Safe and sound

Refugee nurses can be a vital resource, but early identification of their skills is needed if they are not to be lost altogether, says Jody Raynsford 'W e have the severest recruitment and retention crisis in nursing that we have ever seen in the UK' is the stark warning from Roswyn Hakesley-Brown, until recently president of the Royal College of Nursing. 'Yet there is a pool of talent already here in this country which remains largely untapped: nurses who are also refugees.'

Ms Hakesley-Brown's comments marked the May launch of a new taskforce to help qualified refugee nurses to practise in the NHS. In February, Nurses into Employment - an event jointly run by the Employability Forum and London-based refugee charity Praxis - brought together more than 50 stakeholders to discuss how to ease the path of refugee nurses into the health service.

The emphasis for the task force is on the wider benefits refugee nurses can bring to the NHS rather than just cost savings, says Employability Forum assistant director Sarah Hayward: 'Nurses with refugee backgrounds are often in just those areas where employers are looking for staff - in areas with high accommodation costs, or inner cities.

'Refugees come from a diverse range of backgrounds and trusts are increasingly looking for staff to reflect the patients they are serving.Also refugees are not here on short-term contracts, so by and large they are more settled.'

The task force believes refugee nurses have struggled to practise in the NHS for a number of reasons, and these form priorities for the coming year:

Provision of information about refugees to employers.

Delivering clear and accurate information to nurses.

Overhauling the recognition process.

Developing efficient and transparent processes.

Promoting an understanding of the potential contribution of refugee nurses.

The key lies in not only identifying the skills but also in linking these with employers who have staff shortages - something that has not been done in the past, according to Ms Hayward.

So far, much of the take-up has been concentrated within London, as well as interest in the West Midlands, Scotland and North East. Part of the drive will be about making the refugees visible to employers by developing databases and linking them to employers' databases. The RCN has already established a database of 84 qualified refugee nurses.

'A great number of nurses have emerged in a very short time, because we have been catching them early when they are fresh and the motivation is still high, ' says Ms Hayward. 'Clear employment pathways are crucial, with steps on how to take these nurses through to practice.

This could mean getting information out to advisers who deal with refugees early on to ensure people do not slip through the net - information so they know where to go for help.'

Tapping this valuable resource has proved difficult simply because there are no reliable figures for how many qualified refugee nurses are resident in the UK.

'The problem is signposting nurses with a refugee background, ' says Ms Hayward.

'Most people who come to the UK are not judged on their skills but are assessed on one question - whether they have a humanitarian case.We have to be careful about obtaining that information so that it does not prejudice or unduly influence their asylum claim.

'Finding out what skills are within this group and finding them early on is critical. Unless they are signposted to a specific agency that can give proper advice and guide them through the process, they may well get lost or discouraged and use their skills elsewhere.'

According to Ms Hayward, a change to Home Office rules on asylum means that once a refugee is told they can remain in the UK, they are automatically entitled to work.

'We need to be working at the point people get the decision.

Once they are told they can remain in the country, we can get them channelled appropriately at that stage. They need to be aware of the steps involved and so need to prepare.'

A further issue is the process of accreditation for refugee nurses, which has proved lengthy and complicated. Registration with the Nursing and Midwifery Council is followed by an assessment of a nurse's qualifications, before being accepted on to the Praxis preparation for supervised practice course. In making the process easier, a person has now been assigned within the council as a troubleshooter.

Ms Hayward explains: 'The level of supervised practice is one of the issues and it obviously depends on what kind of nursing system the nurse work in. But it is not just the qualification; the one really important thing is English language.'

The standard international English language testing system exam, as a requisite for registering, is a major obstacle for refugees outside the EU, although EU residents are not required to sit an English language test.

As Ms Hayward says: 'It is not really effectively testing whether you can communicate - some people can speak English perfectly, yet still cannot communicate and vice versa.We need a more rounded testing system focusing on the person sitting the test and the language they will be using in their job.'

But perhaps it will be the last priority that proves the most challenging, in demonstrating to employers and the public the contribution refugee nurses can make. 'The wider perception is very important when you have refugees working alongside others in the profession, ' stresses Ms Hayward.

'There is such hostility towards refugees, and it is vital for us to get the story out to actually help people understand better.Many have really interesting backgrounds and some have worked in major areas of conflict abroad. These nurses have got unique experiences which can really benefit our health service.' l Further information l www. employabilityforum. co. uk/ home. htm l www. rcn. org. uk/news/ refugeenurses. php