Refugees 'can solve NHS staff crisis'

London can solve its chronic NHS staffing crisis by making better use of its diverse and dynamic workforce, a leading health think tank argues today.

A report from the King's Fund says the solution to staff shortages and high turnover lies in:

The report argues that while the capital faces the biggest problems in the country it also has the means to solve them.

King's Fund chief executive Rabbi Julia Neuberger said: "Detailed analysis of London's NHS workforce reveals the highest vacancy and turnover levels in the country. But it also shows we have the most ethnically diverse workforce, as well as a generally younger workforce.

"The scale of the challenge facing the NHS workforce in London is huge, but so are its resources and capacity."

The report's author, Belinda Finalyson, says much more can be done to retain NHS staff and cast the net more widely to attract new recruits.

She wants to see a citywide database set up so information about staff can be shared between employers, and temporary workers can be used more effectively. She also wants more done to encourage people who have left the NHS to return.

But the report says radical solutions to the staffing crisis are already being put in place by some London NHS trusts.

The Guy's, King's and St Thomas' School of Medicine is attracting more working-class and ethnic minority students from the local community who do not have the usual academic grades.

"They have done this by realising traditional medical schools require academic levels unlikely to be achieved by students from deprived communities," says the report. "GKT works with local schools to encourage students to apply."

The youngsters - whose Alevel results are lower than those of students admitted to conventional medicine courses - train alongside other students, but complete the course in six years instead of the normal five, "allowing them to study at a more appropriate pace and with better support".

In its first year, nine students entered the programme and all completed the initial stages. In 2002, 20 joined the course, with 24 planned for later this year. The majority are from ethnic minority backgrounds and from families with little or no experience of higher education.

The report adds that asylum seekers, rather than being a problem, can be part of the solution. Refugee doctors often find it hard to get work in hospitals. So the London Deanery, responsible for postgraduate medical and dental training in the capital, has launched a scheme under which they spend six weeks on a hospital placement and six weeks in primary care, such as a local clinic. During the attachments they receive computer and language training and practise CV-writing and interview skills.

In 2001, nearly 30 doctors took part and 17 of them are now working as senior house officers at London hospitals.

Employing nurses from overseas is not new, but many find it hard to adapt to life in London. To overcome this problem University College London Hospitals introduced a support scheme for recruits from the Philippines. The trust offers them accommodation, a welcome pack and helps them arrange things like bank accounts. It also has a "buddy system" in which established Filipino nurses help new arrivals.

The report, In Capital Health? Creative Solutions to London's NHS Workforce Challenges, notes: "The trust has a very high retention of the nurses."