Many foreign London nurses considering leaving UK, large survey

  1. the nhs in london could face a staffing crisis in the future with more than four out of every 10 overseas nurses working in the capital admitting they are considering leaving the health service to take up posts in other countries.

    2005-05-24 - that is the key finding from the biggest ever survey of internationally recruited nurses working in the capital, which has been published today by the king's fund and the royal college of nursing. a major concern of the survey is that two thirds of filipino nurses working in london - one of the largest overseas nursing staff groups - are considering leaving the uk to work in the us.

    report author professor james buchan said: "the nhs and independent health care sectors rely heavily on overseas nurses to deliver health care - without them, parts of the health service would collapse. they perform a crucial and valuable role but our survey shows the nhs is playing a high risk game by relying on these overseas staff to commit long term to the nhs.

    "many of these nurses are considering leaving the nhs and that would pose real problems. it's clear the nhs needs to up its efforts to grow its own workforce to ensure we have the right number of nurses for the future. the good news is that many of these nurses also signal that they could stay on if their uk employer treats them well."

    almost 400 nurses took part in the survey from more than 30 different countries. it sought to find out why overseas nurses choose to work in the uk, where they are working and how long they are intending to stay. among the key findings are:

    exploitation - many of the nurses surveyed, especially those from sub saharan africa, believe they are under-graded and underpaid in relation to their experience and responsibilities, while many reported being treated unfairly by the recruitment agencies that brought them to the uk. this shows bad practice persists in some organisations ( mainly outside the nhs ) and that some nurses are still being exploited.

    back-door recruitment - despite a government clampdown on the 'active' recruitment of nurses from developing countries, the survey revealed clear evidence of 'back-door recruitment' with many nurses reporting they had initially worked in the uk for private sector employers before moving quickly, or immediately on completion of their adaptation course, to work in the nhs. some nurses, mainly from sub saharan africa, also reported that they had to pay for some of the services provided by agencies and that they even went without pay during this period of work.

    motivation - although nurses coming to the uk can hope to earn many times more than they can in the developing countries of sub saharan africa, the survey revealed that many are here primarily for professional development or to take the opportunity to travel. almost two thirds of nurses for whom finance is a significant factor reported that they were the sole or main breadwinner, and more than half said they regularly sent money back to family and friends in their home countries.

    rcn general secretary beverly malone said: "this is further compelling evidence of the weakness in the government's code of practice. with two-thirds of nurses reporting that a recruitment agency has been involved in their move to the uk, it is imperative the government takes urgent steps to extend the code to cover the private and independent sector."

    following the survey findings, the king's fund and rcn are calling for:

    -- the department of health should implement house of commons select committee recommendations and track the number of overseas nurses the nhs recruits and employs. it should be more transparent about how many overseas nurses it plans to recruit in the future.

    -- all uk employers should work with each international nurse they recruit to draw up individual career plans to ensure these nurses can work effectively and meet their career aspirations.

    -- the "back door" recruitment via the private sector undermines the doh code of practice on international recruitment. as a result, the nhs should commit to making available sufficient resources for the necessary number of adaptation and supervised practice placements within the nhs, rather than relying on nurses to pay for nursing home-based adaptation and then recruiting them soon afterwards.

    king's fund chief executive niall dickson added: "this survey shows there are big problems with the way international nurses are being treated - it's clear many of them feel underpaid and exploited. we've got to find a better way of treating this vital group of workers if their experience in the uk is to be a positive one both for them and for our health system. unless we address this issue fast those nurses thinking of moving to another country are more likely to make the move and that could have serious consequences for the nhs."

    the first findings of the survey are published today in the nursing standard. please visit www.kingsfund.org.uk/pdf/nursestudy.pdf to read the survey findings from 9am on wednesday, 18 may.

    1. for further information or interviews, please contact the king's fund media and public relations office on 020 7307 2585, 020 7307 2581 or 07831 554927. an isdn line is available for interviews on 020 7637 0185. for the rcn press office, please contact rachel dufton on 0207 647 3633.

    2. the survey findings are published today in the nursing standard. it is a major strand of a research programme the king's fund, in partnership with the nhs in london, is carrying out into international nhs recruitment in the capital. please visit http://www.kingsfund.org.uk/pdf/nursestudy.pdf to read the survey findings.

