Matter for discussion: Support for internationally educated nursing staff

The current nursing workforce remains in crisis with approximately 50,000 vacancies in the NHS and 3,500 in social care. The UK is reliant on the internationally educated nursing workforce with more than 1 in 5 nurses and dual registrants on the NMC register being trained internationally. These professionals, from diverse backgrounds, play a vital role and contribute to the smooth functioning of the health care system, bringing with them knowledge, experience and diversity that will support health care delivery to our diverse population.

As we strive to reduce health inequalities across communities, the knowledge, skills and experience that this workforce brings with them can have a transformative effect on the way in which we engage with, listen and respond to people from diverse backgrounds that hold different health belief models.

The delivery of safe and effective care is at the heart of nursing and the internationally educated workforce has highlighted specific issues that need to be addressed. These include ensuring that they work in safe spaces and are free from the corrosive impact of bullying, harassment, discrimination based on race and the intersection with other protected characteristics, such as religion and belief. The trauma they experience impacts on health and wellbeing which then affects performance, decision making and capability.

Exploitative terms and conditions are commonly reported by internationally educated members. Restrictive immigration policies, including the ‘sole responsibility rule’ relating to children of single-parent households, keeps them separated from their children from extensive periods of time. Those on work visas are also unable to access public funds. This remains a key risk to their financial stability.

There are several barriers to this workforce finding affordable and decent housing. Staff report discriminatory practices such as being refused rentals upon arrival to view a property. Internationally educated recruits also describe facing unaffordable deposits and that furnishings and fixtures seen on viewing a property are replaced with poorer quality items. There is also variation in support provided by employers. The RCN is aware of a best practice example where a trust partners with a lettings agency and provides quality apartments that they manage for staff and their families. 

Internationally educated nurses’ knowledge, experience, commitment and dedication to UK care delivery and patient wellbeing is seen across all sectors and the development of resources to support them addressing challenges will ensure a resilient workforce. 

The reading list for this debate is available here.

References

Nursing and Midwifery Council (2023) Mid-year data report September 2023. Available at: https://www.nmc.org.uk/about-us/reports-and-accounts/registration-statistics/