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Widening Participation in the Healthcare Workforce


NHSE wants an inclusive and diverse workforce. Trusts have been encouraged and supported to include different groups into their workforce so that it reflects the cultural, social and economic make-up of the communities they serve. This is seen as an important policy goal. The NHS Equality, Diversity, and Inclusion (EDI) Improvement Plan notes that, ‘A diverse workforce that is representative of the communities it serves is critical to addressing the population health inequalities in those communities’.

NHS Trusts are being seen as ‘anchor institutions’, where they can strategically manage their resources to respond to local priorities and reduce health inequalities. They act as key employers in local communities and are highlighted in the NHSE Long Term Workforce Plan (LTWP). Along with NHS Trusts, the LTWP also views Integrated Care Systems (ICS) as playing a lead role in future widening participation work.


This project aims to examine the use and development of the Widening Participation (WP) programme in NHSE, framed by the idea of an NHS anchor institution and within the context of the central role played by ICSs. We will scope the nature of ICSs WP programmes in terms of their focus and the foundations that support them.

We aim to examine the several initiatives that the ICSs have developed, focusing specifically on groups in society they have identified as being under-represented and challenged in the labour market:

  • We will look at the provision of supported employment programmes for young people with learning disabilities.
  • We will look at the provision of employability support for those often marginalised in the labour market. For example, those ‘Not in education, employment, and training (NEETs), people with lived experience of homelessness and military veterans.
  • We will look at the development of pathways for school and college students to enter the NHS workforce, for example through work experience, ‘T’ levels and internships.


In Phase 1 of the study:

  • We will review the forward plans of all ICSs to map whether and how they propose to take the EDI agenda forward.
  • We will hold Roundtable(s) to include national and regional experts and those from representative bodies of the diverse groups addressed in the study.

In Phase 2 of the study:

  • We will select four ICSs and their healthcare providers reflecting region, socio-economic conditions, and demographics, but also differences and similarities, in their forward plans as they relate to our three streams.
  • Two of these case studies will be identified for follow up.
  • We will collect data through focus groups and interviews with key stakeholders in the respective case study sites.


April 2024 – April 2026


NIHR Policy Research Programme: NIHR206121(05)

Policy relevance

Widening Participation enshrines a key policy principle underlying the NHS, that the workforce should reflect the socio-economic and culturally diverse population it serves. This is designed to positively impact on its capacity to address health inequalities.

The WP agenda also addresses the NHS recruitment challenge. Many of the groups covered can provide new and potentially reliable sources of labour into the NHS workforce, bringing with them a range of talents.

The ICS framing of this study ensures that policy makers, practitioners and health and social care providers become an important audience for its findings.

Representatives from the various marginalised groups within the labour market, who stand to improve their quality of life from access to NHS employment, will also have an interest in the study’s findings.


The main output from this study will be a report of findings. All participants will receive a copy of the summary and recommendations. The full report will be published online on the Unit’s website. We will also prepare further outputs, working with local partners (Applied Research Collaboration South London and Making Research Count) and national stakeholders, particularly representative and independent sector organisations for these marginalised socio-economic groups. We will present findings at academic conferences and publish at least one article in a peer reviewed journal. We will organise feedback events involving those with lived experience of the labour market exclusion covered in the study.

Project status: Ongoing