    3. survey facts and figures

    -- returns were analysed from 380 international nurses who were london-based rcn members. they came from more than 30 different countries. the philippines, nigeria and south africa were the three most commonly reported countries of training

    -- there was a broad age profile of international nurses. while most nurses from australia and new zealand were aged 34 or less; more than 60 per cent of nurses from sub saharan africa were aged 40 or older - usually with many years of clinical experience

    -- at the time of the survey 69 per cent of the nurse respondents were working in nhs hospitals in london, 13 per cent were working in the independent sector and 10 per cent were working in nursing homes

    -- in the last four years almost 60,000 international nurses have registered with the nurses and midwives council in the uk - nearly half of all the new nurses registering to practice. it is believed that one in four nurses working in london is from overseas.

    -- the code of practice for the international recruitment of healthcare professionals was published in december 2004 to set out standards and guiding principles for the recruitment and employment of healthcare professionals from abroad.

    4. the king's fund is an independent charitable foundation working for better health, especially in london. we carry out research, policy analysis and development activities, working on our own, in partnerships, and through grants. we are a major resource to people working in health, offering leadership and education courses; seminars and workshops; publications; information and library services; and conference and meeting facilities.

    5. royal college of nursing ( rcn ) is the voice of nursing across the uk and is the largest professional union of nursing staff in the world. the rcn promotes the interest of nurses and patients on a wide range of issues and helps shape healthcare policy by working closely with the uk government and other national and international institutions, trade unions, professional bodies and voluntary organisations.

    http://www.kingsfund.org.uk
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    21 Comments

