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Celebrating and Supporting Internationally Qualified Nurses
For this NHS Overseas Workers Day, we focus on Internationally Qualified Nurses working in the NHS; their contributions, challenges and how our work is addressing this.
By: Dr Gloria Likupe
For this NHS Overseas Workers Day, we focus on Internationally Qualified Nurses working in the NHS; their contributions, challenges and how our work is addressing this.
As we celebrate this year’s NHS Overseas Workers Day, it is good to reflect on the contribution that internationally qualified nurses (IQNs) make in the UK. The UK National Health Service (NHS) estimates that around 1 in 8 nurses (12%) are trained outside the EU. In NHS hospitals and community services in England specifically, nearly one in five (18.5%) nurses are overseas nationals, this rises to 2 in 5 nurses working in social care settings (Palmer et al 2021).
This number is projected to increase further as in recent years overseas nationals have accounted for around a quarter of nurse joiners on the Nursing and Midwifery Council (NMC) register. As the largest employer, the NHS has always benefited from overseas recruitment and from nurses coming from other countries to live and work in the United Kingdom. This is in line with the NHS Long Term Plan 2021/2022 that set out the ambitions for the NHS over the next 10 years, identifying ethical international recruitment as a workforce priority.
Worldwide, internationally educated nurses make an invaluable contribution to health systems by providing diverse skills and promoting cultural sensitivity in patient care. As the demand for care and for nurses is increasing, the necessity to attract, and importantly, retain IQNs is vital.
Challenges
However, IQNs working in the UK often face challenges related to cultural integration, communication barriers, a perceived lack of recognition for their prior experience, and potential discrimination. Many report feelings of being treated like novice nurses despite having years of experience in their home countries, leading to challenges in adapting to the professional culture and sometimes feeling undervalued (Sheeny et al. 2023). In addition, many felt they were not being used in roles that matched their prior experience and qualifications, and that integration during their initial spell of employment was often found to be challenging (Devereux 2023). These and other factors from the research show why retaining international nurses is proving to be a challenge at a time when the NHS needs nursing staff more than ever.
Dr Pamela Cipriano points out that these challenges are faced by internationally recruited nurses worldwide by stating “Nurses face numerous challenges: physical, mental, emotional and ethical, and it is imperative that we address these challenges in a way that promotes their overall health” (Church 2025) These challenges can impact their effectiveness at work as well as their personal and family lives. Nurses can fall into depression, burnout and stress which could result in suicidal ideation.
Support
NHS trusts in England have put together a range of support for IQNs which include but are not limited to:
Financial support to trusts for international nurse recruitment, sharing learning and best practice to ensure consistent, high-quality offers and interventions.
A small grants scheme, offering diaspora groups the opportunity to apply for funding to strengthen their pastoral support offer for international nurses in the UK.
Refugee nurse support pilot programme being delivered in partnership with the Department of Health and Social Care, Liverpool John Moores University (LJMU), RefuAid and Talent Beyond Boundaries (TBB), supports refugees who are qualified as nurses in their home country to resume their nursing careers in the NHS.
Our work
Despite these challenges, many IQNs also find opportunities for professional development and positive experiences within the NHS, especially with adequate support systems in place. Pamela Cipriano has stated “By prioritising the wellbeing of nurses, we are ensuring that they can continue to provide the high-quality care that is critical to the health of our communities" (Church 2025). These opportunities can only be realised by health care systems recognising and addressing facilitators and barriers to IQNs’ success and wellbeing.
The Nurse Suicide Project is contributing to this end by conducting ground-breaking research that addresses IQNs’ experiences, some of which may lead to suicidal distress. We are using an intersectional critical feminist lens and storytelling methods to create a safe space for nurses to express these experiences. In doing this, we are supporting the recognition and utilization of IQNs' specialist skills by the world’s healthcare systems. In conducting this research, we are acknowledging that all health systems benefit from a more diverse and better-skilled healthcare workforce, ultimately leading to improved patient outcomes and a more inclusive healthcare system. The project team recognise that most research on suicidal distress is colour-blind and has overlooked the experiences of nurses from the global ethnic majority, including IQNs. The team are proactively working with nursing communities across the spectrum to ensure their views and voices are represented in their research.
In the UK, the Nurses and Midwives Council calls for health and care employers to fully support IQNs into UK practice to create the most inclusive environment possible. We further this call by highlighting that collaboration among policymakers, healthcare organizations and regulatory bodies is crucial in developing strategies for the integration and utilization of IQNs' specialist skills.
