A brief guide to the International Retention Toolkit

This toolkit aims to support the reduction in turnover of international staff in the NHS by improving their experience at work – it is hoped that this will then enable them to stay, thrive and build lasting careers in the NHS

CREDIT: This is an edited version of an article that originally appeared on NHS Employers

As employers focus on growing and sustaining ethical recruitment pipelines for internationally recruited staff, it is equally important that we retain as much of this workforce as possible.

Based on a framework of four pillars, this toolkit brings information, best practice examples and resources together in one place and focuses on what organisations, systems and regions are already doing to create the conditions for all international staff to thrive in the NHS.

Pillar one: Creating strong foundations

The first pillar focuses on creating strong foundations in the months before your new recruits arrive in the UK. First impressions are important for anyone starting a new job, but consider how they might feel as they prepare to leave behind friends and family, familiar surroundings, language, and cultures to start a new life in a different country.

Review your recruitment timeline to consider where and when your organisation can offer support. The International Recruitment Toolkit contains a useful recruitment timeline for overseas nurse and midwife recruitment (page 61) and overseas doctors (page 90).

As well as the support you offer locally, diaspora groups can also provide the pastoral and professional support your international nurses and midwives will need. A list of diaspora groups can be found in the International Recruitment Toolkit (page 73) and can be shared with your new recruits so they can find out about the support available to them before they arrive.

Pillar 2: Making new recruits new welcome

The second pillar is about ensuring new recruits feel welcome when they arrive by helping them settle into their new communities by pointing them towards local services.

Consider what they will need during their first few months in the UK to establish themselves to live, work and beyond, such as bank accounts, National Insurance numbers, GPs, somewhere to live, UK sim cards, access to shopping, schools, public transport and other amenities.

Helping them with these arrangements will make a big difference to how well they ease into life in the UK. Introducing some coordinated social activities can also prove very helpful in encouraging integration into teams.

This supportive approach during the recruitment and onboarding stages means you are more likely to retain staff, and for this reason, this information is included in this toolkit and the International Recruitment Toolkit.

Pillar 3: Building belonging

Pillar three focuses on building belonging. This relies on cultural sensitivity and an awareness of how it feels to be working and living in a different country.

Research shows that having English as a second language can impact on an international nurse’s sense of personal and professional belonging. Accents, abbreviations, local turns of phrase and conversational speeds can result in international staff feeling left out of workplace small talk or deskilled despite years of professional experience (University of Huddersfield (2022) International nurses and their initial integration into NHS England’s healthcare workforce: a population analysis).

Enabling your international staff to build social networks, to share stories and solutions to these challenges can help to reduce feelings of isolation and support them to bring their passions, culture, and personality to their role.

You should also consider the role of leaders, managers and the wider workforce and what support or training they will need to raise awareness and support their international colleagues with these challenges.

Pillar four: Maximising personal and professional growth

The fourth pillar is about maximising personal and professional growth to ensure that all internationally recruited staff can fully realise their potential.

Research shows that a common driver for international nurses to migrate to the UK is career progression. However, analysis reveals that progression is slower and less frequent for international nurses than for domestic nurses at all bands. 

The WRES 2022 report also highlights that just 44.4% of BME NHS staff (which may include internationally recruited staff) believe their trust provides equal opportunities for career progression or promotion.

Your retention strategy should focus on enabling all international staff to achieve their career aspirations. Their ongoing personal and professional development will also lead to job satisfaction and in turn a feeling of being valued by their employer.

International staff should have access to the same personal and professional development opportunities as your UK workforce and should be tailored to each individual’s preferences and career aspirations. As part of this process, they should be offered an annual personal development review and a personal development plan should be agreed.