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Reducing Pre-registration Attrition and Improving Retention

Reducing Pre-registration Attrition and Improving Retention

A report and set of resources aimed at supporting the NHS and higher education providers in reducing the level of student attrition was launched today at an event run by Health Education England (HEE).

The RePAIR (Reducing Pre-registration Attrition and Improving Retention) project has enabled HEE to gain an in-depth understanding of the factors impacting on healthcare student attrition and the retention of the newly qualified workforce in the early stages of their careers.  Covering the four fields of nursing (adult, child, learning disabilities and mental health), midwifery and therapeutic radiography, RePAIR explores effective interventions to improve retention across the student journey – from pre-enrolment to two-years post-qualification. Take a look at the executive summary

This extensive national study is based on detailed insight from numerous stakeholders including nearly 3,500 pre-registration students, service and university representatives, regulators, and policy makers.  

The overriding message from the RePAIR Report is a positive one, in that a 96% of students agreed that they had made the right decision in enrolling on their course.  However, the study has identified a range of factors, which if unaddressed, could affect the supply of newly qualified practitioners – these include financial pressures, student confidence levels and the importance of the clinical component of a course to students which is heavily influenced by the clinical supervisor (or mentor) and the culture in that clinical setting.

Using a unique dataset, HEE has gained an understanding that 33.4% of students (2013/14 and 2013/15 combined percentage) do not complete their studies on time.  Although, further analysis suggests that most students who experience an interruption to their studies, go on to complete within a further 24 months of the standard pathway for that programme. Whilst accepting some variation across programmes and years of study, the report also includes evidence of percentage change improvements in the observed expected observed expected attrition metric, including those broadly in the region of 50 per cent for the period of 2009/10 and 2016/17 - a target set by the government in its 2014/15 mandate to HEE. 

The RePAIR recommendations set out what should be done system wide to improve retention. These include ensuring prospective students really do understand the career they have chosen and the requirements of the course, encouraging the creation of buddy schemes to provide support to students during their studies, standardisation of practice assessment documentation and the importance of preceptorship schemes.

The RePAIR toolkit, is aimed at all those involved in the education, training and supervision of pre-registration healthcare students and those who are newly qualified.  It showcases excellent examples of best practice and effective interventions from across the country designed to improve retention and a bespoke cost calculator developed to encourage organisations to investigate the costs and benefits of local retention initiatives.

Quick links 

In her foreword to the report, Professor Dame Christine Beasley, Chairman of the RePAIR steering group, said:

Attrition has been under the spotlight for many years and whilst not all attrition should be considered negatively, unnecessary attrition does incur a significant cost to the health and care system – to universities and to healthcare providers and, importantly it impacts on the health and wellbeing of healthcare students and those who are newly-qualified.”

Professor John Clark, Regional Chief Nurse who led the RePAIR project at HEE added:

Attrition is everyone’s business. Every individual or organisation providing pre-registration healthcare education or contributing to clinical placement education must ask how they can work together with HEE to respond to the recommendations made in this report.”

Professor Lisa Bayliss-Pratt, Chief Nurse, HEE, and Interim Regional Directors for HEE London and South East, responded:

RePAIR has provided a unique and fascinating insight into what motivates students to stay or leave their chosen healthcare programme. It has been a catalyst for further work to explore some of the emerging themes including valuing Year 2 students, the culture of care, understanding student confidence and early career choices. I am particularly keen to understand the relevance of the findings to the new models of pre-registration education and training that are being implemented.”