Staff Story – International Recruitment: July 2025
Meeting: Trust Board – Public Meeting
Date: 9 July 2025
Report Title: Staff Story – International Recruitment
Agenda Item: PUB25/07/1.4
Author: Lenka Tabackova, Recruitment Specialist – International Recruitment
Lead Director: Simon Chase, Chief Paramedic and Director of Quality
Purpose- Discussion/Review
Link to CQC domain:
- Caring
- Responsive
- Effective
- Well-led
- Safe
Link to EEAST’s Strategic Mission:
- Patient Mission
- People Mission
Link to Strategic Risk:
- SR1 Demand and Capacity
- SR2 Quality Governance
- SR7 Workforce Sustainability
- SR8 Staff Retention
Equality Impact Assessment: No negative impact identified
Purpose: To assure the Board that recruitment of a wide and diverse workforce will strengthen the ability of the Trust to deliver excellent care and support to the East of England.
Recommendation: The Trust Board is asked to accept the Staff Story to show how we are diversifying to deliver excellent care and support to the East of England.
Executive Summary:
This staff story comes from one of our newest international Pre-Hospital Practitioners (PHP) recruits, offering a personal perspective on their experience of joining EEAST, integrating into the team, and living in the East of England.
Introduction / Background:
This Board paper introduces a presentation by Mahmoud Adel Agiza, an internationally qualified nurse who joined EEAST in February 2025. Mahmoud brings with him over 15-years of nursing experience, having practiced in both Saudi Arabia and Egypt. His extensive clinical background and international perspective enrich our growing team of overseas professionals.
Mahmoud is one of 20 international nurses recruited by EEAST from the Philippines and Egypt as part of our strategic initiative to address workforce challenges and enhance the diversity and resilience of our clinical teams. The first cohort of international nurses arrived in July 2024, and Mahmoud is the most recent addition, currently based in Stevenage.
In his presentation, Mahmoud will share his personal and professional journey – from applying for a PHP role with EEAST, navigating the recruitment and relocation process, to undertaking OSCE exam preparation, OSCE exam, ECA and PHP training. He will also reflect on his experiences working on the ambulance, adapting to new clinical practices, and the challenges and motivations that have shaped his transition into the UK healthcare system.
This presentation offers valuable insight into the lived experience of our international recruits and highlights the importance of continued support and integration efforts to ensure their success and retention within the Trust.
Key Issues / Risks:
Different Clinical Practices and Ways of Working
- For the Nurse: International recruits are unfamiliar with UK-specific clinical protocols, documentation standards, and patient care expectations.
- For the Trust: There is a risk of inconsistent care delivery or errors if adaptation support is insufficient. This can impact patient safety and service quality.
Regulatory and Legal Compliance
- For the Nurse: UK healthcare has stricter safeguarding laws, mandatory reporting duties, and professional accountability standards (e.g., NMC Code of Conduct) that may differ significantly from their home countries.
- For the Trust: Failure to ensure full understanding and compliance can lead to regulatory breaches, reputational damage, or legal consequences.
Cultural and Workplace Integration
- For the Nurse: Adapting to a new culture, language nuances, and team dynamics can be isolating and stressful, potentially affecting performance and well-being.
- For the Trust: Poor integration can lead to low retention, reduced morale, and underutilisation of skilled staff.
Training and Support Demands
- For the Nurse: The need to pass the OSCE, complete ECA and PHP training, and adjust to new systems can be overwhelming.
- For the Trust: There is a significant time and resource investment in onboarding, mentoring, and training, which may strain existing teams.
Financial Investment and ROI
- For the Trust: Recruiting internationally involves costs for:
- Visa sponsorship
- Relocation support
- OSCE preparation and exam fees
- Initial accommodation and pastoral care
- Training and supervision cost If retention is low, the return on investment is compromised.
Emotional and Social Challenges
- For the Nurse: Being away from family, adjusting to a new climate, and dealing with homesickness can affect mental health.
- For the Trust: Without adequate pastoral support, these challenges can lead to burnout or attrition.
Options:
To effectively prevent and address the challenges faced by internationally recruited nurses, their integration into EEAST must go beyond recruitment – it requires a sustained commitment to retention, clinical safety, and high-quality care. These professionals bring valuable experience and diversity to our workforce, but without support structures, the risks of staff attrition, clinical errors, and low morale can increase significantly.
We must also look beyond the financial cost of international recruitment. These nurses leave behind their families, communities, and established lives to contribute meaningfully to our society and healthcare system. Their journey is not just professional – it is deeply personal. Recognising this sacrifice is essential to building a culture of respect, empathy, and long-term support.
How does this report link with EEAST’s vision, purpose and values?
The report aligns strongly with the Trust’s vision, purpose, and values across all four strategic missions:
- The integration of internationally qualified nurses like Mahmoud Adel Agiza directly supports this mission by enhancing workforce capacity, ensuring responsive care delivery, and bringing global clinical expertise to frontline services.
- The report highlights the importance of multi-layered support, from executive leadership to local teams, which is central to creating an inclusive and empowering workplace.
- It acknowledges the personal sacrifices made by international recruits and calls for pastoral care, mental health support, and cultural integration – key elements of a people-focused strategy.
- The report addresses the financial investment in international recruitment and the importance of retention to ensure a sustainable return on investment.
- It also highlights the need for efficient onboarding and training, which supports productivity and long-term workforce stability. By investing into the international recruitment, the Trust not only protects its workforce investment but also builds a diverse, compassionate, and sustainable service.
Summary:
As per the Executive Summary
