Internationally educated nurses (IENs) make a vital contribution to the NHS. They bring clinical expertise, diverse perspectives, and resilience built through navigating different healthcare systems. Yet data consistently shows they face a disproportionate risk of regulatory referral and disciplinary action in the UK, a pattern that demands serious and structural attention from patient safety leaders.

60%
Rise in NMC referrals involving IENs in recent years
2,373
Referrals identified through Freedom of Information data
52%
Of referrals were employer-initiated

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Why This Matters

Patient safety is not just about clinical procedures and systems. It is also about the conditions in which nurses are expected to deliver safe care. For internationally educated nurses, those conditions include navigating unfamiliar regulatory frameworks, cultural expectations, and institutional norms, often without adequate structured support.

Freedom of Information data reveals a troubling picture: referrals of IENs to the Nursing and Midwifery Council (NMC) have risen sharply, with the majority being employer-led. This raises critical questions about how NHS organisations are supporting, or failing to support, their internationally recruited workforce.

"Supporting IENs to navigate patient safety in the UK is not a welfare issue alone, it is a patient safety issue. When nurses are unsupported, patients are at risk."

What the Article Examines

This article explores the specific challenges internationally educated nurses face when navigating the UK patient safety landscape, and what nurse managers, patient safety leads, and NHS organisations can do to address them. It examines the data on referral patterns, considers the structural factors that contribute to disproportionate risk, and sets out practical approaches to building equitable and safe working environments.

Key Topics Covered

Regulatory navigation and NMC processes for IENs, FOI data on referral patterns and what they reveal, Role of employers in supporting safe practice, Structural and systemic factors affecting IEN performance, Recommendations for nurse managers and patient safety leads.

Publication Details

Journal:Nursing Management
Publisher:Royal College of Nursing Institute (RCNI)
Reference:NM2185
Published:23 September 2025
Type:Evidence and Practice (Peer-reviewed)