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International nurse recruitment a 'long-term investment'

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Recruiting nurses from overseas is a “long-term investment” for an organisation because they are less likely to jump ship once they join, according to a top nurse at a renowned trust.

Andrew Carter is leading a major international nurse recruitment drive at Oxford University Hospitals NHS Foundation Trust (OUH) to help plug gaps in the workforce.

“It was a big hurdle that was put in place to get over”

Andrew Carter 

The campaign started in January 2018 and to date the trust has managed to secure 70 international nurses from across India, the Philippines, the Middle East, Africa, the Caribbean and the US.

Despite the early success, the trust’s nurse vacancy rate has yet to show signs of improvement and in fact has increased slightly from 13.7% in January 2018 to 14.1% in January 2019.

The trust, which runs John Radcliffe Hospital, Churchill Hospital, Nuffield Orthopaedic Centre and Horton General Hospital, is seeking to recruit at least another 130 nurses from overseas.

In an interview with Nursing Times, Mr Carter, associate chief nurse at OUH, acknowledged that recruiting via this route had a higher cost attached but he said the trust would “reap the benefits” later.

He added the trust expected to claw back the money by improving its retention rate because international nurses were more likely to settle in the area and stay in post for longer.

andrew carter

andrew carter

Source: Oxford University Hospitals NHS Foundation Trust

Andrew Carter

“There is an increased cost but what we know from successful recruitment events going back probably 10 years when a lot of trusts went down to the Philippines to recruit is that the nurses that we recruit are looking to base themselves in the area and we see that the retention rate is very good,” Mr Carter said.

“Over the next three to five years our aim is to see our retention rate improve and that’s where we will get to reap the benefits of what we are investing now,” he added. “So, it’s a long-term investment is recruitment such as international recruitment.”

Mr Carter said OUH has had to work “creatively” to fill gaps because there were not enough student nurses coming through in the UK.

“We are facing the challenge that most organisations are with the fact that in the UK there are not enough nurses currently that are graduating to meet the workforce demands we are seeing,” he told Nursing Times.

In addition, the trust has faced an exodus of European nurses.

Trust figures obtained by the Oxford Mail show the number of nurses from the European Union starting work at OUH fell from 809 in 2015-16 to 395 in 2017-18, while the number leaving grew from 230 in 2015-16 to 386 in 2017-18.

Mr Carter said Brexit had a part to play in this decline, but he stressed that it was not the only factor – highlighting the “big impact” the introduction of English language testing for European nurses had.

The Nursing and Midwifery Council extended the International English Language Testing System (IELTS) to recruits from the European Economic Area (EEA) in 2016. It had previously only applied to overseas nurses outside the EEA.

“It was a big hurdle that was put in place to get over, that did change the numbers that we saw,” Mr Carter told Nursing Times

However, in November last year the NMC approved plans to relax the language test, lowering the level required to pass the writing element from 7 to 6.5.

Mr Carter said he believed this was a “much more realistic target”.

“I can understand why the English language tests have been put in place,” Mr Carter said. “I think lowering scores is low risk because it is about the way we support and nurture the nurses when they arrive.”

He noted how the trust had successfully recruited from Europe before the English language test was extended and many of those nurses were still with the organisation and now in senior positions.

“There are not enough nurses graduating to meet the workforce demands”

Andrew Carter 

The NMC is continuing the review its international regulation system and has not ruled out further changes in the future.

The trust is seeking band 5 nurses from overseas and Mr Carter said it had found recruits for areas that had been difficult to fill locally such as theatre, neonatal and paediatrics.

“They are able to help us with what we are finding to be the biggest challenge areas for recruitment within the UK,” Mr Carter said.

While acknowledging that competition was high for registered nurses from overseas due to current national shortages, Mr Carter said OUH was a hot pick because it was “renowned worldwide”.

The trust is also conveniently placed for international recruitment because Oxford Brookes University is one of only three test centres for the objective structured clinical examination (OSCE), which overseas nurses must pass before they can join the NMC register.

Mr Carter said seeing the nurses arrive and settle well into the trust was “one of the proudest moments” of his 27-year career in the profession.

“I have seen the commitment and high standard of quality of the nurses coming in and they want to be with us in Oxford and I think that’s the important thing, that every nurse that we employ regardless of what country they are coming from wants to be here,” he added.

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