University Hospitals of North Midlands NHS Trust (UHNM) has implemented a raft of interventions to support high quality training and inclusive talent management for their internationally educated workforce (IEW).
UHNM is based across two sites, Royal Stoke in Stoke-on-Trent and County Hospital in Stafford. The trust is a specialist centre for major trauma for North Midlands and North Wales, employing over 11,000 staff that serve a population of approximately three million. 20.5% of UHNM staff are international recruits.
UHNM is working to create and encourage a strong culture of inclusion where staff feel valued and respected. All employees are asked to make a commitment to the organisational values; which were co-created by staff, patients, and carers.
Talent management was identified as a priority within UHNM's workforce strategy. Numerous interventions have been developed as part of its dedicated IEW programme, including specific actions to support high quality training and talent management for the IEW. These include:
- Delivering a comprehensive induction process that provides guidance and support for the required training, and empowering the IEW to take on development opportunities as they arise.
- Organising introduction and familiarisation meetings for the IEW with key contacts from corporate nursing and the recruitment team.
- Assigning all new IEW recruits a named contact for support .
- Providing a digital welcome booklet to each recruit with detailed information about:
- the local town and the region,
- local supermarkets and prices of daily goods,
- local banks,
- accommodation and facilities local to the trust,
- the recruitment journey and processes they can expect,
- staff development opportunities,
- staff equality network groups,
- and other equality, diversity and inclusion (EDI) work across the trust . - Supporting the IEW to complete their objective structured clinical examinations (OSCE).
- Ensuring annual appraisals and personal development reviews set personal goals and highlight any training and development opportunities.
- Ensuring access to leadership development programmes to enable peer learning and networking.
- Providing opportunities to achieve additional academic qualifications via trust links with both Keele and Staffordshire University.
- Delivering a development programme incorporating mentoring for the IEW (alongside underrepresented groups).
- Providing 'Enable' training to managers to support them to lead with cultural awareness and competency and foster a culture of civility and respect within their teams.
- Signposting new recruits to IEW networks and forums.
- Utilising staff feedback to inform the need of additional pastoral care and raise awareness for issues affecting the IEW, especially when recruiting and onboarding a targeted refugee cohort.
UHNM's programme for recruiting internationally educated nurses (IENs) and refugees has had a significant impact on the workforce, IEN retention, organisational reputation, and organisational culture.
Since 2021, 217 overseas nurses and six refugees have been appointed and onboarded, with a further 110 IENs scheduled to join in the next eight months. UHNM also has a high retention rate of IENs, standing at 96%. The success of these appointments and high retention rates can be attributed to the focus on training and pastoral care, ensuring IENs feel supported and valued.
UHNM's reputation of being an inclusive organisation has been enhanced as a direct result of the implemented interventions, positively impacting on the number of overseas applicants, as well as enhancing the relationships with agencies sourcing IENs. UHNM now collaborates with higher calibre agencies, reflecting the trust's reputation as a preferred employer for international healthcare professionals. This improved reputation has enabled the trust to address shortages in specific clinical specialties, where there have been previous national shortages.
The trust has begun to see progression for staff recruited through the programme, and actively recognises and celebrates individual successes. UHNM is looking to monitor the rates of promotion, recognising that the IEW bring a diversity of skills and experience which add value to the trust and further improves patient care.
UHNM was awarded the NHS Pastoral Care Quality Award by NHS England in May 2023.
Image supplied by University Hospitals of North Midlands NHS Trust.
Hear from the trust
The Race Equality programme spoke to Emily Foxhall, recruitment manager, at UHNM about implementation of these interventions, the challenges, learning for the board, and advice for board members looking to support their IEW.
The IEW programme is led by a fixed-term lead for international recruitment, with funding for their appointment provided from Health Education England. The lead's role is to manage and oversee interventions for their IEW, from concept to implementation. They manage the teams who support the IEW with their training, preceptorship (the period of structured transition to guide and support all newly qualified practitioners from students to autonomous professionals, and pastoral care). The programme is jointly delivered between corporate nursing and recruitment.
Listening to and acting on feedback from the IEW has been crucial for the success of the programme. Feedback from the IEW is gathered through regular forums that are led by the international recruitment lead, frequent internal staff surveys, and the ethnic minority staff network. This ensures that the IEW have a variety of ways to feedback and that interventions meet the direct and indirect needs of the staff.
Alongside this, an internal workforce group - led by trust executives - has overall oversight of the IEW programme and receives regular reports on the programme's successes and challenges. The trust's chief executive is also visible in the leadership of and commitment to developing the IEW programme. This visible leadership approach has resulted in an increased awareness across the workforce about the importance of the IEW and programme.
In the face of limited resource and workforce capacity issues, the IEW programme took a staged approach and built in small changes - allowing for successful implementation of interventions.
There was a belief from managers that recruiting the IEW and integrating them into teams would require more work. This perceived barrier led to hesitancy from some in pursuing this recruitment route. As part of the programme, managers who successfully recruited and onboarded the IEW were asked to share their learnings to dispel this misconception.
The importance of engagement and feedback is key. By actively listening to the experiences of the IEW, UHNM has gained valuable knowledge that has shaped its approach to recruitment and onboarding. The trust board acknowledge that feedback from the IEW has played a crucial role in the success of the IEW programme.
UHNM's trust board also recognises that the IEW has a key role to play in the future of the NHS workforce and the need to value not just their skills but their experience and culture to ensure they provide an inclusive environment for employees and patients alike.
- As a board member, actively seek to learn from other organisations that are supporting their IEW well. This will improve confidence and capability to implement interventions that will make a difference, in turn improving the levels of applications, retention and support for the IEW.