T Level system strategy: conversations with integrated care systems

• Gloucestershire ICS has successfully placed over 86 T Level students. This number has over doubled in the space of a year, particularly in health.
• Expanding career options for students is essential, with a focus on local employment needs. This could lead to placements in areas such as estates and facilities and cybersecurity.
• Maternity services have successfully implemented T Level industry placements, providing opportunities for them to become maternity support workers.
• T Level students should be encouraged to join the NHS workforce through bank roles.
• The establishment of a T Level network facilitates sharing best practices among organisations.
• The system is supporting with mythbusting and raising awareness of the T Level and industry placements across organisations.
• The ICB is looking at how to expand T Level industry placements into social care settings, which involves looking at how the curriculum works in this area.
• Starting small and seeking advice can lead to successful T Level industry placements, as well as tailoring support for different types of organisations.

• Mandy references collaboration with FE providers. Employers interested in the approach can refer to our guide Making links between health and care and further education guide, which explores how these sectors can work together to strengthen the talent pipeline. 
• Dispelling myths is key to encouraging organisations to offer T Level industry placements. Our resources, Recruiting under 18s into the NHS guide and Supporting T Level industry placement students under the age of 18 article, provide practical guidance for employers on addressing common concerns and sharing information with colleagues.
• Gloucestershire is expanding T Level industry placements in several different areas beyond the Health T Level. To support this, Skills England has developed occupational maps that show how T Level qualifications can lead to a wide range of career pathways.

Sam: Hello everyone and welcome to the second in a series of conversations with Integrated Care Systems about how they are supporting T Level industry placement delivery and upscaling the number and variety of T Level industry placements on offer in their system. I'm Sam Jonas, Programme Lead for our T Level programme here at NHS Employers and I'm looking forward to discussing T Levels today with two colleagues from Gloucestershire ICB. Mandy Tucky, ICS Apprenticeship and Widening Participation Programme Lead and Kate Loram, We Want You Project Support Officer. 

Coming up, we'll be exploring how as a system, you can support organisations with their T Level industry placements. Placing T Levels is an integral part to the system-wide talent pipeline. We'll look at what role the system can play in supporting this agenda, explore how Gloucestershire ICB is developing its strategic direction, and reflect on successes and challenges.

Don't forget to check out the other resources we have available to support upscaling T Level industry placements on our NHS employers T Level hub. Now, without further ado, I'll pass straight over to Mandy. Thanks so much for joining us today, Mandy. If you could start by giving us an idea of what the T Level landscape looks like in Gloucestershire ICB, that would be fantastic. 

Mandy: Hi, thanks for that introduction, Sam. Within Gloucestershire, we've recently started to develop and expand our T Level provision, particularly within the non-clinical settings, so particularly within our ICB. So we've decided to look at how we can support our young people to think about perhaps careers within the NHS that they hadn't perhaps thought of before, so particularly around sort of digital, finance, marketing, business admins. 

So what we've done this year is teamed up with our local FE colleges to look at how we can support and place some of those non-clinical roles within our ICB. So we've been able to place, in fact I'm going to hand over to Kate at this point because Kate will know how many we've been able to place, but we've placed a number of different T Level students within the ICB. But what we've also looked at doing is trying to go out to our system partners and place within primary care and also social care as well. So we've done some fantastic work at being able to get some non-clinical T Level students out into those different sectors within the system as well which has been great. So Kate, tell us a little bit more about how many we've got within the ICB. 

Kate: So within the ICB we've got over 86 different students on placement at the moment with us. We've got them hosted in quite a variety of different organisations so we've even got them kind of outside their normal contexts. For example we've got someone doing digital technology working within our primary care networks at Dr Surgery to help them improve their communication techniques, their websites and things like that.

We've got them working with our private social care partners. We've got them working within obviously our hospitals and within our ICS system as well. So we've got quite a breadth of different students on different sorts of placements. And it's going really, really well. The feedback we're getting is how much they're enjoying them and how much people are enjoying the new concepts and the new ideas that people are bringing in. 

Sam: Thanks so much Kate and Mandy for that introduction there. And as you sort of correctly highlighted, there are a vast, I say vast number, there is a good number of T Level courses that suit a great variety of different roles in the NHS. We do know, however, perhaps unsurprisingly, but it is the health T Level that tends to be the most popular one for students looking at doing a career in health and care. 

Mandy: Our health T Levels have been really, really successful and we're seeing at least 80 to 90 per cent of them going on either to further higher education, going on and doing their degree programmes, or potentially coming into employment within our NHS organisation. So we've seen some fantastic success stories there.

What we're also starting to see is people realising the benefit of that pipeline. So really starting to engage our young people earlier in terms of career opportunities within the NHS so that we can really guide and help and support them to think about where their careers might take them so that actually the T Level gives them a really nice introduction into kind of working within those NHS and social care environments. And then potentially then seeing how that can lead on either to further training or further employment.

So we're really starting to see people's mindset changing around actually how we can really support our young people to consider those career options within health and care.

Sam: And I think that's so crucial. I think it's a really important point you've touched upon that obviously you have a certain number of students going on to do the health T Level and you'd think at that point they probably do have a vested interest in health and care, but it's not just about that. It's about expanding their understanding of the variety of careers available.

I mean, we hear examples from employers all the time of a student who goes in thinking, I want to be a nurse, has the opportunity to see a physio and then decides they want to do a physio in the future. So there's, all sorts of different stories going on there. And perhaps also, as you've said with the non-clinical T Levels, it's that opportunity to, to highlight that the NHS and health and care more widely does have a role regardless of your, your interest and the sort of the, what you would traditionally associate with the sector, that would be relevant to the topic.

Mandy: Yeah, you're absolutely right. And we've certainly seen with some of our T Level in health students, they've gone off and done ODP, so operating department practitioner. They've gone off to do paramedic science, as well as some of them going off and doing nursing and other allied health professional programmes. And I think the other thing that's been really valuable for our T Level health students is that they've been able to join the bank. So they've been able to actually become part of the paid workforce. And that has been fantastic for them to be able to really develop their skillset and to become part of the NHS family if you like and it really gives them such a great foot in the door to be able to then go on and decide on what career avenue they want to take. So yeah, some brilliant examples. 

Sam: Thanks Mandy. Would I really be able to answer how many are doing the health T Level? 

Kate: So at the moment we've got 56 different students that are doing the health T Level and the majority of the rest of the people that aren't doing health T Level are focusing around business and we take them from across three different colleges.

