International Recruits Review

Healthwatch Hertfordshire was commissioned by the local ICB to undertake research with internationally recruited staff to understand why they might want to leave working for the NHS.  They spoke to 349 people.

Despite some very positive experiences, 49% said they were seeking employment opportunities elsewhere, indicating that there is significant work to be done to retain internationally recruited staff, with our findings also highlighting key areas for improvement.

Most had a positive experience, receiving regular communication and support during each stage of the recruitment process. However there were clear inconsistencies between HR departments and recruitment agencies, with suggestions for improvements including more practical support, assigning a main point of contact, and meeting staff at the airport.

Many were not aware of their role and responsibilities prior to arrival, and 57% were not assigned to a clinical area - with many allocated to wards in which they had no or little experience. International recruits also received little clinical and technical support when working on the wards, despite the operations of the NHS being very different to their home country.

Many had a positive experience of induction, commenting that the process was smooth and informative. Suggestions for improvement included providing practical support and information to help international recruits settle and adjust, as well as more one-to-one support and pastoral care.

Many enjoy working for the NHS, describing the culture as “supportive” and “welcoming” and shared positive examples of good teamwork and collaboration, and caring colleagues and management. However key concerns included staffing pressures, unmanageable workloads, difficulties maintaining a worklife balance, feeling undervalued and lack of diversity in leadership.

Over 50% have faced negative experiences at work, including cases of bullying, racism, discrimination and harassment from both patients and staff. Some felt unsafe to speak up and did not feel confident that their Trust would address their concerns – emphasising the importance of ensuring there is zero tolerance and improving mechanisms to ensure international recruits feel able to raise concerns.

77% felt they had access to training and learning opportunities. However, many raised concerns about the lack of equal opportunities for career progression and progression and clear indications of favouritism and bias.

Living in the Community: Most were satisfied with the area they live in and felt they had settled into the community, having built strong relationships and networks. Concerns focused on the cost of accommodation, safety, and feeling lonely and isolated.