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As Barts and the London approaches its merger with Newham University Hospital, it reminds of the Health Careers Ladder that Newham pioneered a number of years back.  This mapped out career paths in the NHS and engaged with local schools and colleges to attract local people.  One of these schemes - the Doc Route Scheme is still underway with the Barts and London Medical School/Queen Mary's.  The scheme provides for a one year learning placement at the Hospital prior to entry to the Medical Degree for school students with the potential to go on to be doctors.

Most jobs in the NHS are graduate or equivalent entry, a position that will strengthen when nursing becomes all graduate entry in the next few years.  So how do you get on the ladder?    Effectively there are two ways.  Firstly, schemes like the Docs Route give extra support to students to enter highly competitive professions such as medicine. We have a similar scheme called Bridge into Nursing that provide extended learning placements for pre-access and access level nursing students in Tower Hamlets. As noted here, this has an equalities dimension in that we have relatively few students coming forward from Bangladeshi communities.   East London communities are generally low skilled compared to the national average, and, although local schools have improved greatly in terms of exam results, areas such as science are still pretty weak.  So this area needs a lot of work, and patience in that even successful schemes take a long time to deliver results, and students typically need a good deal of pastoral care.

A second way is to promote from within.  This offers the prospect of recruiting at a lower level and upskilling on a "grow your own" basis.  This is a moving picture.  Some jobs already need a postgraduate qualification, and for undergraduates this can offer a daunting prospect if they are studying part time.  I can think of many excellent examples of departments such as Physiotherapy or Occupational Therapy putting a lot of effort into supporting staff in support roles through to professional qualification, but not all areas offer this option.  In nursing, staff in support roles can get themselves seconded into professional training, but this is a highly competitive process. Newham again offers good practice, having developed a career progression route for healthcare support workers to move up to Assistant Practitioner level.

Putting more rungs on the health careers ladder is not easy, and means huge effort and dedication by students and staff looking to progress themselves.  We need recognise that in east London, communities face significantly more barriers to health careers, and subsequently need our help and support.