Using Social Prescribing to support new International Medical Graduates

A growing proportion of our NHS medical workforce completed their primary medical training overseas. The number of International Medical Graduates (IMGs) working in the NHS has increased 40% in the last 5 years. In a recent report the General Medical Council recognised the impact for postgraduate medical training and workforce development. For example, in helping new colleagues understand the way the NHS works.

In Humber and Yorkshire, we welcome a high proportion of IMG colleagues to help with our GP workforce crisis. Data repeatedly shows that GP trainees who are IMG do less well in professional exams than UK trained doctors. National initiatives look to address these issues.

But in Humber and Yorkshire, there was increasing concern that many of the barriers to settling and thriving in UK general practice were not to do with clinical training but wider issues. Health Education England Yorkshire & Humber therefore led innovative work to introduce broader personal support for IMGs newly arriving in our region. They developed an enhanced induction programme for new colleagues.

Humber & Yorkshire is heavily reliant on recruiting International Medical Graduates to meet its primary care workforce needs. Doctors who have trained overseas and come over to work in General Practice here are a highly valued contribution to our primary care teams. There has been much work focusing on providing clinical inductions in health service settings – understanding of the NHS and how general practice works in the UK. But less attention has been paid to the personal and family needs of this crucial workforce.

Many of these needs are not medical – in other words not related to professional training but the wider factors that support health and wellbeing. Addressing these needs potentially falls under the remit of Social Prescribing initiatives, but with a distinct focus on new IMGS.

HEE set about with 2 pieces of work. First they developed and implemented a new My Story survey tool to identify needs and problems being experienced by IMGs. TO address the problems identified, they introduced a new Social Prescribing Link Worker dedicated to working with IMGs to address the issues identified.

The Academy of Primary Care has supported HEE in evaluating the work done to consider if and how the service should be sustained.

The PI is Caroline Mills, Health Education England Humber & Yorkshire, and Gareth Harrison.

The Co-Is are Puja Verma, Nicholas Broadwell, and Clare Fozard.

Analysis of the My Story tool confirmed the non clinical nature of key challenges faced by new IMGs. These included problems with securing suitable accommodation, school placements for their children, getting a driving license, dealing with loneliness.

Analysis of the SP intervention showed high take up of the scheme, delivering a range of practical supports and outcomes for IMGs from sorting out bank accounts to getting a driving license. Feedback from IMGs who used the service was positive. IMGs described feeling less isolated.

It is not yet possible to assess whether the initiative is having any impact on differential attainment and career progression for IMGs but work is ongoing.

An evaluation of The Social Prescribing Scheme Pilot for International Medical Graduate GP Trainees in Yorkshire and the Humber.  Puja Verma, Joanne Reeve, Caroline Mills and Gareth HarrisonBritish Journal of General Practice 2023; 73 (suppl 1): bjgp23X733869. DOI: https://doi.org/10.3399/bjgp23X733869

Second paper in preparation.