So whilst we talk about the health T Level, we've got a lot of students doing the adult nursing pathway. We've also got actually some students on placement from the mental health pathway, which we're really proud of accomplishing because it can be quite a different, a difficult area to find placements in. 

Sam: It's just fantastic to see the huge numbers that you're working with in Gloucestershire. It's amazing. Do we know how much this has grown over time, even anecdotally? What's the increase we're seeing here? 

Mandy: Well, we have doubled in the space of a year, particularly within our health tea level. So we have kind of gone from 20 and really significantly increased that and doubled that across our organisations. And that is looking at, you know, we are looking at growing that year on year where we can. I think one of the other areas where we've seen some fantastic growth and opportunities is in maternity. So our maternity services have really embraced T Levels.

And actually what they're doing now is looking for those opportunities for those T Level students to become maternity support workers and to be able to then support them through to look at doing their midwifery degree apprenticeship potentially. So a great success story for maternity. And they were hesitant for similar reasons to mental health pathways around actually what were we exposing 16, potentially 16-year-olds to within a very highly pressurised environment where they may well see things that they may well not have ever been exposed to in their lives, but actually they have embraced it 110 per cent and they've really kind of turned it around and proved them wrong actually, in that actually they are mature enough to be able to see and handle the experiences that they're being exposed to. And that in turn has given the staff confidence to be able to kind of really showcase all aspects of their profession that they're able to do with our T Level students. 

Sam: Thank you Mandy and it's so true. I think the real challenge is just getting one T Level student into a space. And the moment there's a T Level student in an area that might be sort of traditionally hesitant to host a student, they almost invariably see that they're such an asset and such a boon to the area and so engaged in method of learning that you tend to find it just grows and grows from there. So I mean, you've hit the nail on the head. We can advocate the T Levels as much as we want, but it's actually the students who really sell the success of the industry placements. 

So fantastic. And I'll use that to segue into talking about the sort of system wide strategy as yourself, Mandy and yourself, Kate, both work for the ICB. Perhaps starting with you, Mandy, could you give me an overview on the sort of the guidance that you offer to the system? What is it that the ICB is supporting with to increase the upscale of T Level placements?

Mandy: Yeah, we have a number of different things that we do to help and support. So we have a T Level system-wide network, which is an opportunity for us to bring all of our system partners together, those that are currently supporting T Levels, but also to be able to open that out to people that perhaps are considering supporting T Levels and what that might involve. 

We do an awful lot of work around kind of myth busting around actually what does it mean to take a T Level student. Still, there's a lot of people within the system that haven't heard of T Levels, they don't know what that means. So a lot of our work is spent actually doing a lot of breaking down some of those barriers and enabling people to understand a little bit about what a T Level student is and what they can do. 

We're also looking at how we can use our T Level students to be able to help and promote the opportunities that they've been given. giving them the chance to kind of say, actually, this is my story. This is what I've been doing and this is how successful it's been. And this is what I've really enjoyed and have got out of that. Again, really starting to think about how we can use that case study approach to be able to showcase that across the system.

One of the other things, and again, think Kate will probably be able to talk a little bit more about this that we've discovered quite early on is that each organisation does things slightly differently. And so one of the things that we're really trying to look at doing across the system is how we can kind of have that little bit of an overarching process, if you like. So to be able to kind of support with documentation around actually this, here are some templates that you might want to use that might be helpful to be able to support you in terms of what you might need for kind of risk assessments, contracting, all of that kind of thing. So that's something that we've worked across all of our system partners to be able to put together sort of some proformers that they can then take and adapt according to their own different organisations. Kate, I don't know if you want to say a bit more about that because you've been instrumental in putting all of that together. 

Kate: It's one of the things that we find at two levels is people get worried about the paperwork when they first come in, terms of what do we need to do with them, where do you hold the risk assessments and all that sort of information.

So actually when I first started, T Levels were quite new to me. So I was having conversations with the different organisations in terms of how they've approached it. And I was looking for the similarities between the organisations. We've kind of developed like a banked induction thing that we can now send out to different organisations. And what that's allowed us to do is involve people that haven't got as much as, I say as much resources, but people that work in smaller organisations like the GP surgery that haven't got that information to kind of pull from. We put a pack together that they can use to help with the inductions and take away from that. 

And we're kind of following up from this at the moment. So with the ITST Level network, we sent out like a questionnaire to the T Level students to find out what their induction's been like, what's been the strengths, what's been the weaknesses, to kind of look at how we can improve a more cohesive approach from all the different organisations so that every student gets the best out of their learning. And that's kind of what we're focusing on at the moment to make sure that we're all approaching it in the same way and that we're offering the support. So if we've got someone that is confident and experienced in T Levels, we're talking to them about what has made them strong and what they like. And if we've got someone that's a little bit newer, we can say, actually, this is what we have found has worked to kind of share that best practice and learning with everyone. 

Sam: Thank you, Kate and Mandy. I've got so many questions now. I don't really know where to start with this one. I think I forgot to take them in the order I thought of them. So Mandy, you mentioned about the power of pulling together stories and sharing case studies and the like to sort of promote T Levels to organisations that might not be so well acquainted. What does that look like practically? Does that mean yourselves and Kate going out and getting those stories, collating them? I'd just love to know a little bit more about that aspect. 

Mandy: Yeah, it's a bit of everything really. So we sometimes look at shaping it around events. So for example, National Apprenticeship Week, there's a T Level Thursday, think it is, isn't it? So we again are around T Level Thursday, so our organisations might produce a short film where they might have filmed one of their T Level students. So we've got a brilliant short little film from our acute trust talking about a T Level student that's gone on and become an ODP. 

We also, because we've got some really strong connections and some strong networking, what we're able to do is actually perhaps go out to our GP practice and say, hey, we'd love you to be able to just put a few words together, either as an email or as a short little voice note. So we use lots of different media and lots of different forums, but what we're really keen to do is ensure that actually it's hassle-free, it's no bother, we don't need it professionally done. 

All we want is kind of the vignettes, the snippets of high-quality information that enables us to be able to then think about how we can develop our communication strategy around, look, this is what person X has said about their T Level experience, this is what the T Level supervisor has said about their experience. We use lots of different ways and mechanisms to do that, whether that be, as I say, a really short recording on someone's mobile phone, a quick email, or sometimes as I say, even a longer piece, which we're looking at doing for a tailored campaign. 

