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Abstract Background The paper reports on a survey of recently arrived international nurses working in London, to assess their demographic profile, motivations, experiences and career plans. Methods A postal survey was conducted in October-December 2004 on a sample of 1000 nurses who were London-based international members of the Royal College of Nursing (RCN). The usable response rate was 40%. Registration data from the Nurses and Midwives Council (NMC) were also analysed. Results The Philippines, Nigeria and South Africa were the three most commonly reported countries of training (in total, more than 30 countries of training were reported). Sixty per cent of the nurses from sub-Saharan Africa and more than 40% from South Africa and India/Pakistan/Mauritius were aged 40 or older; the youngest age profile was reported by the Australia/New Zealand/USA nurses. Two thirds of all the respondents indicated that a recruitment agency had been involved in their move to the United Kingdom (UK). Three quarters of the respondents (76%) reported that they were required to complete a supervised practice course/period of adaptation in the UK in order to be eligible to practice as a nurse in the UK. Two thirds (69%) of respondents were working in NHS hospitals in London, 13% were working in the private sector hospitals and 10% were working in private sector nursing homes. Most of the nurses reported they were the major or sole wage-earner contributing to household income. More than half of the respondents (57%) reported that they regularly sent remittances to their home country. The majority of respondents (60%) indicated that they planned to stay for at least five years, but just under half (43%) also reported that they were considering a move to another country. Conclusion One critical issue for UK policy-makers is to determine if internationally recruited nurses will stay on in the UK, move back to their home country, or move on to another. That these nurses have made at least one international move means they are likely to have the propensity to move again. As such, retention efforts in the UK will have to take account of their career aspirations.

Foundation trusts will in theory have greater freedoms over pay, non-pay rewards and recruitment, although details are still unclear. Foundations are likely to differ in their use of these powers, partly because of desire and partly because of practical limits. Taking advantage of new powers for short-term gain, at the expense of other trusts, will have negative effects if not part of a wider development of HR practice.