Ten e-surveys were emailed in the first round and responses were received from 34 participants within the one month pilot, of which one was incomplete. The profile of the respondents is summarised in Table .
Few respondents reported difficulties obtaining a UK visa, the majority using a working holiday visa (available to Commonwealth citizens aged 17–30) or work permit. Professionals had worked in a median number of 2 cities (range 1–15, mean 3) and usually as a 'locum' where locum work is defined as temporary or contractual employment. The median time spent in the UK was 3 years (range 3 months – 8 years, mean 2.5 years). Employment was typically gained through a recruitment agency in the UK or in their home country. There were 27 professionals still in the UK, most of whom were working in Social Services (n = 9), for the NHS full time (n = 8) or as a locum (n = 7) or in private practice (n = 6). Over half of the respondents (67%, n = 23) reported they would not stay in the UK permanently. Table summarises these results.
Motivation to work in the UK
Respondents were asked why they initially chose to work in the UK. Travel (n= 29), money (n = 23) and career opportunities (n = 16) were the primary motives expressed. One respondent answered ...to experience living in a country other than my home country.' (Physiotherapist, Australia)
Expectations prior to working in the UK
Respondents were asked what their expectations of working in the UK were prior to their arrival and how they compared to their experience. There were mixed responses, many reporting they believed the UK would be superior to their home country in terms of resources, professional expertise and funding (n = 5) ; others assumed it would be the same (n = 15).
Thought it would be similar to Australia – maybe not quite so advanced with their techniques. Experience was pretty much what I thought it would be – depends on the different hospitals, which is the same back home. (Speech and language therapist, Australia)
I thought that the workforce would be more superior and be able to provide good guidance. I expected there to be far more resources to enable service users to achieve an element of self actualization. Experience: poor management, poor team and case planning, lack of resources and especially money to provide for the needs of service users. (Podiatrist, Australia)
I just expected to work and earn money to travel but in reality it is a time when you can really work on your professional development, which is what I am doing. (Physiotherapist, Australia)
Skills and Training
Respondents were asked what skills or training could have better equipped them to work in the UK and to describe their perceptions of the quality of training in the UK. Many felt they had adequate skills and training to work in the UK (n = 15) but highlighted greater knowledge of the health and social care systems would have been beneficial particularly those working in social services (n = 6).
My training and skills were of English standards. The only adjustments I had to develop skills around was to know the culture of the community and adjust strategies of intervention. (Speech and language therapist, Australia)
Most perceived that the undergraduate training in the UK was of a lower standard than their country of origin (n = 23) but that opportunities for continuing professional education were superior in the UK (n = 10). Some felt that their undergraduate training equipped them more thoroughly to enter the workforce with more confidence in their role than their UK counterparts.
I believe the broad 4 year undergraduate training in Australia is of very high quality. This allows for multi-skilling and confidence from day one. Therapists trained in Australia tend to be a lot more confident in their skills and are more used to working within multidisciplinary teams. (Occupational therapist, Australia)
Others felt that each system had its advantages.
The UK training is more practice based and reflective. SA training is more theory based. (Social worker, South Africa)
UK pre-qualifying training inferior due to shorter course length. Good first year graduate program compensates for this. (Physiotherapist, New Zealand)
Attractiveness of working in the UK
Respondents were asked what was good about working in the UK. The most attractive features were greater access to Continuing Professional Development (CPD), wider variety of specialisation, more career opportunities and a well-defined career structure. Experiencing a different system and culture was also a theme as well as travel and greater earning power.
Accessibility to latest research and professional development (remote location of many Australian practices limits this). Number of jobs available with very acute caseload (far fewer in Aust). Opportunity to develop quickly as a therapist given our undergraduate skills and general confidence as therapists. Close proximity to Europe and travel opportunities. (Speech and language therapist, Australia)
Difficulties working in the UK
Respondents were asked what was not good about working in the UK. The most unappealing features included large waiting lists and correspondingly large caseloads, poor recognition or respect as a professional, the bureaucracy, the weather, or for some professional groups, racism.
Understaffing of all health professions; Too much paperwork and repetition of paperwork; Reduced hospital standards; Distance from home. (Podiatrist, Australia)
Some people find it difficult to accept that although not trained in the UK the level of skill you bring into the profession is of high value. (Social worker, South Africa)
Participants were also asked how the status of their profession in the UK compared to their country of origin. The majority (n = 24) felt the status of their profession was lower in the UK than in their home country compared to eight who felt it was the same.
I expected to retain the same high status that my profession has back home with other professionals and the communities who appreciate the services provided by the profession. This was completely opposite when I got here (UK) and shocking to me. This discrepancy creates difficulties in working with partners to bring about desired change. (Social worker, South Africa)
Benefits and suggestions for country of origin
When asked how their country of origin could benefit or learn from their experience of working in the UK, most responded they had gained a much broader skill base and knowledge of how a different system works.
I have such a vast array of experiences now to draw on, both good and bad which I can take home with me. I think I am much more worldly now. (Physiotherapist, New Zealand)
I have experienced many management styles, and government agendas, and would be able to take the advantages and disadvantages of these systems back to Aust. and formulate better solutions to problems. (Speech and language therapist, Australia)
Due to excellent continuing education [in the UK] I feel I will have a more up to date knowledge base which I will attempt to pass on when I begin working again at home. (Physiotherapist, Australia)