Sam: That's fantastic. Thank you. And as you say, those vignettes are so powerful. It doesn't need to be professional. It almost sells the story better to hear from the students live from the students directly from the students. This is the enjoyment of the industry placement. This is what they've learned. This is their ambitions. So thank you for sharing that and Kate, to sort of explore a little bit further, something that you mentioned, you talked about the differing support needed between the different organisations in the system. Could you maybe go into a bit more detail about that? Cause obviously you work with everything ranging from large acute hospitals all the way to a GP surgery who might be new to T Levels. Have you found, I mean, you've obviously found that the support has differed, but in practice, what does that look like? So what do you offer an acute hospital versus a GP surgery or perhaps a care home or the like? 

Kate: I think it's more focusing on what the commonalities are between the organisations rather than the differences on them. Because fundamentally, every organisation wants to support their new staff coming in to find these pathways moving forwards and to get everyone on board. So actually we go in with this is what we can do. This is our kind of our standard template. This is the induction information. This is what we can do for you. And then we say, actually, what do you individually want from the outcome? What is it that your organisation specifically needs? 

The hospitals have got really well established teams that manage and deal with T Levels and they've taken the learning on from apprenticeships and they need a different sort of support than someone that is taken in the first time. So for example, if you're taking on a finance student and you're a bit like, well, I don't know what we do about safeguarding. The levels of experience, the professional experiences of people differ. And so actually what we do is we support them depending on what they want. So I don't need to offer safeguarding training or any information on that, particularly to a hospital staff where that's fundamentally what they've been put down.

Whereas actually some of the finance team will not have got that working with vulnerable individuals experiences as much. So actually it's going and saying, okay, what would make you feel more comfortable at this point? And then giving them the information they need so they can make an effective decision and support the students effectively through their journey. And it has been working really well because the feedback we get is that students are settling in really nicely and people are comfortable with what the students are doing and how to manage them and how to support them. And it helps overcome that little bit of a, what do I do with a 16-year-old? Because actually, learning that relationship with teenagers, not everyone's comfortable with it. It's actually training staff on kind of how you can deal with it, how you can act as a mentor figure. That's really important to pretty much every organisation. 

But I think it's more about the individuals and their personal experiences, whoever's leading the programmeme as well. I think that's a big part to deal with it. 

Sam: Thank you, Kate. And it sounds like the way that you bring this all together is through having a T Level network. So I'd love to hear a little bit more about this T Level network. What sort of format does it take? How regularly do they meet? I guess the purpose, the yeah, just everything. So I don't know who wants to take that one Mandy, maybe perhaps back to yourself.

Mandy: Yeah, I can start with that one if you like. Yeah, that's great. What we realised early on was that actually we needed a forum to be able to bring everybody together. Otherwise you were starting to having offshoots of conversations left, right and centre, often repeating conversations. And we suddenly thought, actually, we need to bring everybody together that's supporting our T Level students.

So what we do is we bring all of our system partners that are hosting a T Level student together about once a month. We're literally looking at extending that to sort of bi-monthly now that we're kind of in the swing of things a little bit more. 

And what we then do is we then bring our colleges on board every kind of quarter to be able to give a bit of a quarterly update. And one of the things we talked about early on was actually, do we invite our college partners in at the get-go right from the beginning? Or do we want to have this as a system opportunity for us to be able to explore how it's going to be working for us within the system? And actually what we then decided was that we probably needed to be able to have a safe forum for those internal conversations around, know, actually, how are we going to do X, Y and Z? What does the paperwork documentation look like? How do I go out and promote this and what have you? And then to bring our colleges in for a little bit more of a focused discussion around what are our colleges doing around T Level provision, how are they looking at growing and expanding their programmeme, are there areas that we can work with them on in terms of thinking about how we can support expansion into, say mental health settings for example, or more primary care settings. 

So that's the formula that we've worked on within Gloucestershire and it works really well, because it gives our partners that safe space to be able to have those conversations and to be able to share ideas and to also be able to say actually I'm just not quite sure how to do this. And then we can kind of open that out to the floor and say, well, actually we've had that situation and this is what we did. So it enables us to share that commonality and that good practice. And then what Kate and the team are able to do is kind of collate all of our evidence. And that's what then shapes some of those guidance documents, because we're able to have kind of those open and honest conversations. And then what it enables us to also do is to perhaps then go back to our colleges to say, actually, this is something that's come out of our system-wide forum discussion. Would we be able to have a conversation with you around how we can look at delivering X, Y and Z. 

So for example, one of the things that's come out recently is about the next stages. What are we doing to be able to support our T Level students in terms of that onward journey about what they're able to perhaps go on and do. So one of the things that we're now looking at doing is partnering with our FE colleges and potentially bringing in our local HEI and also some of our clinical staff to be able to talk to those T Level students about what those next steps could look like. You know, can you go off to university with a T Level qualification? What happens if I want to go and become an apprentice? What happens if I want to go into paid employment? So we've just again started to build that into some of our provision that we're developing. 

And that has come out of conversations that we've had within the wider forum around actually how are we looking at supporting our T Level students so that they've got that next step on the forward for them really. Kate, I don't know if there's anything you want to add to that?

Kate: I think does influence and does inform the relationships that we do have with the colleges because actually we've got some really good relationships with our colleges and it's probably something we might pick up a little bit later about in terms of management of those. But there are things we put in place through the ICS T Level network is for example we're looking at arranging things like business breakfasts where we get all the T Level students together across Gloucestershire because what we want to do is give them the exposure to not just what they're doing now but also the different potential of all the different things they could enjoy as well. Because with having so many students on placement with us within Gloucestershire, they don't get to experience everything. And we want to make sure that we've got that breadth of contact and the students have got a good network between themselves as well. So it's not just us saying to them, you can do this. It's actually what's your experience like and get them to have those kind of round conversations. So when we've got students on placement in a maternity ward, they can have a discussion with a student from somewhere, a different college and say, this is actually what I'm doing and what that journey looks like for them as well. So it's very student driven.

And as Mandy mentioned, we're doing quite a lot of outreach work as well in terms of going into the colleges and discussing with them upcoming opportunities. For example, I went into a college last week with one of our education nurses and they're discussing some of the upcoming job roles we've got around healthcare support workers and the different routes for that, which will be really beneficial for the students who aren't looking at university. And it keeps a nice pipeline of talent for us within Gloucestershire, which is what we want to achieve as well.

