean/Black British 0.0 2.4 -100.0%

Other ethnic group 0.0 0.7 -100.0%

BME total 5.6 15.6 -64.1%

Literature review: factors that influence university and subject choice of learners 1

• Meeting the entry requirements (Ball et al., 2002b)

• Perception of the university and the course (Greenhalgh et al., 2004)

• Information, advise and guidance (IAG) received (Greenhalgh et al., 2004; NUS, 2011)

• Perception of ethnic diversity - “Will I fit in?” (Ball et al., 2002a and 2002b; Reay et al. 2001)

Literature review: factors that influence university and subject choice of learners 2

Structural barriers

•Geographical proximity of course delivery – localism and travel costs(Reay et al. 2001, Ball et al 2002b; NUS, 2011)

•Combining full-time education with existing paid employment (Reay et al. 2001)

Inclusive learning and teaching environment

•Learning and teaching experience – Stereotype threat and unconscious bias impact teacher-student interaction, pupils’ educational attainment and future career opportunities (Gilborn et al., 2012; Woolf et al., 2008)

•Students satisfaction with clinical learning, course, university and supporting services available (UNISTAT, 2015; NUS, 2011)

Recommendations 1

Pre-application stage

Identify areas where discrimination could occur (ECU, 2012):‒ Access to information streamline and widen access to information about the

course and the profession‒ Entry requirements collect data, analyse, and monitor applications ‒ Admissions process collect data, analyse, monitor and evaluate processes

=Establish mechanisms to ensure admission process is consistent and non-discriminatory (ECU, 2012)

=Effective communication to internal and external audiences (ECU, 2012)

=Regular reviews to assess and advance effectiveness of policy and practice (ECU, 2012)

Recommendations 2

Teaching and learning experience=Identify areas where teaching and learning experience can be improved

‒ Course content‒ Course delivery‒ Lecturer training and experience‒ Unconscious bias

Recommendation 3

Collaborative efforts

=Regional model with voluntary sector to gain practical experience of being

a paramedic

=Education community link-workers (Thomas, 2001; Cohen et al., 2002)

personalised support to course applicants while channelling their needs to the

course providers

=Shared practice and joined up approach of existing initiatives

Stage 2: Data collection

Focus groups/interviews among current and prospective students and

practitioners to

1) Examine prospective students’ access to IAG and knowledge of paramedic

science

2) Explore decision-making of prospective students

3) Examine the admissions process from a student and practitioner

perspective

4) Identify good practice in admissions, course content and delivery

Questions

1) Who do you think should be involved in the process of developing the

action plan to improve BME representation?

2) What challenges might your institution encounter when developing an

action plan to promote BME participation?

References

Ball SJ, Davies J, David M, Reay D, 2002b: ‘Classification’ and ‘judgement’: social class and the ‘cognitive structures’ of choice of higher education. British Journal of Sociology of Education. 23:51-72.

Ball SJ, Reay D, and David M, 2002a: ‘Ethnic choosing’: minority ethnic students, social class and higher education choice. Race Ethnicity Education. 5:333-57

Centre for Workforce Intelligence (CfWI), 2012: Paramedics: Workforce risks and opportunities - education commissioning risks summary from 2012.

Cohen JJ, Gabriel BA, Terrell C, 2002: The case for diversity in the healthcare workforce. Health Affairs 21(5)

ECU, 2012: Equitable admission for underrepresented groups. Equality Challenge Unit, November 2012.

Gillborn D, Rollock N, Vincent C, Ball S, 2012: ‘You got a pass, so what more do you want?’: race, class and gender intersections in the educational experiences of the Black middle class. Race Ethnicity and Education. Vol. 15, No. 1, January 2012, 121-139.

Greenhalgh T, Seyan K, Boynton P, 2004: “Not a university type”: focus groups study of social class, ethnic, and sex differences in school pupils’ perceptions about medical school. British Medical Journal. 2004;328: 1541.

National Union of Students, 2011: Race for equality – A report on the experiences of Black students in further and higher education.

ONS, 2012b: Ethnicity and National Identity in England and Wales 2011.

References

Reay D, Davies J, David M, Ball SJ, 2001: Choices of Degrees or Degrees of Choices? Class, ‘Race’ and the Higher Education Choice Process. Sociology. Vol. 35., No. 4, pp. 855-874.

Saha S, Guiton G, Wimmers PF, Wilkerson L, 2008: Student Body Racial and Ethnic Composition and Diversity-Related Outcomes in US Medical Schools. American Medical Association. 300(10).

Thomas L, 2001: Widening participation in post-compulsory education. Emerald Group Publishing Limited.

UNISTATS, 2015: Course data comparison – the official website for comparing UK higher education course data http://unistat.direct.gov.uk

Whitla DK, Orfield G, Silen W, Teperow C, Howard C, Reede J, 2003: Educational benefits of diversity in medical school: a survey of students. Academic Medicine, 78(5).

Woolf K, Cave J, Greenhalgh T, Dacre J, 2008: Ethnic stereotypes and the underachievement of UK medical students from ethnic minorities: qualitative study. BMJ Research.

