International recruitment best practice - OSCE webinar 29 August 2019 Adele Bunch, Programme Lead for workforce supply
Poll questions
University Hospital Southampton International Nurse Experience Rachel Palmer Education Lead / International Nurse Lead
University Hospital Southampton • Fourth largest teaching hospital in Europe • 13,000+ staff • Major trauma centre • Regional centre for cancer care, neurosciences, cardiothoracic & vascular and children’s hospital • Innovative research facility
What we offer • Relocation assistance • Support with applying to register with the NMC • Meet & greet • Comprehensive induction – week one • Support with OSCE preparation – commences week two • Adapted preceptorship program • Pastoral support
University Hospital Southampton – International Nurse Experience • Long established history of international recruitment with a strong Filipino community in the area • Supported by HR, education team, clinical managers and their peer community • 207 international nurses recruited since 2016 – arriving from 2017 onwards and going forward to OSCE • OSCE pass rate 99% overall, 75% first attempt • Retention rate 99% – (1 after second fail and 2 before receiving decision letters) • No repatriations to date
University Hospital Southampton – International Nurse Experience Recruitment streams • Currently work with: - – two key international agencies recruiting predominantly in the Philippines – one agency in terms of EU applicants • UHS recruitment via international job fairs i.e. Australia and direct applicants from a range of countries and our surrounding area locally • International nurses working in non-registered posts • Staff referring friends and family to UHS or via agencies
University Hospital Southampton – International Nurse Experience Recruitment streams • Agency streams – Normally have already achieved language requirement at point of interview – Agency support with NMC application process • UHS direct recruits – Advise on the NMC application process – Monitor their progress with the NMC stages of application – Liaise with the NMC via Third Party Access to understand any delays in application process – Liaise with Universities – Commence staff in pre-registration B4 post once they have an NMC OSCE decision letter • Time frame risks dependent upon visa situation
University Hospital Southampton – International Nurse Experience • UHS staff with international qualifications – Scope staff with international qualifications and interest in progressing to NMC registration – Advice on routes to registration – English language requirements -sign post to support. • UHS previously tried a pilot with a language school but poor outcomes – NMC Test of Competence Stage 1: - CBT – once sign posted on route to registration, staff who achieve the English language requirement do not seem to have issues achieving CBT independently – NMC Test of Competence Stage 2: - OSCE – once staff receive an NMC OSCE decision letter they are allocated to an OSCE preparation cohort • Study leave • UHS fund the OSCE
OSCE Preparation • Delivered by our various Care Group Education Teams working collaboratively together – we do not have a specific OSCE education team • Since 2017 we have reduced the number of days in the OSCE prep program – Previously 10 study days over 5 weeks and a mock OSCE – time to first OSCE 12- 13 weeks – Currently 4 taught days covering APIE and skill stations over two weeks (will be reviewed with new curriculum impact) • For large cohorts use of an external company to provide training on occasions – Mock OSCE – First attempt OSCE ideally within four to six weeks depending on availability at exam centres – Bespoke support for those who fail OSCE based on individual need – Supernumerary in their clinical area up to first OSCE. If unsuccessful at first attempt this is then reviewed locally with the individual, education team and clinical manager in line with a bespoke individual plan
OSCE Prep - UHS OSCE Preparation Program Indicative Content – Adult OSCE Day 1 Day 2 Day 3 Day 4 Day 5 Expectations for us and Implementation Skills: A, P, I, E, MOCK OSCE • them Evaluation BLS Complete run through With detailed feedback to • Intro into different parts Scenarios Subcut/IM the candidates • of OSCE Skills: Cath Removal • • • APIE Wound Care CSU • • • Skills Peak Flow Fluid Balance • MUST • Paperwork Inhaled Medicines Assessment & Planning Homework: Homework: Homework: Homework: Look at Neuro obs in Look through BNF info to Evaluate learning. Prepare Practice Neuro Marsden search and increase drug to undertake APIE observations assessment knowledge and feed back Practice to group for next session, PHQ9 each person – different Write a care plan for a group of drugs look at depressed patient NCM guidelines on administration Look up WHO pain ladder Look up pain assessment scales
