Experiences of EU and non-EU internationally educated nurses and midwives in the UK: a scoping review

The UK's health and care system is increasingly dependent on international recruitment to fill workforce gaps. In 2022-2023, nearly half of new Nursing and Midwifery Council (NMC) registrants were internationally educated nurses and midwives (IENs), with most coming from non-EU countries such as India, the Philippines, and Nigeria. While European Union (EU) nurses played a substantial role in NHS recruitment during the early 2010s, Brexit and subsequent immigrant policy changes contributed to a decline in EU recruit and a shift toward non-EU sources. This shift highlights the importance of understanding the differing experiences of EU and non-EU IENs. This scoping review explores recent literature on IENs' experiences in the UK, with attention to similarities and differences between these groups.

We searched Ovid MEDLINE, Ovid Embase, Ovid PsycINFO, EBSCOhost CINAHL, and Web of Science for peer-reviewed articles that explored the experiences of IENs in the UK between 2010-2024. Three reviewers screened articles for eligibility, and data were charted and coded thematically.

Thirty-three studies met inclusion criteria. We identified eight key themes: (1) migration motivation, (2) registration processes, (3) workplace adaptation, (4) deskilling and recognition, (5) discrimination, (6) job satisfaction, (7) social integration, and (8) coping and support. IENs frequently migrated in search of better professional opportunities but encountered complex processes. Many struggled to adapt to the workplace, with non-EU IENs more likely to report deskilling, limited recognition of prior experience, and visa-related restrictions. Discrimination was a persistent issue, particularly for Black and non-EU IENs, leading to poor job satisfaction and career progression. EU nurses, while previously benefitting from automatic qualification recognition, increasingly reported marginalisation following Brexit. While some IENs reported receiving good support from their employers and managers, others described inconsistent or absent support, and many relied heavily on religion or informal peer networks, especially from shared cultural or national backgrounds.

IENs in the UK face diverse barriers spanning regulation, professional adaptation, social integration, and discrimination. These challenges vary by region of origin, particularly between EU and non-EU IENs. As international recruitment continues, tailored and sustained action is needed to improve IENs' integration, retention, and wellbeing.