Contact

7th Floor Queens House 55/56 Lincoln's Inn FieldsLondonWC2A 3LJ

Tel: 0207 438 1010Fax: 0207 438 [email protected] www.ecu.ac.uk

www.hee.nhs.uk

Workshop sessions 1. Universities approach to E&D – Here 2. Service Organisations approach to E&D – Ashby Room 3. Workforce Race Equality Standard -

Quorn Room

Universities approach to Equality and DiversityParamedic Practice29th July 2015

Introductions

• Vicki Severs - Senior Schools and Colleges Engagement Officer• Ann Ball - Admissions Tutor, Paramedic Practice• Andy Kirke - Paramedic Practice• Current Paramedic Practice students

An overview of Paramedic Practice at Sheffield Hallam University

• 2 year course• Diploma in Higher Education• Course fees paid

• Entry requirements: 280 UCAS points, experience prior to application, driving licence by interview stage

• Who are we looking for?

• 100% Student Satisfaction overall in 2014 NSS• High employability rates - high demand for paramedics• High rates of further training, promotion and CPD in the profession

An overview of Paramedic Practice at Sheffield Hallam University

• Places: 49 places 2014/15• Applications: 768 applications - More than 15 applications per place• Applicants: 7.4% BME, 85.4% White, 7.2% Unknown• % Conversion Application to Enrolment:o BME: 5.3%o White: 6.7%o Unknown: 3.6%

Student voice at Sheffield Hallam University

Introducing…….

Daniel Chow Herpreet Bains John Reeves

Proposed Action Plan

• Stage 1: Research, investigation and preparation Data analysis and embedding of standardised reporting Equality Impact Assessment of pre-application and enrolment processes Staff engagement and training Recruitment of Student Ambassadors and Role Models Further discussions with EMAS re. work experience opportunities

• Stage 2: Activity Marketing messages: Equality Impact Assessment; joint campaign with Northampton Recruitment Activity: Use of role models, review of Open Day date setting process Schools and Colleges Engagement: staff training, Health & Social Care Roadshow,

work with target schools and colleges, Staff Conferences Community Engagement: 'Careers in Health Professions', joint led community

engagement event Communications and staff awareness: key messages for all staff

To increase the numbers of BME students on Paramedic Practice

Feedback

What can we learn from your experiences?

Are we considering the best approach?

What opportunities are we missing?

Equity and diversity in paramedic Science

• FDSc 2 year pre registration programme

• Course fees paid.

• UCAS 280 or experiential knowledge considered

• UK full licence and C1 practical booked by course start

• 100% student satisfaction 2014 NSS

• 100% employment rates

• 2016 3 year BSc

• 320 UCAS or experiential knowledge considered

Overview of provision

The University of Northampton

:

Enrolment Data:

FULL-TIME UNDERGRADUATECourse

Stage

TOTAL <21 >=21 F M

Asian or

Asian

British

Black or

Black

British

Chinese Mixed Other WhiteNot

Known

Yes NoNot

Known

Home EU OtherNot

Known

FdSc Paramedic Science1 25 10 15 13 12 1 24 2 23 25

2 47 11 36 25 22 2 42 3 6 41 47

At 1st June 2015 24 white and 1 BME student (stage 1) and 42 white, 2 BME and 3 unknown at stage 2. For 2013/14 there were 44 white, 2 BME and 3 unknown at stage 1 and 24 white and 2 BME at stage 2. For 2012/13 there were 24 white and 3 BME at stage 1 and 19 white and 1 BME at stage 2.

Application

• Data is lost if candidate is offered alternative course on first sift in admissions

• This year 10 BME students were part of the 230 interviewed.

• Last 3 years between 4- 12% BME per cohort.

Paramedic Science

Proposed activities for 2016 – using the Whole Lifecycle Model

•Pre-entry Access Outreach and Capability: •Open day activities to include – Use of technicians and paramedics from Black and Asian backgrounds. ( paid for their time) •Developing DVD / U Tube video for use at 2016 Open Days / School and College outreach events. •Marketing flyers to reflect a multi-cultural staff and student group. •Delivering talks at community based events – e.g. Northampton / Leicester / – Black and Asian events. •Working with schools and colleges to promote the profession – outreach workshops at FE and Sixth Form Colleges. •Working with local schools / Ambulance trusts to develop / shadowing work experience – Summer work experience 1 week workshop •Web and flyers – dropped to Local Community groups – Black and Asian Community Centres. •Use of Face book page for paramedic science – with features on BME paramedics. •Transition into HE: •Offer interview to (up to 5 applicants per year) from BME groups who have the potential to succeed but lack the full entry tariff points for entry – using a UON Compact Agreement with an FE College – (possibly Leicester )

Paramedic Science

A Compact programme – for Paramedic Higher education: for 13 – 16yrs olds attending school and 16-18 yr olds attending college.

• Working with BME students from a wide range of backgrounds to enable them to enter university and successfully gain employment in emergency care.

• We believe everyone should have an equal access to study in higher education and that it is important to equip students with the knowledge, skills and experience to help them succeed.

• The Compact programme will be designed to support students through activities, advice and impartial guidance, from secondary school age through to graduation and employment.

• We will offer a small bursary to Compact students who take part in the programme at the University – School of Health and upon successful completion of the programme – a chance to apply for Paramedic Science Education.

Paramedic Science

What would it include?

Paramedic Science

taster lectures and workshopssummer and Saturday schoolsopportunities to shadow our studentsone-to-one support with writing personal statementshelp in preparing for interviews.

Thank you for

listening

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Q & A

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Next steps

• Linking this work with national work

• Forming an “steering group” Midlands and East approach

• Completing the research April 2016

• “doing”• Evaluation• Pre Paramedic pilot

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Three ask

1. Share2. Recommend3. Accountable

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Thank you!

www.hee.nhs.uk welcome ! “promoting ethnic diversity in paramedic education and the profession”...

Documents

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paramedic educationresults

positive change