Identifying barriers to equality and diversity within the trainee advanced practitioner workforce

BACKGROUND: Despite efforts to promote equality and diversity in the NHS, data show persistent disparities and a slow pace of progress toward achieving workforce race equality. Advanced practitioners can promote inclusivity and drive cultural change, but there is a lack of data on the composition and workplace experiences of the advanced practitioner workforce. AIM: To collect detailed data on the ethnic profile of trainee advanced practitioners in the North East and Yorkshire region of England and on their experiences of equality and diversity, and to identify barriers and enablers to developing a diverse and inclusive advanced practice workforce. METHOD: Trainee advanced practitioners were recruited through purposive sampling to complete a survey about their demographic characteristics (including ethnicity), their experiences of equality and diversity, and their perceptions regarding equality of opportunities for professional development. Some respondents' experiences and perceptions were explored in greater depth through focus groups and one-to-one interviews. FINDINGS: A majority of the 152 survey respondents were nurses, female and from a white ethnic background. Twenty seven (90%) of the 30 respondents who reported experiencing discrimination were from a minority ethnic background. Participants expressed concern about the lack of representation of minority ethnic groups in advanced practice roles and about unclear and unfair recruitment and promotion practices. Participants often found equality, diversity and inclusion initiatives insufficient, superficial or failing to address structural barriers. CONCLUSION: Sustained, organisation-led strategies are needed to embed equality and inclusion in policies and practices. The study findings have informed the development of a toolkit that supports equitable recruitment and career development for advanced practitioners.