In October 2025, the Florence Nightingale Foundation began a policy project to explore how the UK can better retain, develop and learn from its internationally educated nursing and midwifery (IENM) workforce. While the fundings are being analysed and written up, hear from Maranda Wheelock, FNF’s Policy and Research Intern, on her experience of working on the project team.
I joined FNF as a Policy and Research Intern in November 2025 and was really excited about working on this project. I already had experience conducting policy research through my Master’s degree – on asylum seekers and refugees’ mental health needs in the UK. However, that work was entirely desk-based: this project at FNF was my first time interviewing and directly engaging with health and care professionals. It was a valuable experience to hear from some of the people behind the survey data.
I interviewed 22 internationally educated nurses and midwives at different stages of their careers and from a range of countries and professional backgrounds. Their journeys to the UK and experiences since arriving were each unique, but shared clear commonalities. One thing came through consistently: a genuine passion for their work.
"Working with the steering committee has been equally valuable. Their expertise spans a range of sectors and regions across the UK, bringing perspectives and insight that would not have been possible to capture through research alone."
Maranda Wheelock – FNF Policy and Research Intern
Currently, just under one in four NMC registrants working in the UK gained their professional qualification outside the UK. No part of our health and care system can function without their contributions.
We know there has already been a lot of work done to better support these communities, not least by diaspora associations. What FNF is aiming to do is to build on all this work and provide a comprehensive look at the entirety of the IENM workforce across sectors, settings, and nations. This includes participants’ journey to the UK, arrival, career progression, future plans, and their role in bi-directional learning.
To help us do this, we launched a national survey to gather experiences from the internationally educated workforce. We reached 1,120 nurses and midwives from all four nations, spanning across every sector, and various career stages. It was clear to me that level of response is a testament to FNF’s strong community, and the results are grounded in their experience. We want to say a huge thank you to each and every nurse and midwife who shared their experience through the survey.
Now that I am analysing the findings, what I have found most interesting is that UK systems are not allowing organisations to fully harness the talent that Internationally educated nurses and midwives bring.
These professionals have qualifications and experience that the UK health system needs to function and transform.
We found that 38% of IENMs arrive in the UK with at least one additional qualification beyond what is required of UK-trained nurses and midwives. This includes master’s degrees, post-basic diplomas, teaching/education qualifications, and specialty certifications. For example, 11% arrive in the UK with a master’s degree, which equates to over 23,000 IENMs who held a master’s degree at the point of NMC registration.
46% of IENMs come to the UK with more than seven years of experience. When narrowing to just midwives, this jumps to 52%. These are established professionals, bringing clinical expertise, leadership capabilities, and a breadth of skills.
“I have a wealth of experience in nursing as an infection control nurse, lecturer and a nursing administrator. I have experience working in other countries as well. All my skills in administration, teaching and clinical practice can contribute positively to the country. Unfortunately, it’s not valid in this country and I started as staff nurse after 23 years of experience in nursing.” A nurse trained in India now working in acute care
Despite what they bring, only 38% of IENMs feel their academic qualifications, experience, and skills from their home country have been fully or mostly recognised by their UK employer. Lack of recognition impacts their ability to pursue post-registration educational opportunities, receive pay reflecting their experience, and utilise clinical skills that can benefit both patients and workforce capacity.
Without an established system for recognition, outcomes are inconsistent and inequitable. This is not a recent shortcoming. Our results suggest that IENMs have not felt significant changes to their experience with recognition over the last 20+ years, with those arriving between 2000 and 2005 showing same level of recognition as most recent arrivals.
Ultimately, the result is a health and care system that is less able to serve its patients and service-users. For example, the NHS in England has committed to shifting care from hospitals into community settings in its new 10 Year Health Plan. Internationally educated nurses and midwives with advanced qualifications and extensive clinical experience are precisely the workforce needed to drive that transformation. However, systemic failures in recognition mean those skills are left on the shelf.
Internationally education nurses and midwives are an integral part of the UK nursing and midwifery workforce. Across the UK, many organisations are already showing what good recognition looks like. But isolated examples are not enough. Systemic standards and consistency are needed for recognising the qualifications and experience these professionals bring.
FNF aims to release the full report in autumn of 2026. Watch this space for more updates. Find out more about the Steering Committee.
Finally, we want to thank each of the 1,120 nurses and midwives who spent their time and energy sharing their experiences. As leaders in their profession, they are committed to advocating for change.
