Case Study

Widening participation as a strategic approach

Find out how the trust used widening participation initiatives to help the local refugee and migrant population return to a career in healthcare.

30 March 2021



Sandwell and West Birmingham Hospitals NHS Trust sits in the second most-deprived area of England, with low-quality housing, a transient community, and poor levels of education.

Widening participation is a core strategy for the trust which benefits both the organisation and the local community. From facilitating people from the local refugee and migrant population to return to a career in healthcare, to engaging with young people and ex-offenders, the trust and the community have reaped huge rewards.


Key benefits and outcomes

  • Enabled over 300 people to take steps to get back into a medical workforce role - with 40 per cent now employed in the local NHS.
  • Placed four interns at the end of their learning disability internships into paid permanent work in catering, hospitality and finance in the trust or other local trusts.
  • Developed a workforce representative of the local area and patients, using diverse methods of recruitment and talent spotting.

What the organisation faced

Sandwell and West Birmingham Hospitals NHS Trust sits in the second most-deprived area of England, with low quality housing, a transient community, and poor levels of education.

With 7,000 staff, the trust is the largest employer in the area and is building a new £663m hospital – Midland Metropolitan University Hospital. They developed a widening participation programme to attract a diverse workforce, capturing talent from the local community who have a wealth of transferable qualifications and skills. This participation is critical to the trust’s ambition to become the best integrated health care provider in the UK.

What the organisation did

Widening participation is not a bolt-on at Sandwell and West Birmingham. Their approach has been recognised nationally, with several awards. The team has developed partnerships and initiatives to cover:

  • Learning disabilities - partnering with local schools, colleges, local authority, and specialist centres to create twelve supported internships.
  • Former offenders and those leaving prison - worked with the Department of Work and Pensions, Sandwell College and the construction company Balfour Beattie to help build the new hospital, demonstrating that positive recruitment of ex-offenders is part of their construction workforce recruitment strategy.
  • Empty accommodation - a grant was secured to convert one of the empty nurses’ homes into studio accommodation for up to 32 young homeless people aged 16-24. Working with local homeless prevention charity St Basil’s, the accommodation was offered on the condition that residents complete an apprenticeship to give them employment opportunities. The widening participation team also negotiated with the local Mercure hotel to offer young individuals at risk of homelessness, catering and hospitality roles whilst living in the hospital block.
  • The local refugee and migrant community - the team realised that the International English Language Testing System (IELTS) English qualification or Occupational English Test (OET) were the main barrier to these skilled practitioners in this community re-joining the health care workforce. They secured funding from the local authority for what became the award-winning Health Overseas Professionals (HOP) programme, to help skilled people back into suitable employment.
  • Local recruitment – worked closely with local partners to support NHS job searches and applications, along with interview advice and guidance. From schools to job centres, the team provided information on how to transfer current and previous experience into roles within the NHS. It also provides a mentoring circle that takes individuals on a journey of confidence-building, identifying suitable roles and making winning applications.
  • People with mental health considerations – working with a network of local schools and academies the trust identified students with a supported learning plan and arranged access to the world of work in a healthcare setting. The programme provides 30 weeks of insight and guidance through a supported internship, tailored to the individual’s preferences, such as health care, business, finance or administration.
  • Young people – the trust has a thriving apprenticeship programme delivered internally by the widening participation apprenticeship team with over 180 apprentices placed with them at any one time.

Results and benefits

All of the programmes have had a positive impact not just on the trust, but also on the wider economy and community. The project team report a more inclusive culture within the trust.

HOP has not only enabled over 300 people to take steps closer to getting back into a medical workforce role, with 40 per cent now employed in the local NHS, it has changed the mindsets of people within the NHS. One participant commented: “The HOP programme has given me and my family hope.”

It has created economic benefits for the families of those medical professionals who now have a much better chance of securing employment in their original field. There are also cultural benefits in that the individuals and their families are now much more integrated into the local community and across a range of cultures. This has a positive knock-on effect on local shops and services.

Benefits of the other programmes include:

  • People who secured roles benefitted from getting to know others as a peer group, and also from the opportunity for professional development.
  • Improvements in the local community, with people in a better economic situation, able to improve their housing situation.
  • The placement of four interns at the end of their learning disability internships, receiving permanent work in catering, hospitality and finance in the trust or other local trusts.
  • Community focused support for professionals to return to practise, helping them to feel confident returning to the workplace.
  • Growing a workforce representative of the local area - this makes the whole trust look and feel more inclusive. This also has a positive effect on patient care, with people feeling they belong in the healthcare setting.
  • Supporting inclusive, diverse methods of recruitment and talent spotting which ensure a diverse workforce committed to giving the best care to the community.

Overcoming obstacles

Many of the individuals on the programmes suffered from a lack of confidence and low self-worth. This was addressed by creating networking opportunities with others on the programme, to share experiences and provide mutual support. The trust also worked with a local college to arrange professional development for individuals, including an accredited certificate in leadership from the Institute of Leadership Management.

Another obstacle was service managers understanding the psychological challenges faced by the people who secured a job through the trust’s programmes. Educating service managers and managing their expectations was critical.

Doctors who want to join the NHS need to undertake a clinical attachment to support their registration with the GMC. This had been a huge barrier for people from overseas who wanted to work for the NHS. Engaging with the trust’s education lead resulted in an email to all consultants explaining why attachments were important and requested their support. Consultants now understand why the placements are needed and are more supportive.

Takeaway tips

  1. Recruit and nurture a board champion – many of the programmes the trust delivered would not have been possible without executive support.
  2. Look for ways to interpret policies to get a positive outcome – carefully consider each individual’s circumstances and any potential risks. Panel discussions can help secure a more balanced outcome.
  3. Employment is a bonus – be careful not to badge programmes as being about securing jobs for people. True inclusion is about increasing opportunities, not just getting them onto a payroll.
  4. Securing funding - be creative with how you pitch your programmes. Something that looks overwhelming could be integrated into existing work.
  5. Develop a partnership network and build a community approach.
  6. An individual’s journey can be complex - take time to understand them.
  7. Different people are capable of different things, so one size doesn’t fit all.
  8. Holding partners to account - open and regular communication plus carefully tracking progress to ensure targets are effectively met is critical.

The trust has been supported by NHS Employers through its Diversity and Inclusion Partners Programme, access further information.