Sam: Thank you Kate and Mandy. I mean, again, a few reflections there. I think that's fantastic. I absolutely love the model of having that sort of monthly or as you say, soon to be bi-monthly opportunity for employers across the system to meet and discuss, but also involving the providers. I think one of the big takeaways from speaking to a number of employers about this is it also encourages provider collaboration, which is perhaps something that's new. And in fact, it can't be a bad thing. They have the opportunity to learn and develop as those offering the T Level as well so it's fantastic to hear that you've integrated those two aspects but still maintain that safe space, so that organisations can have that discussion and I think the second point that I'd be really keen to explore a little bit further perhaps with yourself Mandy is you mentioned that you invite those offering T Levels but do you ever have any attendance from those who are not yet offering T Levels as an opportunity to engage with colleagues who are perhaps a little more advanced in the space?

Mandy: That's where we're looking at doing our next steps as well, actually. So we haven't at the moment. And again, what we're looking at doing is a communication, a comms piece around actually going out, particularly to our ICB colleagues. But we have done it around sort of social care. We've gone out and kind of done a piece around actually, what is a T Level? Do you think you could host a T Level student within your organisation? What does that look like? So we're just starting to build up our communications and strategy around that really, so that we can then start to think about inviting people to come in to say, would you like to come in and find out more about T Levels, come along to this event, whether that be one of our T Level network meetings or whether we host something a little bit separately. But yeah, that's exactly what we're wanting to do really is to kind of, we're testing the water with some of our T Level students, and we know we've got some departments waiting in the wings because they're just going, we're just going to have a look to see how they get on in X, Y and Z area. And then if they do really well, then yeah, we're definitely on for the next wave. So we're doing it slowly but steadily.

And I think again, that would be one of my tips is if you're new to kind of getting some of the particularly the non-clinical T Levels is start small and get it right and then you can grow and build and kind of gather momentum. So in our first wave, we've got kind of two or three different areas within the ICB. And so we've got one GP practice, we've got a number of social care partners. And then in our second wave, we're hoping to just kind of grow and increase that and start to encourage more departments to come on board. So what we'll start to do now over the next coming months is to start ramping up that comms piece ready for kind of the next intake so that we can start to build those relationships with those different areas that might be interested. 

Sam: Thank you, Mandy. And I mean, I appreciate what you're saying about it being useful for non-clinical T Levels, but I think it's also got real value for clinical T Levels as well, particularly in those spaces that perhaps are underrepresented at the moment. We've touched upon them, the GP surgeries, the social care environments and the like. 

And I think in our conversation we've just had about the of the offering from the ICB, you've really revealed the power of having that system-wise strategic direction. It's about being the facilitator, the convener, bringing people together, being that central point of support, collating that documentation. So we've got such a raft of successes and you should both be really proud of the sort of the system's strategic direction in Gloucestershire.

But as we know, these things come with challenges. So perhaps moving on to challenges, perhaps starting with yourself, Kate, what have you found has been perhaps a bit harder to implement or some of the challenges you've faced in your role?

Kate: So I came from Wales and so T Levels were brand, brand new to me and I hadn't got a clue. So actually I had a personal challenge of kind of trying to understand what T Levels were and where they got. But actually I think it held me in really good stead because coming in with that kind of like, I don't quite know what a T Level is, it really helped me to understand the challenges that different organisations do face and kind of the questions they've got asked and to kind of like, my first thought was like, what do we do about risk assessments? So I'm assuming that other people have got a similar sort of process, like what do we do here? So actually it's really nice for me to kind of coming in from that perspective because it's made it quite simple because I've maybe been able to answer all my own questions and be like, these are all the questions I've had and take that as a learning point to help other people with supporting and developing their placements. And that's been really useful. 

And you do get the questions around my awareness of like, you know, the time taken. So I do think we do get challenges, particularly for non-clinical placements in terms of like, well, I work from home on this day or this day. How do we facilitate that? But the recent update that they've made that they can spend 20 per cent of their placement time at home on some placements, that has made a big difference for people because actually it allows us to have the flexibility to say, actually, yes, you can take them in for one day a week and then they can go home and they can work for two hours, but you can actually facilitate that a lot better. So it's really nice to see how T Levels are adapting their programmemess and their placements to suit people's needs as well. 

And similarly with ICT, because ICT placements, think it's 50 % of their placements now can be done remotely. And whilst we want them in and we want them learning, it's nice that organisations have got a little bit of flexibility and that's really helped to build them on board as well. 

Sam: Thank you, Kate. And I feel like I should add that the flexibility is for 20 per cent, remote working, hybrid working also apply to the health tea level, which I think offers some really interesting opportunities for the future. So it'll be, it'll be fascinating to see how that develops. 

And you're completely right. The flexibilities are moving in the direction of allowing more flexibility and allowing the opportunity to sort of experience different, different careers and different opportunities. So Mandy, over to yourself from your perspective, what has a challenge or the biggest challenge perhaps been?

Mandy: I think one of the, say it's a I think it's probably an opportunity rather than a challenge was we have recently looked at how to expand our T Level provision into our social care partners, knowing that we don't have a T Level in social care. So actually one of our challenges was actually how do we ensure that the T Level in health pathway is applicable to our social care partners? How are we going to ensure that actually if students go out into a social care setting, they're going to be able to get the relevant skills and clinical-based skills really that perhaps are needed for that health pathway?

So one of the things that we did to overcome that was to work with some of our social care providers and our local college to look at how we adapt that curriculum. So we went through and looked at that curriculum and we looked at the core areas and then we were able to map with our social care partners around, well actually they would get exposure to this in this setting or this isn't a good example whereby instead of talking about, I don't know, a very clinical nursing example, you could bring in a social care example about how you perhaps help somebody with eating and drinking within a social care setting. So that has been really valuable for us to be able to work with our colleges to be able to look at how to kind of break down some of those barriers so that we can really start to see how we can support our T Level students across multiple different areas of opportunities really. 

And so what we're now also looking at doing is doing a similar sort of thing with our primary care colleagues. So again, thinking about actually what kind of clinical skills, would a T Level student be able to be exposed to within that primary care setting, within that GP practice? How can we ensure that actually that is within the curriculum in some way, or form so that they can see the relevance, they can see, yeah, I get that, I can see how I can understand that. So that's one of our next pieces of work that we're really working on. 

And I think one of the other challenges is around kind of that working relationship with our partner organisations and our colleges and something that has been really pivotal to the success of our T Levels is about working in partnership so that we work really closely with our colleges around actually this is what we are able to support. This is what our organisations can deliver. How can we help and ensure that that fits in with what you're able to deliver from a college perspective? So we've really kind of worked in partnership to come up with a model that works well for us within Gloucestershire.

