The Difference We can Make
It is important that we all work to improve the experience of our colleagues, creating inclusive, culturally and psychologically safe environments. Here are some ways that organisations and teams can help internationally educated colleagues.
We want to hear from you
If you have any questions about the information in this resource, or you feel there is information which would be useful to add, please get in touch with the Centre for Workforce Supply at nes.cws@nhs.scot.
Improving the Experience
Creating an inclusive, supportive, and welcoming workplace is essential to helping internationally educated colleagues thrive within NHS Scotland. Managers play a key role in supporting successful recruitment, induction, integration, wellbeing, career development, and long-term retention.
The checklist below outlines practical actions managers can take throughout the employee journey, from recruitment and onboarding through to professional development and workplace inclusion. These actions are designed to help colleagues feel valued, supported, and connected to their teams, while promoting equitable opportunities and a positive working environment for all.
Use this checklist as a guide to support the successful integration, development, and retention of internationally educated colleagues within your service or team.
| Step | Area | Actions for Managers |
|---|---|---|
| 1 | Recruitment Integration | Standardise recruitment to ensure fairness and transparency, including pay parity and acknowledgement of existing qualifications. |
| 2 | Offer Early Contact | • Provide opportunities for recruits to meet the team before starting in post and ideally before migration to the UK. • Make yourselves available to recruits. • Offer virtual visits to their new workplace. |
| 3 | Induction and Integration | • Provide a structured induction, with consideration of supernumerary time. • Offer tailored support to individuals, recognising their particular integration needs. • Balance the need to recognise prior experience, with avoiding dropping people in at the deep end with insufficient support. • Make people aware of routes to speak up and raise concerns. • Explain about healthcare team culture differences, including hierarchy. • Reinforce your approachability. |
| 4 | Accommodation, Living Conditions, and Support | • Boards should be able to provide information on local accommodation options and help people find good and affordable places to live. • You and other colleagues, including IR leads & local educators, can support and advise people to manage the cost of living in the UK, for example by helping them to ‘shop around’ for good-value energy. |
| 5 | Networks and Cultural Integration | • Provide mentorship programs that pair recruits with experienced staff. • Connect recruits with diaspora associations. • Support the development of peer support networks, perhaps grouped by country of origin. • Offer unconscious bias and cultural humility training for all staff. • Encourage cultural exchange within teams, providing safe spaces for dialogue on cultural differences. |
| 6 | Language and Communication | • Share guides to support the understanding of local language, including dialects and medical terminology. • Offer support with language development and encourage team members to adapt communication styles. |
| 7 | Community Engagement | • Encourage participation in community and cultural events to aid societal integration. |
| 8 | Create Inclusion and Belonging | • Recognise and celebrate religious holidays. • Involve international staff in decision-making and leadership. • Promote psychological safety. |
| 9 | Career Progression and Professional Development | • Offer a future by facilitating career planning that recognises ambition and existing experience. • Provide access to resources that support the professional development of international colleagues. • Ensure equitable access to opportunities for development and progression. |
| 10 | Policies, Practices, and Workplace Culture | • Support flexible arrangements to accommodate cultural practices, for example religious practices. • Encourage feedback from international staff on their experiences and workplace needs, showing a commitment to continuous improvement. • Regularly review team policies with an inclusion lens. • Promote a zero-tolerance approach to discrimination. • Use inclusive language in communications. |
Challenges with Communication
For many internationally educated colleagues, English is not their first language and starting work in a health setting without confidence in English can be challenging. Effective communication is key when it comes to providing safe and high-quality care.
How patients and staff speak can make it difficult for internationally educated colleagues to understand. This can lead to confusion and miscommunication, which could potentially put patient safety at risk. Internationally educated colleagues may feel uncomfortable speaking with colleagues or patients, and this can lead to feelings of isolation and anxiety.
You can help your colleagues by adjusting how you communicate:
- Speak slower.
- Consider your language, avoiding jargon, idioms, confusing expressions and slang.
- Pay attention to colleagues’ responses and body language. Have they understood?
- Be prepared to repeat yourself in a sensitive way.
- Encourage colleagues to practice their language skills by asking open-ended questions.
- Be patient, kind and attentive
The importance of non-verbal communication
Of course, communication is about more than language and it is important to remember that there are differences in many aspects of communication across cultures, including body language.
Here are some things you can do to help:
- Educate yourself and your team: Learn about and teach the non-verbal communication styles common in the cultures represented within your team, such as gestures and personal space norms. Ask your internationally educated colleagues to help with this.
- Promote awareness and flexibility: Encourage team members to become aware of their own non-verbal cues and to adapt their non-verbal communication to accommodate cultural differences.
- Encourage open dialogue: Foster discussions about non-verbal communication preferences and misunderstandings to build understanding and respect.
I struggled due to a topic of communication. I was generally misunderstood by most member of stand as I was thought to be unfriendly.
You can make a difference
Working with colleagues and implementing the recommendations of this guide, we can all help to create a more inclusive, equitable, and supportive environment for internationally educated colleagues.
This enhances the integration and retention of these valued colleagues, but also enriches the cultural competence of the entire workforce. Ultimately, this can lead to improved patient care, more cohesive teams, and a healthcare system that truly reflects and respects the diversity of the communities it serves.
The collective impact of these measures can transform where you work into a model of inclusivity and cultural humility, showcasing the difference that understanding, respecting, and valuing diversity can make in the NHS.
Next Steps