Study 3 will be recruiting internationally qualified and ethnically diverse nurses from spring 2026. You can find more information on the study page or get in touch using the contact form.
References
Devereux, E (2023) NHS must recognise overseas nurses’ prior experience, urges report. Available at: NHS must recognise overseas nurses’ prior experience, urges report | Nursing Times
Church, E (2025) International Nurses day 2025 theme revealed. Available at: https://www.nursingtimes.net/nurse-wellbeing/international-nurses-day-2025-theme-revealed-10-01-2025
Palmer, B Leone, C and Appleby, J (2021) Return on investment of overseas nurse recruitment: lessons for the NHS. Nuffield Trust Available at: www.nuffieldtrust.org.uk/sites/default/files/2021-10/1633336126_recruitment-of-nurses-lessons-briefing-web.pdf
Sheeny, L Crawford, T and River, J (2023) The reported experiences of internationally qualified nurses in aged care: A scoping review, DOI: 10.1111/jan.15913
Don’t give us a sticking plaster
About a month ago I saw an advert about the healthcare workers' mental health crisis in the UK: healthcare scenarios followed by individual shots of healthcare workers being overcome with emotion in various places. I was pleased to see such a successful film had been made and was receiving widespread coverage when the jarring tag lines drifted onto the screen.
by Dr Anna Conolly
About a month ago I was sitting in a packed cinema.
As the pre-film adverts played in front of me, I was distracted and I started to feel guilty about being there on a Sunday afternoon – was all my children’s school uniform ready for Monday morning or had I left some in the washing machine? Then, suddenly my attention was held by the large image of an ambulance, covered with bloody tissues, after treating a trauma, with a member of an ambulance crew, slightly removed, looking at the mess then walking away.
Still from 'Sicker than the patients' by Frontline19, 2024.
This was followed by similar scenarios such as family members on a hospital ward singing happy birthday to their father, supposedly a cancer patient, as a male member of staff watched or a nurse broke bad news to a couple in a side room. These scenarios were followed with individual shots of healthcare workers being overcome with emotion in various places, such as a nurse who broke down in a supermarket. All filmed as if taken by CCTV cameras with loud sound editing which captured the healthcare workers unsteady breathing, the film appeared very realistic and was completely effective in making you feel real empathy for healthcare workers.
I was pleased to see such a successful film had been made and was receiving widespread coverage when the jarring tag lines drifted onto the screen:
With over half suffering from poor mental health many NHS staff are sicker than the patients. Not that they would ever let you see it. Donate now so we can provide the therapy they urgently need.
Sticking Plaster
I almost screamed No! at the cinema audience. The advert, made by Frontline 19, an organization who received backing from Boris Johnson to help healthcare workers during and after the pandemic, positioned mental health support, paid for by charitable donations from the public, as the solution for the healthcare workers mental health crisis in the UK.
I am a researcher, and I have been working on workforce wellbeing for the last 3 and half years. The images that the advert displayed did not surprise me, however, I was more than a little irritated by the messaging used at the end. Because the images shown in the advert were so emotive I was cross that such a powerful film could be used to support an agenda that only represents a ‘sticking plaster’ approach to providing support for healthcare workers in the UK. I believe that chronic underfunding has led to systemic and cultural failings within the NHS. It is the organisation that requires healing, in order for the workforce to have a healthy environment in which to do their jobs.
Social Justice
Social justice has always provided the bedrock of the provision of healthcare in the UK. Founded in 1948 on the principle that healthcare services ‘are free for all at the point of delivery’ the NHS was, for decades, the envy of many countries. However, decades of little or no workforce planning, underfunding of the health service workforce, and massive staffing shortages have led to significant structural challenges.
Even before the pandemic, pressure in the health and care system was taking its toll on staff and was not sustainable. Reports described staff as running on empty and as the shock absorbers in a system lacking resources to meet rising demands. Excessively over-worked staff who suffer from mental distress and trauma due to not being able to provide the care they feel their patients are entitled to does not chime well with the social justice principles the NHS was founded upon.
I would argue that the chronic underfunding has gone too far and sticking plasters are no good to those who work within the NHS. Our government must acknowledge the scale of investment and organisational culture changes that are needed to keep the NHS going and ensure the health of both our healthcare workers and patients.
If you are a nurse or health worker who is in need of support, we have a range of support links here.