But we've done that with our colleges. So we know that we will interview students in partnership with our college. We've looked at the timing of when our students come out on placement, what sort of skills that they need to have perhaps undertaken and what academic study they might need to have undertaken before they come out to placement so that they're actually well prepared for going into that clinical setting. And we've used kind of the feedback from our T Level students experiences, but also our supervisor experiences to be able to work with our colleges to be able to think about how can we ensure that we've got the best programmeme that's going to meet the needs of everybody. So I think that's been really positive as to how we've kind of overcome some of those challenges really. 

Sam: Thank you, Mandy. I think those are perhaps two of the most positive challenges I've heard in a very long time. So that's been fantastic and such important work. And please do keep us updated on how you're mapping that curriculum to social care and primary care and the like. It's so transferable, but it does require a little bit of work, which I guess is another advantage of having that system level strategic direction that you're able to essentially coordinate that and provide advice and guidance to colleagues.

We've touched a lot about the sort of the future plans, the development about how you'd like to see the guidance develop in the future. I think to just touch on a few, you're talking about expanding the T Level network. You've talked about that expansion into primary care, social care, other areas, looking at non-clinical T Levels as well. But just, there anything further you'd want to add in that sort of future development, future plans? 

Mandy: I will go to Mandy. I think we definitely want to look at widening out the scope of where we can place our T Level students. So again, thinking a little bit wider than health and care roles. Obviously we've to a lot of non-clinical roles, but thinking about our estates and facilities, maybe thinking about kind of the construction side of things. Where have we potentially got opportunities for us to be able to look at where we can grow that workforce? 

And again, thinking around kind of actually what Skills England are talking about around actually where are our key areas of growth that we need? And we're thinking Gloucestershire, we're talking a lot about cyber. We've got a big cyber security centre within Gloucestershire. So again, thinking about actually how can we kind of support that in terms of thinking about some of our T Level students that we might be able to have within with the NHS, because actually we need to know and understand about cyber security too.

So again, it's really thinking about how we can place ourselves within our geographical demographics. You know, what have we got going on within our local area? What are our key employment areas? We know that our young people are much more likely to probably stay put because of financial implications. You know, it's harder to perhaps go away and study. So we've got a golden opportunity here to think a little bit about how can we kind of support the growth of our local population and, and fill that in with kind of the wider demographic of what we've got within Gloucestershire to be able to help and support and promote our young people. 

Sam: Thank you, Mandy. And I think you've mentioned something really important there in terms of that sort of workforce planning. It can happen on a micro level, it can happen on a macro level. And I think again, that's where the system can really support looking at what does the organisation need? Do they need certain allied health professions? Do they need maternity support workers, to take some clinical examples. And again, as you've sort of said, the wider examples of states and facilities, cyber, what does it look like on a local level, a hyper-local level, that sort of system level. And so that's fantastic to hear that's all in your, in your sights to be done for the future. Kate, do you have any reflections from your personal experience of anything further you're looking to develop in the future? 

Kate: I think it's really looking kind of outside the box with placements, so you don't necessarily assume that, I will have to have a student that's experiencing this area to work within this organisation. Actually think what skills have you got? What skills do you want to demonstrate? And it's a skills focused development, because that's what we want from our future workforce. We want to make sure that they're developing the skills that we need. And that some of that is focused around those basic levels of employability skills, such as timekeeping and communication and how you have conversations on teams and all this sorts of stuff. So actually don't just say, I must have this sort of placement because I'm this sort of organisation. Actually, the students that come to us have so much enthusiasm and passion and knowledge that we don't have that bringing them into an organisation in any capacity will only really benefit that organisation because they are going to have all this extra insight for their future workforce moving forward. So it's like, it's looking for the opportunities, not focusing on the restrictions, I think is a big thing for the T Level placements.

Like what can you do, even if it's not ideal, what's your stepping stone to get there? And I think it's really nice to be able to offer a variety of placements that suits those interesT Levels and help develop the students in that way. 

Sam: Thank you, Kate. It's really lovely to see your enthusiasm for the skills and qualities of the students shine through there. And it's so true that they really are the future workforce and a skills-based sort of development does work to encourage them to consider a wide variety of different careers. 

So as we start to bring this to a close, I think it would be great to hear from both of you a piece of advice or guidance for other systems who are looking to do a similar sort of strategic support for T Level industry placements. So perhaps, Kate, what's one piece of advice or guidance you'd like to share with other colleagues who might be listening? 

Kate: Focus on your relationships with the colleges, because I think once you set those clear expectations with the colleges in terms of what you can deliver and how it works for you, then I think you're setting yourself up for success in that way. And actually go beyond what the minimum expectation is. It's not just like, we can offer them a placement. It's those ongoing visits and those, even if it is slightly informal emails, like, do you have any more placements to help with? Or actually we're pretty full. It doesn't have to be a huge piece of work. It's just ongoing communication and collaboration and that development of those relationships really helps support the learning of the students, helps make sure they get those really positive experiences, which translate to good experiences for the staff working with them and hopefully good outcomes as well. 

Sam: Thank you, Kate. And Mandy, a piece of advice or guidance from yourself? 

Mandy: I would say if you're new to looking at developing T Levels, start small, go where the energy is, and also ask for help and advice. Get some hints and tips from those that have already done it and been successful. So that's what we did. We knew that our T Level in health was really successful within our organisation. So we went and asked them, how have you done it? How have you succeeded in this? What hints and tips can you give us that we can then build into how we can then look at developing that within the ICB? So that would be my take home message is start small, go where the energy is, but don't be afraid to ask for help and advice from those that have already previously done it because it will save you an awful lot of of heartache, I guess, and it will really help it to turn and run a lot more smoothly. 

Sam: Thank you, Mandy. Yeah, you're completely correct. It's not about reinventing the wheel. It's about drawing on the power of collaboration with other stakeholders and what have they done? What can be, what could be my favourite phrase, pinched with pride and how can that be expanded across the system? 

So I'd just like to thank you both, Mandy and Kate, for speaking to us today. It's been incredibly insightful. I'm really impressed with the of the ambition to scale up the strategic direction from the ICB and how you're linking it to so many other elements such as schools engagement and talking to HEI's about future talent pipelines and the like. It's all starting to come together as that sort of wider picture. 