  3. by   lee1
    Money talks obviously but until working conditions improve it only allows temporary relief-------
  4. by   plato353
    i am a nurse from south africa definately condidering leaving the uk.exploitation of nurses within the uk is not a new concept.i have taken my nclex in new york but failed this year.however now that it is being held in london it makes life easy.there are numerous factors why migrating to the us is a good career move
    think about it the department of health here wants the 30 year old plus nurse to fill the gap in the nurse labour market.(nursing times 24-30 may 2005) why because no one is entering at younger stage due to competion from other professions.those young nurses ( uk trained) that do complete their training head off to australia and new zealand.coupled with the fact that the govermant has announced a 60 billion short fall in the pension fund. if your lucky retiring at 70 as proposed you will live only 10 years because at present nurses have the highest death rate after police man 10 years post retirement(department of health)the cost of living here is high.i would like to urge all foreign nurse to take the step and leave the uk.
    if your professional aspirations are not catered for and reflected in your pay whats the use.this program of the goverment of agenda for change(meaning higher pay for more work that you do) should be called agenda for bringing less change in your pocket.look at child benefit ie tax credits( a goverment program to help pregnant mothers return to work faster) for pregnant foreign nurses they are not entitled to it.claiming it( not malicously i have to state) could mean ban that will loose their leave to remain in this country (rcn bulletin 25 may-7 jun 2005 page 3).effectively meaning deportation.(hello you dont have to be a rocket scientist to figure out we are not wanted here).
    its time for last call to all foreign nurses at the departure gate..make sure you board the plane and a visa to a country that would fill your proffesional aspirations
    basically i am angered :angryfire and i welcome the kings report because for along time they have been talking about this.my wife and i had to delay the start of our family and we will rather leave. god willing we should be heading for the states or australia.[img]images/icons/icon6.gif[/img]
  5. by   germain
    Quote from plato353
    i am a nurse from south africa definately condidering leaving the uk.exploitation of nurses within the uk is not a new concept.i have taken my nclex in new york but failed this year.however now that it is being held in london it makes life easy.there are numerous factors why migrating to the us is a good career move
    think about it the department of health here wants the 30 year old plus nurse to fill the gap in the nurse labour market.(nursing times 24-30 may 2005) why because no one is entering at younger stage due to competion from other professions.those young nurses ( uk trained) that do complete their training head off to australia and new zealand.coupled with the fact that the govermant has announced a 60 billion short fall in the pension fund. if your lucky retiring at 70 as proposed you will live only 10 years because at present nurses have the highest death rate after police man 10 years post retirement(department of health)the cost of living here is high.i would like to urge all foreign nurse to take the step and leave the uk.
    if your professional aspirations are not catered for and reflected in your pay whats the use.this program of the goverment of agenda for change(meaning higher pay for more work that you do) should be called agenda for bringing less change in your pocket.look at child benefit ie tax credits( a goverment program to help pregnant mothers return to work faster) for pregnant foreign nurses they are not entitled to it.claiming it( not malicously i have to state) could mean ban that will loose their leave to remain in this country (rcn bulletin 25 may-7 jun 2005 page 3).effectively meaning deportation.(hello you dont have to be a rocket scientist to figure out we are not wanted here).
    its time for last call to all foreign nurses at the departure gate..make sure you board the plane and a visa to a country that would fill your proffesional aspirations
    basically i am angered :angryfire and i welcome the kings report because for along time they have been talking about this.my wife and i had to delay the start of our family and we will rather leave. god willing we should be heading for the states or australia.[img]images/icons/icon6.gif[/img]
    Welcome to the US, if its here that you come. Good luck.
  6. by   letina
    Quote from plato353
    i am a nurse from south africa definately condidering leaving the uk.exploitation of nurses within the uk is not a new concept.i have taken my nclex in new york but failed this year.however now that it is being held in london it makes life easy.there are numerous factors why migrating to the us is a good career move
    think about it the department of health here wants the 30 year old plus nurse to fill the gap in the nurse labour market.(nursing times 24-30 may 2005) why because no one is entering at younger stage due to competion from other professions.those young nurses ( uk trained) that do complete their training head off to australia and new zealand.coupled with the fact that the govermant has announced a 60 billion short fall in the pension fund. if your lucky retiring at 70 as proposed you will live only 10 years because at present nurses have the highest death rate after police man 10 years post retirement(department of health)the cost of living here is high.i would like to urge all foreign nurse to take the step and leave the uk.
    if your professional aspirations are not catered for and reflected in your pay whats the use.this program of the goverment of agenda for change(meaning higher pay for more work that you do) should be called agenda for bringing less change in your pocket.look at child benefit ie tax credits( a goverment program to help pregnant mothers return to work faster) for pregnant foreign nurses they are not entitled to it.claiming it( not malicously i have to state) could mean ban that will loose their leave to remain in this country (rcn bulletin 25 may-7 jun 2005 page 3).effectively meaning deportation.(hello you dont have to be a rocket scientist to figure out we are not wanted here).
    its time for last call to all foreign nurses at the departure gate..make sure you board the plane and a visa to a country that would fill your proffesional aspirations
    basically i am angered :angryfire and i welcome the kings report because for along time they have been talking about this.my wife and i had to delay the start of our family and we will rather leave. god willing we should be heading for the states or australia.[img]images/icons/icon6.gif[/img]

    I have read your post with very mixed feelings and will try to respond objectively.
    I agree with much of what you say, particularly your points regarding pension fund issues and most definitely the impact of Agenda for Change.
    I do however feel compelled to point out that these issues are not just directed at foreign nurses, they apply to all of us, nurses who have given many years of service to the NHS. I have been a nurse here in the UK for 28 years, I hold a position with a great deal of responsibility and my salary is less than that of my 26 year old son who works in private industry. I have, on many occassions, funded my own study in order to further my career. And the reward? None, apart from my own personal and professional development. So what am I going to do? Like you, I'm heading to the US for a better life and where this profession of ours is valued.
    I guess what I'm trying to say is that please don't think you are not wanted here because you are a foreign nurse. I have worked with many colleagues from other countries and none are treated any differently than their UK counterparts, not in my experience anyway. We all get the same pay and conditions. And we all feel the same frustrations.
    I wish you luck in whatever you decide to do.
    Tina
  7. by   madwife2002
    I too read your post with mixed feelings. I work on a ward where we have nurses from all over the world and in my opinion we are all treated the same. I was told by a recruiter from overseas that when they recruit from the philipines they know that they will only stay for around 18 months because we are a stepping stone for the US, I questioned the expense of this and was told well at least we fill the gap for a short period of time! If oversea's nurses are employed by the NHS rather than agencies, then I am sure they have access to the same resourses that UK nurses are. I know on my ward the oversea's nurses are placed on courses and study day's. In fact one of our D grades has been on more courses and study days than I have. In fact I am sure most of the oversea's nurses on my ward have accessed more courses in the past 14 months than I have.
    I must add that i have a lots of courses under my belt from previous employment and as I am emigrating myself do not feel i should access study days in the same way.
  8. by   mattsmom81
    Hmm. Well I am a US nurse and I do not feel valued...most nurses I know feel the same. So...don't expect massive respect here either.