OSCE Challenges The early days…..at a time with nationally high fail rates • Understanding the OSCE content – Early days little information from the OSCE centres – Shared experience from other Trusts crucial – Now an OSCE facilitators network and national meetings with OSCE centre and NMC representation • Pastoral care – Along way from home – Exam anxiety – Failing OSCE • Cohort size / frequency – Small numbers initially – Adapting to larger cohorts – Managing staff still in progress once next cohort commences
OSCE Challenges • Suitable teaching space & resources – Taught program – Independent and peer practice – Out of hours teaching • Administrative elements of OSCE prep program: – Booking OSCEs – Capturing results from candidates – Reporting results to the UKVI Border Agency and – Reporting results to the Recruitment agencies • Adapting OSCE prep program as new aspects introduced • Flagging variation in local practice to OSCE environment
Nursing & Midwifery Workforce International Recruitment Linda Gilmour Matron Practice Development & Education linda.gilmour2@nhs.net Mobile 07770335909
Starting point • Autumn 2014 • Vacancies: 337 wte in October ‘14 • Maternity Leave – not covered • Bank Office – unable to fill shifts • Agency expenditure: highest 900k May 2015 • Rostering – rosters not effective, unallocated hours, imbalance days of the week • Recruitment – slow • Business case for International Recruitment approved
Business Case • Needed to recruit from – Local – Regional – Europe – Non-Europe
Overseas • Interviews in Philippines November 2014, March 2015 & September 2017 • Total appointed 350 • May 2015 Overseas Nurse Programme on site • April 2016 OSCEs
Senior Nurse International Recruitment • Started January 2015 • First programme in December 2014 • Evaluation from programme • Devised new programme • Close links with the existing Filipino community
THOUGHTS AND FEELINGS BEFORE START • Where are we going to live? • How is it going to be working in the UK? • Are we going to be alone? • Who is going to support us? • What about the paperwork? • Are we going to feel comfortable? • Are we ready to work in UK? • Nursing in our countries and UK?
Content… initially • Two days admin – bank, NIN, trust recruitment, understanding area – accommodation, welcome to the NHS, ID badges, rosterpro, email account • Three days - Mandatory training e.g. fire, infection control, resus, conflict management, safeguarding, blood hound, sepsis, diabetes
Competencies • IV + workbooks • Documentation – Safety booklet, discharge, NEWS and SBAR, • Blood monitoring • Simulation days – OSCE • Medicines management – including pod • Professional body / Unions • BA & ME • NMC
Competencies continued • Whistleblowing • Library • E learning – NEWS, infection control, information governance • Dementia • End of life care • Consent • Hopes and fears • Survival toolkit • OSCE prep & exam within 8 weeks
Valuable learning • Hierarchy – mentors • Relationship with ward managers • Support of NHS staff • ‘Mother, friend, manager’ • Expectation of ward staff • Understanding ward expectation • Extended support, understanding, patience
Valuable learning continued • Allocated recruitment personal • Full time coach • International nurses able to coach each other • Extended supportive community off site support & social • Local cross Trust working advice, support & peer assessment • MOCK OSCE • Facilitators cross country network
Ongoing support • Open door to Lead Nurse and Coach • Phone / email support 24/7 • One to one meetings • Time in clinical practice with recruits • Book in sessions for competencies on the ward • Review if concerns
Ongoing support continued • Drop in visit round the wards • Practice educators in majority of clinical areas • BSUH community Facebook page • Yearly International Conference • Career development clinics • Preceptorship Year 1 Enhanced Year 2
Developments • Links with NMC & Home office • Test centres x 1/2/3 • Local support – peer assessment • OSCE Mock • Peer training on wards • Assessment criteria • Re-takes • Expanding facilitators networking group
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