Please do keep in touch. I'm sure you will. We'd love to hear how this goes. And for those listening to this conversation, we hope you found this useful to inform your own industry placement delivery. And as ever, please do get in touch if you want to share your own in T Level industry placement journey with us here at NHS employers. This is just one of a series of conversations I'm having, so please do feel free to check out the others. And once again, thank you, Kate. Thank you, Mandy.

• BOB ICS has scaled T Level placements from 62 students at pilot to 170 students in 2025.
• A diverse range of placements are on offer including in health, business admin, engineering, and digital sectors.
• A community of practice enhances collaboration amongst employers and education providers.
• Support for smaller organisations is crucial for equitable access to placements.
• A focus on celebrating achievement boosts morale and encourages participation.
• Effective communication and networking are key to developing successful industry placements.
• Documentation and resource sharing prevents duplication of efforts.
• The future focus of the ICS includes expanding placements in primary care and social care.

• As part of celebrating T Level industry placement achievements, employers are invited to apply for T Level Employer of the Year at the annual Apprenticeship and Skills Awards. In 2024 we spoke to a number of those regional finalists who shared their top tips and reflections.
• To find out more about how systems are collaborating to upscale their T Level industry placement delivery NHS Employers spoke to the previous seven industry placement coordinators, tasked with developing placements in their integrated care system.
• Shilp Bhatt references the Strategic Development Network, an organisation funded by the Department for Education to support organisations looking to support T Level learners. Their range of webinars are a useful resource for those starting on their industry placement journey.
• The Gatsby Foundation has developed a suite of resources to support the development of mentors for students on an industry placement.

Sam: Hello everyone and welcome to the first in a series of conversations with integrated care systems about how they are supporting T Level industry placement delivery and upscaling the number and variety of T Level industry placements on offer in their system. I'm Sam Jonas, Program Lead for our T Level programme here at NHS Employers and I'm delighted to be joined today by Shilpa Bhatt, Apprenticeship and Widening Participation Lead and Interim Retention Lead at Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System, which as you can imagine, we'll be referring to as BOB from now on, as it's a little bit of a mouthful. 

Coming up, we'll be exploring how as a system, you can support organisations with their T Level industry placements, placing T Levels as an integral part to the system-wide talent pipeline. We'll look at the role that the system can take, explore how BOB is developing its strategic direction, and reflect on overcoming challenges.

Please don't forget to check out the other resources we have available to support upscaling T Level industry placements on our NHS Employers T Level hub. Well, fantastic. Thank you so much for joining us today, Shilpa. We'll go straight in with a question. So if you could start by giving us an idea of what the T Level landscape looks like in BOB ICS.

Shilpa: So T Level has been a bit of a journey for us. We were one of the pilots in 2019. So one of the trusts was a pilot. So we had a little bit of a head start on there. But after COVID, when it actually took up, we scaled up. started when in 2022, we had 65 T Level students and it's now grown to around 170 T Level placement students. We have seven local colleges and we have a thriving community of practice. So we have employers and providers in our community of practice. It's a key integral part of our supply for the workforce. You've mentioned that you've scaled up from 62 to I think it was 170 T Level industry placements. What T Levels are those in? Where the students going on industry placement? 

The T Levels we offer in range of disciplines or subjects. We currently have, the majority are health students, of course, but we offer placements in business admin, engineering students, as well as digital students. Our next thing that we're going to look at is the health students. They often have placements, or most of them have placements, in two phases. Some of them have first-year placements in social care, and then they have placements in NHS trusts, care homes, hospital estate teams, community pharmacies and charities. And for example, we've had placements in hospices and dementia charities as well. 

Sam: And I think it's really important that you clarified that they're sort of spending some time in one organisation and some time in another organisation as that really helps give them a solid understanding of the careers they could do in the future.

Shilpa: And some of the things that within our hospital trusts, the departments that have offered placements, the wide range of departments. So we've had placements in maternity unit, transplant units, theaters, spinal wards, dermatology, for example, occupational therapy, physiotherapies. There's a wide range of experiences that students are able to gain from these placements. And wherever possible, the employers try and match the student interest if it's possible. 

Sam: That's great. That's great. Thank you. And you mentioned obviously it's a huge increase from that 62 to that 170. And I would imagine at the same time, the amount of organisations offering it has grown. If you reflect back to the start of when you were first hosting students, what's the sort of progression of organisations? Was it all acute to start with and now has it moved to other areas? It would be great to have a bit of a vague timeline.

Shilpa: Yeah, so when we started, had two acute trusts that started. One was part of the pilot and of course they were ready to role. Our three acute trusts were first forthcoming in offering placements. We had then the community health trust offering placements. Alongside social care were also offering placements. So we had that going in parallel. One of our other community trusts didn't join us until this academic year. So it was a journey to get all employers to come into this programme. We also got charities involved. So I think that's still a bit of a slow kind of area that we need to grow into. And again, primary care is an area that we would like to grow as well. Amazing. Thank you. And we'll be touching on the different support you offer different types of organisations later.

Sam: But just for now, obviously yourself as a system lead, how do you support your colleagues? What's the role that you take when you interact with organisations across the system? 

Shilpa: So I think it's about motivating organisations to work together, share resources, know, managing their emotional, cultural aspects of it. You know, as a group we meet, but we need to kind of how we manage the small providers, giving space to the small providers, as opposed to the large providers who are in the space of providing this large colleges who are providing T Level for the students. But also how I support the employers is by creating positive culture amongst employers, making sure that we work collaboratively, save time, save money. And that I think getting them to understand the benefits of T Level and also getting them to understand that what they can offer and what they can't offer. So it's about that two-way conversation with the providers. 

The providers understand what the employers can manage to offer, what they can't. And I think in all this, it's about enhanced learner experience. As the programme grows, we want to make sure the learners have choice of placements. We are able to develop and grow our programme and be able to offer our students those aspirational possibilities and learners have a voice within all this as well. And it is important, I think, for us as organisation to actually take time and, you know, make sure that we take an opportunity to celebrate what we have done so far. Because very often that celebration, it's almost like we have to recognize that what we have developed is good as well. 

Sam: Thank you. And I mean, I think you've hit the nail on my head. That's the great advantage of having system level direction. It's that facilitation, bringing people together, preventing that rework and as you've correctly identified, it's so crucial to celebrate and what better way than to celebrate with colleagues who are also offering industry placements in the same space? 

