Nurses arriving from the European Union to take up jobs in the NHS admit they may not have the “right” language skills to work effectively, and often have difficulty slotting into the healthcare system.
These were among findings from a study by the National Nursing Research Unit at King’s College London, which reinforces the need for strong induction and ongoing support for overseas nurses.
“Being generally competent in English did not mean they had the ‘right’ language skills”
The NNRU’s review shows recruitment of nurses from other European countries has risen sharply, as more exercise their right to work across the EU and because of tighter controls on nurses coming from developing countries.
It has been driven even more strongly over the last 18 months by trusts seeking nurses to sure up shortages in the wake of the Francis report into care failings at Mid Staffordshire Foundation Trust.
A recent investigation by Nursing Times found at least a third of trusts were actively recruiting overseas, with Spain and Portugal particularly popular. Most trusts have stipulated that recruits are thoroughly checked and then put on induction schemes.
The fact nurses could already speak English was one of the key factors that drew them to the UK, according to the latest study, which involved an online survey and in-depth interviews with nurses from a range of EU countries, such as Bulgaria, Greece, Poland and Romania.
“Once here respondents felt being generally competent in English did not mean they had the ‘right’ language skills to work effectively in the health service,” said the report. “This was also a concern shared by professional regulators who have been unable to test language as a pre-requisite for registering EU migrants.”
In addition, the research highlighted overseas nurses’ concerns about their training, and the social and cultural issues, that can make fitting into a “very different UK health system far from straightforward”.
Study author Ruth Young, a reader in health policy evaluation at King’s College London, said the language issues often had a regional link. “It’s things like words for different types of pain or colloquialisms and ways of speaking that are not part of the standard English you have learned in your home country,” she said.
“Like any new job, it’s a learning process when you first start and the organisations that are receiving migrant nurses need to take account of that kind of thing in their induction and the support they give people when they first arrive.”
Employers also needed to recognise the differences between the many EU countries, she added.
“Each has their own professional culture and people come here with different experiences,” she said. “There’s a huge variety and you need to recognise that in the induction process, be flexible and adapt to what people need.”
The study also revealed that some overseas nurses struggled to get their qualifications recognised in the UK and so took on healthcare assistant roles or ended up working as housekeepers and cleaners. They could benefit from “additional training to get them up to speed”, said Ms Young.
Another key issue highlighted by the research – part of the wide-ranging PROMeTHEUS study of the movement of health professionals around the EU – was the difficulty overseas nurses had in returning home.
“People don’t necessarily come thinking it will be long-term but life happens and it becomes long-term,” noted Ms Young. “They stay because they have more career opportunities in the UK.”
Poorer European countries in particular were likely to suffer from a drain of nursing talent, warned the report.
However, as reported by Nursing Times last week, nurses trained in the UK could themselves be the target of recruitment efforts by the US soon, as public healthcare provision is set to expand massively under “Obamacare”.