Retention of pre-registration nurses in the UK has been a longstanding challenge. With an attrition rate hovering around 25 per cent, the impact on workforce planning and long-term staffing in health and social care is significant. The reasons why nursing students leave their programmes are complex, interwoven and often personal, ranging from financial pressures and academic struggles to difficult placement experiences.
While we know that no single factor causes attrition, the conversation has increasingly turned towards what higher education institutions can do to support students more effectively. The key lies in identifying those at risk early and intervening in meaningful, practical ways. This resource offers insight into how one institution tackled the challenge with a simple but effective data-informed model that is already showing promise.
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A new way of looking at higher education retention
Higher education retention strategies must address both academic and non-academic factors. Traditionally, student achievement and attendance have been used as markers of success. It’s well-established that students struggling academically often attend less, and those who disengage are more likely to drop out. But these indicators alone don’t tell the full story.
Our approach recognised that while attendance and assessment are useful indicators, they must be part of a broader picture including engagement levels, behavioural professionalism and well-being.
We developed an initiative to support a cohort of adult nursing students by:
• Tracking attendance, engagement and academic performance
• Monitoring fitness to practice referrals
• Assessing professional behaviours, as judged by both academic staff and students
• Hosting all data on an e-portfolio to support reflection, provide a central repository for feedback and offer a structured approach to personal and professional development.
A small team comprising the course director, a senior adviser and each student’s personal adviser reviewed the information every six months. Each student was categorised as low, medium, or high risk of attrition.
Based on this assessment:
• Students received a short, personalised email summarising their progress
• Those identified as higher risk were offered tailored support, such as referral to learning enhancement teams or well-being services
• Feedback was positive and action-oriented, focusing on growth and development rather than deficit.
This structured, cyclical review made it easier to spot patterns, intervene early and build a dialogue between students and staff.
Early results and reflections
Feedback from both students and staff has been overwhelmingly positive:
Students:
“It has given me a better understanding of what areas I need to focus on”
“It is motivating and encouraging to receive feedback”
“It was nice to see how I was coming along and where any improvements can be made”
Staff:
“I found this opportunity very useful. It helped to support our team approach to really focus on increasing students self-awareness, particularly around professionalism and about the skills required to maximise their learning opportunities”
Early signs of impact include:
• An increase in referrals to support services like well-being teams and academic skills support
• Improved student retention compared to previous cohorts
• Reduced referrals for “fitness to practice” for professionalism concerns
Perhaps most importantly, students felt seen. They knew someone was paying attention and cared.
What makes this work?
• Holistic: it looks beyond just grades or attendance, recognising multiple aspects of student life
• Proactive: it offers help before students ask for it, removing stigma or hesitation
• Simple: despite using multiple data sources, the process is easy to implement and manage
• Personalised: it allows students to receive targeted advice, not blanket messages
• Professional: it ensures students are involved in their own assessment of self, building self-awareness and professional behaviours
• Autonomy: it allows students to engage in self-assessment and have access to all feedback and feedforward, maximising development opportunities.
For institutions considering a similar approach, here are a few practical steps:
• Set clear review intervals (e.g., every six months)
• Keep the review team small and consistent
• Use available data wisely, but avoid overwhelming staff or students
• Communicate clearly and compassionately
• Track outcomes to refine and improve the process
• Host all data on an e-portfolio to promote student ownership.
Looking ahead
This is not a silver bullet, but it’s a strong foundation. As we gather more data and feedback, we hope to further adapt the process, perhaps incorporating peer assessment of professionalism.
The takeaway: when we treat retention as a shared responsibility and act early, we give students the best chance to succeed – not just academically, but as future professionals.
Rebekah Hill, Lorraine Randlesome and Rachel Lewis are educators at the University of East Anglia.
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