Recruitment outside of the UK - Salisbury NHS Trust

Nurse taking notes

08 / 11 / 2013

Salisbury NHS Trust shares its experience of recruiting nurses from Portugal to help meet their workforce supply needs.

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Why we decided to recruit nursing staff from overseas?

We have a good record of providing high quality, safe, patient care and staffing levels are an essential part of this. We typically need to recruit between 30 and 40 nurses each year. Despite successfully recruiting newly qualified nurses, like other hospitals across the country, we have found it increasingly difficult to recruit qualified and experienced Band 5 nursing posts in the UK.

We were beginning to rely more heavily on bank and agency staff for surgery, musculoskeletal, acute and elderly medicine. With an ageing workforce and the availability of UK registered nurses decreasing over the last year, we were interested to learn that other organisations in southern England had successfully recruited nurses from the European Economic Area (EEA).

How did we do it?

Initially we enlisted the help of a recruitment agency who is on the UK Code of Practice for ethical recruitment. The agency specialises in bringing registered health professionals to the UK and had been recommended from other organisations in the region who had successfully recruited from overseas.

The agency met with us to determine our suitability for their candidates, in terms of career and professional development opportunities, and what Salisbury as a location could offer the nurses if they came to work in the UK. We were confident that we had found an agency that had an interest in the nurses themselves and not just the needs of our organisation.  

A senior nurse and ward sister went with the agency to Portugal for five days and interviewed 60 candidates. The agency organised the process leading up to the interviews which were jointly carried out with hospital staff. They negotiated employment contracts, helped with professional registration and put in place travel arrangements.

The agency used a ‘values based interview assessment process’ which involved an assessment of the nurse’s language skills, assessment to test their competency, and an interview with our staff that focused on values and beliefs. We also wanted to ensure that the nurses would cope with the transition, especially as they would be leaving behind their family and friends and working in a different culture. In the end we offered posts to 47 nurses and the agency carried out the necessary pre-employment checks.

The agency met the nurses when they arrived at the airport and accompanied them to Salisbury District Hospital, where we provided them with on-site accommodation. We gave them a meal voucher for their first night in the UK and a welcome pack in their room, which included basic groceries. Once they had settled in, some naturally wanted to find accommodation off-site and those that have moved have integrated successfully within the local community. 
In the first few weeks at work we gave the nurses a tailored induction programme to help them settle into their new roles and working environment. This included a classroom based induction programme, together with supernumerary time in the ward. Our main focus was on support, to help them integrate within the hospital and understand the culture of the NHS. The nurses' supernumerary status during induction was between four to six weeks, depending on their individual needs.

Once the new nurses had settled in we had a 'fish and chip supper', to welcome them and give them an opportunity get to know their new colleagues. Our new Portuguese nurses are now very much part of our organisation and they will have an important role to play as we continue to provide the very best care that we can for our patients and the local community.

The impact of this recruitment

  • Three months following their arrival, there was a reduction in the amount we spent on agency nurses.
  • The nurses are enthusiastic, eager to enhance their skills and develop their career.
  • They are keen take on new roles and they bring a new dimension to the wards.
  • They bring learning and insight from Portugal.
  • They have helped ease the pressure by reducing the number of nurse vacancies.

Top tips for other organisations

  1. Plan for your overseas nurses' arrival and ensure your induction programme addresses cultural/organisational differences. For example, a drug round on a Portuguese ward is quite different to a drug round in the UK.
  2. Some of the nurses will take longer to adapt to their new surroundings, so think about extending the supernumerary status for those that are taking a little longer to settle.
  3. Initially, think about other ways to assist your new nurses with understanding the local language and colloquialisms used – a catheter in the UK and Portugal for example mean different things. While their written and spoken language skills will have been assessed, this could alleviate any minor misunderstandings or potential misinterpretation of information in the early stages.

The organisation

Salisbury NHS Foundation Trust provides a wide range of clinical care, including general, acute and emergency services to approximately 225,000 people across Wiltshire, Dorset and Hampshire. Specialist regional services such as burns, plastic surgery, cleft lip and palate, genetics and rehabilitation extend to a population in excess of three million. The Duke of Cornwall Spinal Treatment Centre at Salisbury District Hospital covers most of southern England, with a population of around 11 million people.

Contact and further information

Fiona Hyett, Deputy Director of Nursing  


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