Shilpa: Yeah, I think we had a fantastic T Level Thursday event. And I think that kind of highlighted to us that we have got so many T Level students in different disciplines. We had a T Level student, for example, doing digital who was placed in clinical engineering team and it was really nice experience for the others to hear what, so it was really good opportunity to, to see what the students had to say. 

Sam: And I guess it's motivating, isn't it? Because if you're an organisation that offers maybe fewer placements or perhaps is just interested and doesn't yet offer any placements, hearing from colleagues, seeing the success stories and being involved even prior to upscaling or starting on the industry placement journey is crucial.

Shilpa: Yeah. And it is, you know, upscaling that approach but also recognising that everybody's at a different stage of the journey as well Sam, yeah? 

Sam: Absolutely and so a lot of this we'll be discussing later on in this conversation but there were two points I wanted to pull out for the moment. You mentioned about preventing duplication of work in terms of documentation and the like, could you give us any examples of the documentation that through your interactions with employers, I should say organisations, you've been able to help others with. 

Shilpa: So I think one example that I can give is a couple of our employers have developed a student placement workbook together and they are sharing that as a resource together. The other area is there's been discussion about what induction, how they do induction, those kinds of things and sharing resources. Colleges are beginning to kind of share resources as well. So it's about not duplicating, say the advisory group that they are all required to do. So it's another area that they could work together on. 

Sam: And I think you mentioned something really important there. The reflection that education providers are starting to collaborate more closely together. It's something I've heard from a few different systems at this point. And I just think it's fantastic that you're bringing together employers, organisations, health and care organisations who are in turn collaborating more closely, collaborating more strongly. And it's almost like by osmosis, it's going to the education providers who are also collaborating more strongly. So it's just, it's incredible to see that happening. 

Shilpa: Yeah think initially they were feeling a little bit kind of protective about their students and something, an example, when we started the purpose, when we started this community of practice was just to make sure that there is fair access of placements for our students because the larger colleges were occupying the space in there. So I think it was more to kind of make sure that other colleges are getting that access to the employers and the employers are also learning to work with other colleges as well. That was the beginning of our journey of collaborative conversations. 

Sam: Fantastic. And you can see the widening participation aspect of your role coming in there, talking about equity and equality, which is so important, particularly when we're looking at a sort of system strategic level. You mentioned earlier that you're working with some smaller organisations, the voluntary sector, primary care. I would imagine there's still a lot you want to do in that space, but when it comes to that interaction with smaller organisations and a bigger trust, for example, do you find that the support you need to offer differs? 

Shilpa: Definitely, most definitely. So if I give an example, I'll use primary care as an example in this case, you know, it's very difficult for me to reach all the 67 GP practices in our region. And I think what I need to use is the connectors, the PCNs, workforce leads in the PCNs, the learning environment leads, and get that message out through those connectors. I also feel that it is important that they understand what T Levels are because there is very little that is out there for them. So what I have created is a one-pager sort of just for primary care colleagues to actually just see at a glance what the levels can offer, but also get them to think the kind of things that experiences they can offer would be equally valuable and different. 

Something that was challenging for us in primary care was the primary care colleagues came back saying, actually, the curriculum is very much has care aspects to it and we won't be able to offer the care aspects to it and I think we have negotiated with them that the first year the students would get that work in a care home or in a social care setting. And then the more health related part of the curriculum could be kind of met within the placements in primary care. So I think it seems like a good mix of opportunities for the students as well. 

Sam: You mentioned something really important there because there are, students can go to up to two employers or three if it's through a network. There is the opportunity for the placements to be slightly different. You of course wouldn't expect some of the more clinical skills to be developed during a placement in care, but there's so many important skills you've touched upon such as communication and presentation skills, professionalism. There's so much that can be learned in different environments, which is why it's fantastic to hear that you're considering that as part of the strategy. It's about developing a well-rounded student who has a solid understanding of some of those roles in health and care. 

Shilpa: I think the whole point of getting the students to come and attend our community of practice was to help them build their confidence, know, that communication, that public speaking, that getting that other skills was so important for them, but also networking with each other. think the students were delighted to see, even if it was on the screen, they were delighted to see other students from other colleges sharing their experience. And I think it's worth considering how we can do more often of such activities. 

Sam: Absolutely. Thank you. You've mentioned a few times as community of practice. What does this look like in practice? If you'll excuse the pun, how does this, how does this take shape? 

Sam: The way it started, like it started organically to improve access for our students. And I invited all the colleges that were locally providing T levels at the time. This was in 2022, we made a start and then the employers that were currently providing placement, also would want to kind of look at it. Initially, we started to think about the capacity of placements and also, like I said, making sure that the smaller colleges that get space for it. 

Now it has become a thriving forum, if you want to call it, or community of practice, but we have a very strong engagement. The colleges have representatives from different courses. The employers participate and we have done some amazing things. So we have thought about increasing placements and it came from that that they would like to do a webinar for introduction to T Level and aimed at anybody in the organisation so that front line managers would then hear what T Level are. And we developed that ourselves. We had local colleges who presented and shared how they prepare the students for placements, what is involved in the curriculum, and what sort of placement patterns are available through different colleges. 

The employers then presented about the environment, the opportunities, the paperwork that is required. And we had about 70 people from primary care, from range of different organisations attending that webinar. We had then planned a second part to it, which we did with, actually we did it with SDN. That was effective coaching and mentoring. And that's was again bespoke done for BOB and we wanted to highlight how what support the T Level students would require when they're on placements but also it is a fantastic opportunity for our support staff to take on that role so the burden is shared between the line managers and the support staff who are day-to-day mentoring those young people so it was fantastic. Again, a of our students participated. Our line managers were interviewed. So it was really well attended, well received by the organisation. So it's another way we are trying to grow our placements and opportunities for young people. 

The other areas we have tried to work on is how we facilitate consistent approach to documentation induction and have similar values and standards to the activities that young people are offered. So I think it's that whole piece of things. Again, at this time of the year in summer, we will look at what opportunities or how many placements each employers are able to offer. And that would help the training providers plan for their placements or finding placements as well. So it's a bit of planning, a bit of growing the future workforce, know, future placements, that kind of thing. Yeah, also we want to increase in different areas as well. 

Sam: Thank you, Shilpa. There's so much in there. I'm trying to work out where to start to ask you to elaborate on. That's fantastic. But just before I do, just for anyone listening, the SDN is the Strategic Development Network who organise a huge and varied range of T Level webinars for those looking to embark on or develop their T Level journey. 

