The International Podiatry Pilot Programme

Podiatry International Update, interview with Gabrielle Choucri

Who are We?

Health Education England (HEE) exists to support the delivery of excellent healthcare and health improvement to the patients and public of England. They ensure the workforce of today and tomorrow has the right skills, values, and behaviours at the right time and right place. An essential element of this is to ensure an effective supply of AHP’s, supporting robust deployment and development of staff, whilst supporting retention across professions and geography. (This paragraph is taken from: www.hee.nhs.uk/our-work/ allied- health-professions/increase-capacity/ supporting- international-recruitment) The Directorate of Global Health Partnerships (DGHP) within HEE has significant experience in the development of ethical International migratory pathways, most notably developing a highly successful model for the international recruitment of Registered Nurses which saw over 2,000 nurses joining the English NHS. International recruitment creates a rich, diverse, cultural and knowledge exchange-greatly benefitting the NHS workforce and local communities.

But wait - Why are we doing this? Here are the stats!

• Predicted Podiatry vacancies in 2025 would be double that of 2018-19- an increase from 7.0% to 14.8% (Unpublished data by Health Education

England, HEE and NHS England and NHS

Improvement, NHSEI) • Supply and demand gap of over 1,000 vacancies by 2025 (Unpublished data) • Multifactorial reasons: High retirement rates, low attrition, preference of Private practice over NHS? The Podiatry degree

NO longer being fully NHS funded could have also caused a dip in the number of applicants. (However, there are now bursaries which may have improved application numbers). • Of the 186 Podiatry graduates for the year 2020, less than half went on to work in the NHS (taken from Health Education

England, Student Data Collection Dataset,

June 2020 (unpublished). There are initiatives that attempt to save the profession, including raising the professional profile of Podiatry - which has been an ongoing theme in the Podiatry world. Podiatry contacts in Canada and Australia strive to push the elevation of podiatry as a profession, by creating awareness about the Podiatrists skillset, to create awareness globally but also for the younger minds at school age, so that people know what Podiatry is alongside ‘being a vet, or a doctor’ and the great and varied career it can span and opportunities it could provide. (The following journal backs up the workforce shortage for Podiatry: https://jfootankleres.biomedcentral.com/ articles/10.1186/s13047-021-00470-y)

Initiatives in the UK?

• Return to work schemes • Retention of existing staff- expanding scope of practice/creation of positions • Apprenticeships with Universities and local NHS Trusts • First contact point initiative within GP surgeries • The Podiatry Career Framework Despite these initiatives, there are still predicted gaps in years to come.

The quest to explore International waters: What did we do?

HEE, drawing on the expertise and with the support of numerous Podiatry professionals, including the Institute of Chiropodists & Podiatrists, the DVLA, the Health and Care Professionals Council and the Home office (Visa and & Immigration) studied global markets and international Higher Education Institutions to map educational standards and outcomes for podiatry against UK standards/ requirements. This step was fundamental for the successful and ethical selection of an international partner. (Choucri,2022)

Opportunities found?

As you may have guessed- the podiatry profession globally, is small, niche, complex but rich in potential and determination to succeed and remain strong. Countries still battle for official degree titles and scope of practice, causing complications, and therefore HCPC accreditation would not be possible, therefore they would not be able to legally practice here in the UK. Some countries have very low student numbers entering programmes and graduating; meaning it would be unethical to build migratory pathways with them.

However, here is what Spain could offer:

• 15 Spanish

Universities provide 4-year

Podiatry degrees similar to the UK. (HCPC have a record of accrediting Spanish

Podiatrists) • Over 600 Podiatry graduates in the year 2020 • Not an abundance of Podiatry job opportunities /full time work. Many graduates work in jobs that are not Podiatry, or are offered only a few days clinical work per week. • There is no public health service provision of

Podiatry in Spain, therefore the pilot programme would not drain Spain of much needed professionals. • NHS experience and opportunities are attractive as they are rare in Spain. • Upon returning to home country - the candidates will be able to provide enhanced, once in a lifetime gained experience, to deliver exceptional standard of care in their communities. (Spain are trying to implement

Podiatry in their public health service) • Ethical assurance: There is an oversupply of

Podiatrists (that is, that Spain, trains more

Podiatrists than their domestic services require)

The Proposal

From the research gathered to date, HEE was able to propose a pilot study, partnering with Spanish universities and their Spanish Podiatry governing body (Consejo General de Colegios Oficiales de Podólogos). The pilot study aims to: Recruit Newly Qualified Podiatrists from Spain into pre-agreed NHS Podiatry Trusts. Recruits will be employed initially on a 3-year contract, with sponsorship for a 3-year Tier II UK Visa provided by the employing Podiatry Trust. At the end of the initial 3-year contract the NHS Podiatry Trust will be able to offer a contract extension and Visa sponsorship extension if desired by both the Trust and the Podiatrist. (Choucri,2022) NHS Trusts were invited to bid, detailing their workforce needs, experience of International recruitment, pastoral support, and information about their local areas and teams. Candidates were invited to apply and choose a preferred region including options of city/rural/seaside areas. The pilot will be fully evaluated, and a report shared with stakeholders on completion. The evaluation report will include recommendations made for future recruitment practice and potential rollout.