OSCE case study: Guy's and St Thomas' NHS Foundation Trust
Guy's and St Thomas' NHS Foundation Trust (GSTFT) implemented interventions to support their internationally educated nurses (IENs) through the objective structured clinical examinations (OCSE) process.
GSTFT comprises of five hospitals – Guy's and St Thomas', Evelina London Children's Hospital, Royal Brompton, and Harefield – as well as community services in Lambeth and Southwark. They provide specialist care for patients including heart and lung, cancer, and renal services as well as a full range of local hospital and community services for people in Lambeth and Southwark.
GSTFT have around 22,700 staff, 9,000 of which are within nursing and midwifery, making them one of the largest NHS trusts in the country and one of the biggest employers locally.
GSTFT has been recruiting IENs since 2021, and Royal Brompton and Harefield hospitals, which joined the trust that year, have been doing so since 2016. Since January 2022, GSTFT have recruited a total of 538 IENs made up of 26 different nationalities, across three fields of nursing – adult, paediatric and midwifery.
The trust has a well-structured and organised team to support IENs before, during and after their OSCE training, led by their well-established pastoral care team. The nurses are welcomed by their pastoral care team and wellbeing team on arrival to the country. An outline of the programme is below:
The greater support given to IENs to train for their OSCE exam has meant a consistent first-time pass rate of >51% (>78% prior to NMC changes in 2021/22), compared to the national rate of 35% (100% at three attempts). The trust anticipates an improvement in the first-time pass rate following further rollout of the extended OSCE programme, with early impact being seen at Royal Brompton and Harefield sites where IENs have achieved a first-time pass rate of 79% on the five-week training programme.
The pastoral care has proven fundamental to supporting the wellbeing of their IENs. By extending the accommodation provision to eight weeks, IENs can focus on their OSCE training and have longer to look for a permanent residence. The OSCE team have better support and capacity, making them more able to closely monitor the training and provide check-ins with IENs once they start working within their clinical areas.
IENs have contributed to a reduction in vacancies, especially within targeted hard to recruit areas. This has improved the stability and wellbeing of the workforce overall. IENs provide a unique contribution including skills, and experience, across clinical teams. There has also been positive feedback from both clinical areas welcoming IENs, and from IENs themselves on the support they have received.
Hear from the trust
The Race Equality programme spoke to Gemma Craig, deputy chief nurse, and Sue Cox, deputy director of nursing for workforce and education, at GSTFT about implementation of these interventions, the challenges, learning for the board, and advice for board members looking to support their IEW.