    I also cannot retire til 69 1/2 (the age I can collect my social security if I'm alive and if there will be anything left for me then...the govt has stolen the money from that fund and I suspect they will continue to do so.)
  9. by   madwife2002
    Quote from mattsmom81
    Hmm. Well I am a US nurse and I do not feel valued...most nurses I know feel the same. So...don't expect massive respect here either.

    I also cannot retire til 69 1/2 (the age I can collect my social security if I'm alive and if there will be anything left for me then...the govt has stolen the money from that fund and I suspect they will continue to do so.)

    It is awful isn't it how unrespected we are as nurses worldwide. I too will be working til i am a very old woman, that's if I still have my back :chuckle
  10. by   letina
    Quote from mattsmom81
    Hmm. Well I am a US nurse and I do not feel valued...most nurses I know feel the same. So...don't expect massive respect here either.

    I also cannot retire til 69 1/2 (the age I can collect my social security if I'm alive and if there will be anything left for me then...the govt has stolen the money from that fund and I suspect they will continue to do so.)
    Point taken mattsmom. Difference being, US nurses still seem passionate about their career, despite the lack of respect sometimes. Your new grads especially (from what I read on here anyway). Complete different ball game here. I despair sometimes at what I see and hear, just my observation in my own area. But then again, I suppose I'm what they call 'old school'
  11. by   Faeriewand
    Gee, I didn't know the working conditions for nurses were so bad in the UK! I've often fanasized about traveling to other countries and living there and working as a nurse to be able to experience another culture. London was one of those places I have thought about. Hope they shape up over there and start paying you what your're worth! Why is it so hard for people to understand that if you pay more and make working conditions better that workers will be happier and stay on the job? Good luck to everyone who is considering the big move to the USA!
  12. by   mattsmom81
    I remember the stories my friend (who trained in the UK) told me about nursing across the pond. She could not afford to live on her own on a nurses' salary, which amazed me. She enjoys it here in the US...even married an American (much to the chagrin of her mother..hehe)

    She has told me there are quite a few differences particulary in all the futile care of the elderly and infirm we deliver here in the US. Things are more 'practical' in the UK, she tells me... with less fear of medical lawsuits; she does miss that.

    I love the fact that nurses can travel and work abroad...such a great experience! I encourage all UK nurses to come over if you have a mind to. Give us a try..you might like us and stay. I have enjoyed my UK coworkers greatly.
  13. by   madwife2002
    Quote from mattsmom81
    I remember the stories my friend (who trained in the UK) told me about nursing across the pond. She could not afford to live on her own on a nurses' salary, which amazed me. She enjoys it here in the US...even married an American (much to the chagrin of her mother..hehe)

    She has told me there are quite a few differences particulary in all the futile care of the elderly and infirm we deliver here in the US. Things are more 'practical' in the UK, she tells me... with less fear of medical lawsuits; she does miss that.

    I love the fact that nurses can travel and work abroad...such a great experience! I encourage all UK nurses to come over if you have a mind to. Give us a try..you might like us and stay. I have enjoyed my UK coworkers greatly.

    How lovely and encouraging your words are. Especially to one who is very nervous about coming to US and working over there. I guess as Pat Benner would say I see myself as an 'expert' here in Uk but once I arrive in US I see myself reversed to a 'novice'. that is quite a daunting thought but also and excieting one too.
  14. by   rinku25
    I am from India, I have done my bsc and am currently working at Midessex hospitals, UK. 40% of my income goes to the govt here in the form of tax, national insurance, county council & another 50% of my income goes for the house rent etc., with peanuts left. I wud have to wait for my next salary to clear my credit card payments. Interestingly an article was recently published that international nurses shud not even apply for tax credits 

    I think US wud be a better place for nurses. Gracefully I cleared the cgfns & ielts. Looking forward to opportunities in the US.

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