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Exclusive: Trusts forced to dismiss overseas staff shortly after hiring them

Published on: 4 Jul 2024

Two NHS trusts have been forced to dismiss multiple staff from a cohort recruited from overseas, leading to a row over assurance of their qualifications, HSJ can reveal.

South East Coast Ambulance Service Trust and North West Ambulance Service Trust sacked 10 paramedics they had recently recruited from Nigeria, and referred them to the professional regulator, after realising they did not have the appropriate skills for the role, they said.

The staff who were dismissed formed nearly a third of a cohort recruited to the two trusts in 2022 and 2023.

The trusts indicated they had taken assurance from the fact the Health and Care Professions Council, the professional regulator for paramedics, had accepted the staff onto its register.

NWAS told HSJ it was “not unreasonable for an employer to rely on HCPC registration as assurance of fitness to practise in the UK”, but saw problems with the staff within weeks of them starting work, and dismissals within five months.

The HCPC said it was aware of the issues but would not comment on individual cases.

It accepted individuals on to the register where their qualifications and professional experience met standards of proficiency comparable to its own, it said but added: “It is vital that professionals, whether they trained in or outside of the UK, are supported at key moments of transition in their careers. For those who trained outside of the UK the transition to the UK and entering the workforce requires support.

“Our principles of preceptorship are designed to help all professionals registered with the HCPC to access this type of support from employers, professional bodies, and education providers, when and where they need it.”

It made no comment on the suggestion that its process might be faulty if it allowed so many paramedics onto the register who had since been dismissed.

The spokesman added: “Where concerns are raised, however, they will be rightly considered compassionately and efficiently as part of our fitness to practise processes.”

SECAmb offered the paramedics money to fly home, and some staff had relocated to the UK with family members. The trust recruited 15 paramedics from Nigeria, thinking they had been trained to an equivalent level as English-registered paramedics.

Meanwhile, NWAS dismissed five of 16 Nigerian paramedics it recruited in the same 2022-23 period and said another four had resigned. The five it dismissed were also referred to the HCPC.

A College of Paramedics spokesperson said: “We are aware of this case and sympathise immensely with the paramedics who have been affected. The College of Paramedics has tried to help those affected as much as possible because we recognise that this situation is not of their making.

“What this case has shown us is the need for greater scrutiny when it comes to recruiting from overseas and that every paramedic who works in the UK is qualified and skilled to the same standard. There can be no exceptions.”

HSJ understands both trusts were keen to recruit the staff who they believed had five years’ experience, on the salary of a newly qualified paramedic.

It has become harder to recruit paramedics in recent years, increasing overseas demand, while ambulance trusts are also keen to diversify their largely white and male paramedic workforces. 

An NWAS spokesperson the Nigerian paramedics all came from a university with the same course syllabus, and all but two had entered the HCPC register at the time of appointment, “which is our assurance of their fitness to practise and means that we expected that their course should [have] met the same levels of competency as UK nationals”.

They added: “NWAS has not actively targeted recruitment from Nigeria and would not do so as it is a red-listed country. All of the Nigerian paramedics employed by NWAS applied for open UK domestic adverts for qualified paramedics placed on NHS Jobs.

“NWAS offered a comprehensive relocation package which involved a range of pastoral and financial support for the relocation of candidates and families, in line with NHS best practice. The trust put in place extended induction training, a range of operational support through our local clinical leadership, extensive supernumerary placements, additional skills sessions and a period of support in conjunction with one of our university partners.

“None of the individuals were responsible for our patients and their patient contact was limited to a ‘shadowing only’ capacity during this training period. The training and support offered has gone beyond what would normally be offered to either UK or other internationally qualified paramedics in order to try and support their transition into practice.”

A spokesperson for SECAmb said: ”South East Coast Ambulance Service is extremely proud of all international colleagues that it continues to employ in a wide range of roles across the Trust.

“While we have not recruited paramedics internationally since January 2023, the Trust has a robust recruitment and transition to practice process to ensure that any clinician who transfers from another country or service is able to deliver the very high standards of care that we expect for our patients.

“We take the recruitment of all staff extremely seriously and all our clinicians, including any international recruits are subject to a further rigorous transition to practice programme to ensure they are able to meet the standards of care we expect them to provide.”