This weeks’ blog is by Dr Jon Gorry, Head of Department for Social and Political Sciences  Nottingham Trent University (jon.gorry@ntu.ac.uk ), and Dr Analisa Smythe, Nurse  Researcher, Birmingham and Solihull Mental Health Trust, Royal Wolverhampton NHS Trust, Visiting Fellow Nottingham Trent University (analisa.smythe@nhs.net)

The far-right, anti-immigration riots of summer 2024 stand as the worst British race riots for 100 years. What impact has this violence had on healthcare professionals? How will it impact nurse retention rates when overseas-trained nurses already account for 7 in 10 applications for the Certificate of Current Professional Status (CCPS) necessary for UK-registered nurses now wishing to practice overseas in the increasingly preferred destinations of Australia, New Zealand, or the USA?¹ Even before the riots, according to a survey conducted by the British Medical Association (BMA),² nearly a quarter (23% of 1,239 respondents) reported that they had considered leaving their National Health Service (NHS) job due to racial discrimination, while 9% indicated they had already left within the past two years. Staff from Black, Asian, and other minority backgrounds were the most likely to have considered leaving. ³

The United Kingdom’s increasing reliance on immigrant nurses is well documented. Nearly all (93%) of the last Conservative (2010-24) Government’s 2023 target of 50,000 more nurses was achieved through international recruitment.¹ 1 in 3 nurses in NHS England trained abroad.¹ Over a quarter of the nurses (27.7%), midwives and nursing associates on the Nursing and Midwifery Council (NMC) register are from Black and ethnic minority backgrounds (Nursing and Midwifery Council, NMC 2024). Migration has supported the NHS for many years, however nurses who witness racial tensions may feel fearful and unwelcome.

It should not be difficult to appreciate feelings of insecurity.  Two Filipino nurses were attacked with bricks and Trusts put on extra security including escorts ⁴ The Royal College of General Practitioners (GPs) urged its members to ‘remain vigilant’, ‘travel in groups” ⁵ and move to remote appointments⁶ Muslim health associations report ‘unprecedented’ fear amongst frontline workers.⁷ The first statue to celebrate Black nurses was defaced.

Racism and Islamophobia must be robustly and consistently called out. NHS Leaders have called for zero tolerance of racism against patients or colleagues, no matter what it takes. It is right for professional bodies like the NMC to remind us that Black and ethnic minorities are bringing their professional knowledge and skills for the benefit of all people; they should not have to worry about their own safety or that of their loved ones and it is deeply unjust that since the riots many do not feel unsafe at both work and home.

Both anti-immigration movements and government policies have not sent out much of a ‘Welcome to England’ message. The NHS Long Term Workforce Plan commitment to reduce reliance on international recruitment makes little sense if the natives do not have the necessary skills or qualifications. Overseas colleagues not only bring complimentary experiences, knowledge, and fresh ways of thinking but their presence also serves to make local workers more productive. We must work harder to show that we take nurse retention seriously and stand shoulder to shoulder with all those who feel vulnerable, threatened and unwanted at this time. To help further this end a small working-group consisting of colleagues from Nottingham, Coventry and Warwickshire, Wolverhampton, Shrewsbury and Telford Trusts together with nursing academics from Nottingham Trent, Birmingham and Coventry Universities have come together to create ‘PHAISE’ (Policy-Health-Assimilation-International-Support-Education). This weaving of several different research, policy and practice strands sets to make a difference for international nurses and the organisations and communities they work with through knowledge exchange, policy briefs, grant generation, and academic articles. After the storm we need to encourage rainbows. For further details of PHAISE see: https://www.ntu.ac.uk/research/groups-and-centres/projects/phaise

References

1. Bazeer, N., Kelly, E., Buchan, J. (2024) Nursing locally, thinking Globally: UK-registered nurses and their intentions to leave. Available from: https://www.health.org.uk/sites/default/files/pdf/2024-05/Nursing%20locally%2C%20thinking%20globally%20UK-registered%20nurses%20and%20their%20intentions%20to%20leave.pdfhe Health Foundation.
2. Tonkin, T. (2022) Racism an issue in NHS, finds survey. British Medical Association. Available from https://www.bma.org.uk/news-and-opinion/racism-an-issue-in-nhs-finds-survey.
3. Mahase, E. (2024). NHS staff urged to “accompany vulnerable colleagues” to work amid riots. BMJ. Available from https://doi.org/10.1136/bmj.q1756
4. Church, E. (2020) Filipino nurses attacked as NHS community condemns racist riots. Nursing Times. Available from https://www.nursingtimes.net/news/leadership-news/filipino-nurses-attacked-as-nhs-community-condemns-racist-riots-05-08-2024/. Accessed 19^th August 2024.
5. Hawthorne, K. (2024) RCGP Chair calls out ‘horrific and completely unacceptable’ attacks on healthcare workers. Royal College of General Practitioners. Available from https://www.rcgp.org.uk/News/unacceptable-attacks-healthcare-workers.
6. Hacket, (2024) GP practices move to remote appointments as racist riots spark safety fears. GP online. Available from https://www.gponline.com/gp-practices-move-remote-appointments-racist-riots-spark-safety-fears/article/1883401#:~:text=GP%20practices%20have%20been%20advised,work%20or%20deliver%20home%20visits.