So going back to something you said, Shilpa, we've talked about what this disperse community of practice does and all the different areas it's supporting that sort of upscaling agenda of T Level. But just on a practical sense, do you have a, we hear from a lot of organisations, they have networks or monthly meetings or quarterly meetings. How does it look in BOB ICS? 

Shilpa: So we've deliberately not kept it too frequent. sort of meet quarterly kind of things. It's a very informal group. We tend to sort of have set items on the agenda. it's, you know, updates from employers, updates from providers, any highlights, any issues, challenges, that sort of things. 

And then once a year we do this learner voice celebration type of you know, T Level Thursday is the classic date in our calendar. And I think increasingly we have now got more providers coming on board. And the kind of things that I tend to do to prepare so that we don't have too many frequent meetings is I try and send them a little questionnaire to say, you know, how many placements are you able to offer? A little bit around looking at new areas that the providers are looking at developing. It's a bit of a questionnaire both to the providers and through the employer so that when we are at the meeting, we can then have a sort of a informal mapping, if I call it, of the placements as well as the current status of students. And then the other kind of opportunities that we have, I talked about the webinars, the community of practice has been involved in doing that.

But also I think it is important that we kind of make sure that there is consistency of opportunities, consistency of how we deliver and the quality is maintained as well. And then they often say we need more placements for science. there, who should we contact? So I think it's about me connecting them to different departments as well.

Sam: That's such an important aspect of system level support, you knowing who to connect them to, having connections in those areas, sort of functioning, I guess, as that first port of call for those who might be interested. Y

Shilpa: Yeah, but it's also about creating that positive culture amongst the employers. Often in this current climate, they might want to say, we've got too much to do, but it's that getting them to understand the value and the benefits that it may bring in the future for our workforce as well. 

Sam: Cheerleader and facilitator and advocate. We've talked a little bit about the fantastic webinars that you've put together with the community of practice and it sounds like from your attendance figures, I think you mentioned 70 for the last one, that you're getting through to a lot of different areas who might have an interest in T levels or want to find out more. 

One of the challenges we hear about quite common is getting that, raising that awareness, how to make sure people understand what the T Level is. What methods did you use to get the word out there? You obviously decided to do a webinar together, but then it's how do we bring people in to attend it? 

Shilpa: Yeah. So I think the key thing is I deliberately decided to make it bespoke for BOB so that I used the local T Level students. I used the local employers, so it was very clear on the poster that they will be hearing from the local trust, local organisations about their experiences. You will be able to find out who the local colleges are. How did I get the word out? Through my connectors, actually. 

So within the NHS Trusts, we had different education teams that actually put the word out, I even asked the providers actually to take it to the social care placements that they currently link with. So within the social care space as well, we navigated our way there within primary care. had interest from primary care as well on that webinar. And again, through primary care training hubs, as well as colleagues in NHSE who helped me get the word out to primary care. So I think I would say use your connections to get it out. 

Sam: Let's now move to the future. How would you like to see the guidance that you're able to offer at that system level develop in the future? What's your next plan, I guess? 

Shilpa: So I think the next phase for us is to align whatever we do in the future with the national changes that are happening both in health and education and integrated systems, think, will be a part to it. But also we'll need to re-evaluate their roles as well as the strategies that we are having for our workforce. So I would say the areas I would quite like to focus on is a consistent approach to data collection, but also particularly focusing on destination data and showing that impact, because I don't think we show enough impact of this fantastic experiences that young people have, but also they are the future pipeline of our workforce. 

I mentioned earlier that I want providers to collaborate a bit more. And one of the examples, I would quite like them to focus on not going and setting up their own advisory group. But in effect could have a much more meaningful engagement if all the providers came together and then employers are not pulled into meetings with three different providers. So them coming together and they are keen to get employers to contribute to the curriculum wherever possible. And then the other area, we mentioned primary care. Yes, we have a handful in primary care placements, but where I want to grow is in that space for primary care. So I'm hoping in next academic year, we have, you know, more placements in primary care. I also would like to grow in engineering and science space as well. And giving more opportunities for our learners to network and share their stories. 

Sam: Wonderful. Thank you, Shilpa. All very worthy aims, I would say. So now I'd like to move to advice, if you'd be willing to share some with those who are listening. The first question I sort of have for you in this is what advice do you have for other systems looking at upscaling their T Level industry placement delivery? What have you learned along the journey since the pilot handful of years ago that you'd like to share any reflections? 

Shilpa: I would say certainly it works much better at the system level. Identify who you're champions and connectors are and understand their areas of expertise because you don't have to do everything. Those champions can help you draw into their expertise is what I would say. All organisations and employers will be at different stages of development. They might have different challenges, but they also might have unique strength. Some may take time to join the system working process, so give them a bit of space and time. Don't expect everything to happen overnight. Manage your expectation of colleges, but at the same time, time to work with them. For example, know, help them connect to new placements and things, because I think they are also working to grow the T Level as well. 

I think I mentioned earlier, and I'll say it again, take time to pause and celebrate your collective achievements. Because I think whether you showcase your achievements through data or through student voices or through case studies, all that is equally important, but also giving those individual colleges and employers opportunities to shout out about their own achievements as well. So, you know, it's not always focusing about the system achievements, but about those individual organisations. 

And I would say, don't forget at the centre of all this is the learners and their experience. So always keep that in mind, work from by thinking about the learner at the centre of this. 

Sam: So crutial. Thank you. To round us off today, are there any success stories you particularly want to highlight? 

Shilpa: I think in terms of success stories, obviously the webinars were a huge success. Our T Level Thursday was successful as well. But what I would want to particularly kind of highlight is we've had placements in really different places like dermatology department and digital students having placements in clinical engineering department. So there's limitless opportunities that we can create for these young people. Yeah just carry on offering those opportunities wherever possible.

Sam: Definitely such an important reminder to remember to celebrate so thank you very much Shilpa for speaking to us today I found the conversation incredibly insightful really highlighting what can be done at a system level to support colleagues, whether that be through facilitating, collaborating, supporting with guidance and advice or simply bringing people together to have a really successful webinar, you've highlighted the full range of that system level support so thank you, I'm sure colleagues who are listening to this will also find it incredibly useful, please do keep in touch, it will be great to hear how this continues to grow. 

Shilpa: Thank you for having me Sam, it was a pleasure talking to you as well.

Sam: For those listening to this conversation, this is just one of a number of conversations we're having and please do as ever get in touch if you want to share your own journey with us here at NHS Employers.