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Nursing opportunities in Middle East hospitals are reportedly set to increase

Medical tourism is expanding and the exodus of UK nurses overseas could increase, writes Michael Howie
More than 60,000 UK citizens travelled abroad for treatment last year and that number could rise as low cost, high quality health care overseas becomes more widely available. Jo Wallis, chief executive of nursing agency Geneva Health, says more UK nurses could be recruited in the Middle East thanks to an expanding medical tourism industry. UK residents travelling there for treatment are so far, few, she says, but we expect that to increase. There will be more opportunities for UK nurses to work there. Countries in the region particularly Jordan, which received 220,000 medical tourists in 2009 have been busy forging ties with medical insurers and private hospitals in a drive to attract UK patients. The 300 million Dubai Healthcare City, built with investment from United States

OPPORTUNITIES ABROAD

hospital groups such as the Mayo Clinic, signals the United Arab Emirates intention to become a world medical tourism hub. Ms Wallis explains: We see this as a growth area for UK nurses as it is reasonably easy to get a job there. There is no language test, no green card (as in US immigration) and work visas are easily obtained. Susan Farish works in the paediatric oncology ward at theKing Faisal Specialist Hospital in Jeddah, Saudi Arabia. NHS job cuts in Scotland made her look abroad for work. My salary is 2,500 a month, tax free, plus bonuses and 54 days annual leave, she says.But we work long shifts. Ms Farish has not seen any British medical tourists although she has plenty of UK colleagues. I flew out a month early because of short staffing at the hospital, Ms Farish says. Most people work here for a few years to save money. When my contract runs out in two years, I will return to Glasgow or perhaps London.

ARABIANEYE

European player
Polands low costs and high quality healthcare mean it too is a major player in the growing global healthcare market. The Economist Intelligence Unit ranks it fifth in a league table

Patient safety A research scan by the Health Foundation issued in November 2011 examined the assumption that improving organisational culture and staff attitudes to safety affects patient outcomes directly or indirectly. The foundation concluded that there is some evidence to suggest that improvements in safety culture affect staff behaviours and injury rates, but there is less evidence of a direct effect on patient outcomes. Rather than a one-way causal relationship, in which culture influences behaviours and clinical outcomes, there may be a circular relationship, with changes in behaviours and outcomes also improving safety. http://tinyurl.com/HF-Safety-culture

NOTICEBOARD

Public health The Behaviour Change in Public Health conference will be held on February 29 at Westminster Studio, London. This is an opportunity to understand contemporary developments in behaviour change science, and to hear aboutpractical implementation of initiatives and best practice case studies from around the country. The meeting will be addressed by health minister Anne Milton and the event can be watched live online. www.neilstewartassociates.com Raising concerns about care The Care Quality Commission (CQC) has published a quick guide for healthcare professionals who need to raise a concern about their workplace. The guide lists four steps in

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of countries with medical tourism potential. The European Union (EU) mutual recognition of qualifications directive means British nurses could find plenty of jobs. We have many positions for nurses, says Polish Nurses Association general secretary Grazyna Wysiadecka. Salaries are low but rising, although nurses still need to learn Polish. RCN senior international adviser Susan Williams says more UK patients could seek treatment in Europe once the EU directive on reimbursement for cross-border healthcare is implemented in 2013. There could also be a big rise in medical tourism if domestic waiting lists rise, she says. Workforce expert James Buchan, from Queen Margaret University, Edinburgh, predicts that more UK nurses will seek work overseas, pushed away by wage constraints and fewer job opportunities in an NHS shackled by the governments austerity programme. He says: NHS cost containment and betterjob prospects abroad mean leave factors will outweigh stay factors for more UK nurses NS Michael Howie is a freelance journalist

Elaine Maxwell gave up her job to study for a doctorate thanks to a Florence Nightingale Foundation scholarship

Preparation for new roles

I was a director of nursing for eight years, but I knew my real interest was research. When I introduced changes in line with national policies, I wanted to understand why these were sometimes successful and sometimes not. To find out why, I left my job to become a full-time PhD student. Changing careers is not easy and I would not have done so without the Florence Nightingale Foundations financial and professional support. I also hoped that the prestige of the scholarship would bring me freelance commissions at the end of my study. My research investigated the process of shaping new nursing roles in England and arose from my experience of introducing nurse consultant roles. Even though the nurses appointed to these posts were excellent, none of the schemes achieved their aim of establishing a senior clinical role throughout the NHS. I wanted to know why. My studys main finding was that however new roles are defined in national policy, they need to establish authority in the workplace and that this is dependent on the perceptions of peers and colleagues. I proposed that managers and post holders could develop strategies to increase the success of new nursing roles.

Valid contribution
I think members of the foundations selection panel recognised that people of any age can contribute to the research agenda and also felt that my study might help increase our understanding of some of nursings problems. It is a huge honour to be a scholar and the award certainly increased my confidence. Although I had been a senior nurse, I was definitely a novice researcher. It may be a clich but it is still true that Florence Nightingale was a research role model. At the foundations conference in March (see box) I will be speaking about how to prepare for the implementation of new roles and how to increase the chances that these will be successful NS Elaine Maxwell is a visiting fellow at London South Bank University and a freelance researcher

Innovation and solutions

The second Florence Nightingale Foundation conference will be held on March 8/9 at the Queen Elizabeth II Conference Centre, London. The highlight of the event will be a series of masterclasses hosted by Florence Nightingale scholars who will discuss practice and innovations. A charity gala dinner will also be held on March 8. www.glasgows.co.uk/florencenightingale

the process. It advises staff on speaking out about poor care, the protection they can expect from the law and the role of the CQC. In addition, the CQC publishes fuller guidance on the subject for organisations registered with the watchdog. http://tinyurl.com/CQC-whistle-blowing Scholarship The Barbers Company Clinical Nursing Scholarship enables those in clinical nursing to undertake further education, research or a clinical project.The scholarship is worth up to 7,500 for fees or subsistence in undertaking a taught masters programme. The degree can be at an academic department in the UK or overseas. Applicants should submit a 500-word outline

of the course, research or project and its intended application together with their CV by February 28. http://tinyurl.com/RCN-Barber-Company Midwives The Royal College of Midwives and the Nursing and Midwifery Council (NMC) have published a report suggesting how indemnity insurance can be made available for independent midwives. Under EU Directive 2011/24/EU, from 2013 all healthcare professionals must carry professional indemnity insurance and it will be the regulators responsibility to ensure such cover exists. The reports suggestions would involve significant change in the organisation of independent midwifery practice. http://tinyurl.com/Indemnity-midwife january 18 :: vol 26 no 20 :: 2012 63

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