Integrating Refugee Healthcare Professionals In The UK National Health Service: Experience From A Multi-Agency Collaboration

Abstract

Purpose

Refugee healthcare professionals (RHPs) may encounter several barriers to employment upon moving to the UK, such as conversion of professional qualifications and a lack of familiarity with the recruitment process. The Building Bridges Programme (BBP) is a London-based multi-agency collaboration which helps refugee healthcare professionals seek employment in the UK National Health Service (NHS).

Methods

We have kept an electronic database of all RHPs who have participated in the BBP from October 2009 to March 2018. Data collected include gender, language spoken, country of initial medical qualification, immigration status, religion, ethnicity and professional work experience. In this paper, we focus on employment outcomes and determine the proportion (%) of RHPs joining the BBP who enter employment in the NHS.

Results

Between October 2009 and March 2018, the BBP supported 372 refugee doctors, 42 refugee pharmacists, 69 refugee dentists, 25 refugee biomedical scientists, 4 refugee physiotherapists and 83 refugee nurses. The following are the results for the RHPs who settled into a registered NHS position appropriate to their (home country) professional qualifications: 98/372 (26%) doctors, 4/42 (10%), pharmacists, 17/69 (25%) dentists, 1/25 (9%) biomedical scientists, 1/4 (25%) physiotherapists and 2/83 (2%) nurses. The following are the results for the RHPs who settled in associated healthcare profession positions: 109/372 (29%) doctors, 16/42 (38%) pharmacists, 12/69 (17%) dentists, 10/25 (40%) biomedical scientists, 3/4 (75%) physiotherapists and 34/83 (41%) nurses.

Conclusion

The BBP provides a useful model that is transferable to other countries. Future studies assessing the utility of such programmes should ensure that the long-term employment outcomes of RHPs are more closely tracked. A key limitation of this paper is the absence of a control group of participants who did not join the BPP, which would help to conclusively demonstrate whether participants who joined our programme had a statistically significant improvement in employment outcomes.

Keywords:

• refugees
• curriculum development
• education
• employment

Abbreviations

BPP, Building Bridges Programme; CAPS, clinical apprenticeship programme; GMC, General Medical Council; IELTS, International English Language Testing System; NHS, National Health Service; OET, Occupational English Test.

Ethical Approval

All healthcare professionals joining the Building Bridges Programme sign a consent form confirming that their data can be used for statistical purposes, project evaluation and contractual reporting. The outcomes contained in this manuscript would not be classified as research as per the definition provided by the UK Policy Framework for Health and Social Care Research: http://www.hra-decisiontools.org.uk/research/. An independent ethical adviser at Queen Mary University of London confirmed that the consent form is appropriate to the work being conducted and provided further clarity that this work is considered a service evaluation and not medical research (proof available upon request). The confidentiality and anonymity of participants is guaranteed. There is no potential harm to participants as a result of this publication.

Acknowledgments

The authors would like to acknowledge Dr Stephen Nickless, a retired General Practitioner, for facilitating the Professional Development Group for refugee doctors on the Building Bridges Programme. Louise Lemoine and Anthony Cleary, volunteers, for helping to prepare refugee doctors for the English language tests. Dr Rupal Shah, Associate Dean (Multiprofessional Faculty Development Unit, Professional Development Team, London and South East) and Dr Mohammad Alam (Training programme Director of “Return To Practice”, Barts Health NHS Trust) for providing guidance and practical support to refugee doctors accessing the Clinical Apprenticeships Scheme. Rebecca Fynn and Vaishali Joshi for co-ordinating the structured work placements for refugee doctors at Whipps Cross University Hospital, Barts Health NHS Trust. The authors also thankful for the assistance received from the consultants and medical education departments based at Newham University and Whipps Cross University Hospitals, Barts Health NHS Trust.

Disclosure

The authors report no conflicts of interest in this work.