Following the successful launch for the 2023 cohort of the HSR UK mentoring programme in January, Dr. Gemma McKenna reflects on the role of mentoring in advancing diversity and inclusion in health and care services research landscape in the UK.
Supporting diversity and inclusion in health care is a well-documented ongoing concern across the NHS (Kline, 2014). The NHS long-term plan is explicit in tackling healthcare inequalities and following the global pandemic ensuring inclusive practices in health services research will be crucial to delivering this objective. Ensuring research participants from under-served groups are part of a system of collaboration and co-production in the design of services is also gaining momentum (Darko, 2023). Pivotal to this trajectory are health services researchers and specifically, the inclusion of a diverse range of talented individuals located across UK higher education institutions and allied health focused organisations.
Mentoring: a conduit to uncover inequality
In 2020, Health Services Research UK launched its first mentoring scheme. The aim was to offer our member organisations a tangible programme to support their researchers to develop skills, improve performance, and fulfil their potential. Our first evaluation, in February 2023, made for interesting reading. Mentors and mentees gave positive feedback about their experiences, the former reporting a change in approach from a directive style of mentoring to a more solution focused approach led by the mentee. While mentees focused on practical opportunities to co-author papers, through to gaining understanding of wider higher education employment routes, and pastoral support in a ‘safe environment’.
Delving deeper into the ‘safety’ of the mentoring relationship, uncovered the more common theme which has evolved. The mentees we work with are ‘stuck’ in their careers in varying ways. While this is not an uncommon theme to discover in mentoring partnerships, if we take a broader view of structural biases which pervade academia, we start to see a more pertinent link to a lack of diversity and inclusion in the health services research field.
The representation of women in the sector is strong, particularly when applying for research grants. However, the National Institute for Health and Care Research, NIHR (2021) reported that the percentage of women applying for career awards through their schemes decreases with the seniority of the award. The reality is white men still hold most senior posts across academia and especially in ‘old’ universities (Shephard, 2017).
Often labelled early career researchers – incidentally not early in their careers at all – our mentees reported being stuck at a level in their careers, which means the opportunity to fully realise their contributions to health research might be missed. They can be held back for several reasons, caring responsibilities (not always gender specific but often female led), confidence, unconscious bias practices in recruitment pathways, and lack of support in mentoring and training for leadership positions, to name a few. This presents a complex challenge for higher education institutions and the health services research community, and potentially missed opportunities for health service innovations.
Mentoring: unsticking the stuck in diverse academic talent
So how can mentoring be a useful tool to unstick the stuck in health services research talent? It largely depends on the mentees’ needs. The mentoring process offers a space for self-reflection without the constrains of a formal employer environment. It supports strengthening different skills and can encourage mentees to make difficult decisions, which they may have put off making. For example, moving jobs or changing direction within the same institution. Essentially, uncovering the reasons for the ‘stall’ in progression is the key component to encourage the underrepresented to forge forward and develop their research interests. The role of the mentor is crucial to support this transitional period and in a broader sense, by modelling the position they hold in senior posts will encourage an environment that paves the way for women and people from minority groups to bring their talent to the fore.
The role of Health Services Research
Promoting diversity and inclusion in health services research is crucial if we are to navigate the growing complexity of the NHS landscape. We need innovative healthcare solutions, which are designed bottom up, collaboratively, and with patients at the heart of those approaches. The best way to achieve this is to build communities of practice, which enable researchers to share ideas, build networks, and find informal mentors to guide them forward in their careers. The wider message for our community is this: we need to develop a broader conversation about the limited value of the term ‘early career researcher’. Let’s shift the debate away from limited depictions of age-related career progression metrics and PhD contingent grant awards towards a more holistic view, which values researchers with varied career experience and neurodiverse attributes. We must start somewhere and HSR UK are pursuing various projects to achieve this shift. But what else should be happening? Let’s start the conversation here: over to you…
Dr Gemma McKenna is a Fellow at the University of Birmingham’s Health Services Management Centre, specialising in child and adolescent mental health and public access and usage of primary, urgent and emergency care services, with particular focus on vulnerable groups. She is also a trustee of HSR UK.
Darko, N. (2023). Not ‘hard to reach’ – increasing diversity in research participation. Accessed February 22, from https://www.england.nhs.uk/blog/not-hard-to-reach-increasing-diversity-in-research-participation/
Kline, R (2014). The “snowy white peaks” of the NHS: a survey of discrimination in governance and leadership and the potential impact on patient care in London and England. Available from Middlesex University’s Research Repository.
National Institute for Health and Care Research (NIHR) (2021). Diversity Data Report 2020/2021. Accessed February 2023, from https://www.nihr.ac.uk/documents/diversity-data-report-202021/29410
Shephard, S. (2017). Appointing for Diversity: Can old universities learn from the experience of the new? Society for Research into Higher Education. Accessed February 2023, from https://srhe.ac.uk/wp-content/uploads/2020/03/SHEPHERD_Sue_Appointing_for_diversity.pdf