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Table 4 Migration motives of international doctors and nurses to the UK

From: Migration motives and integration of international human resources of health in the United Kingdom: systematic review and meta-synthesis of qualitative studies using framework analysis

Macro-level driver

International and national factors that exert influence across all international labour markets and also affect the health system dynamics [16, 20]

 

Themes and descriptions

Codes

References to clarify the source of the codes

UK based

Health system factors (these are factors related to the UK health systems including NHS)

Active recruitment

Employment opportunities in the NHS

Safety and security of NHS

Established networks

Support offered for relocation/induction

Permit free training

Active recruitment [21, 25,26,27,28,29,30,31]

Employment opportunities in the NHS [26, 27, 32,33,34]

Safety and security of NHS [25, 26, 35, 37,38,39]

Established networks [29, 31]

Economic factors

Ability to remit money

Strength of pound in global economy

[31, 33, 35, 39]

Political factors

Bilateral agreement

UK referendum vote to leave EU

Safety for family/self, fleeing violence

Ease of obtaining right to remain

Ease of British Citizenship

Ease of movement to the UK from EU

Bilateral agreement [25, 29, 40]

Source country based

Health system

Unemployment

Underemployment

Poor salaries

Poor working conditions

Overproduction of nurses and doctors

Un/underemployment

Poor salaries [41]

Working conditions [27, 33]

Economic factors

Global recession

Devaluation of money

Changes to remuneration

Remittance to home country

Global recession [30]

Devaluation of money [25]

Changes to remuneration [41]

Remittance to home country [38, 39, 42]

Social factors

Corruption in everyday life

Corruption in everyday life [26, 29, 33]

Political factors

Immigration policies

Bilateral agreements

Colonial connections

Immigration policies

Bilateral agreements [8, 34]

Meso-level

Professional-specific factors (e.g. education/training, job conditions) that frame perceived opportunities in a given occupational sector

UK

Training opportunities

Desire to gain postgraduate training

Desire to gain postgraduate qualification

Desire to learn the state of the art in the profession

Status of gaining UK qualifications and training

Training opportunities [26, 27, 32,33,34]

Employment opportunities

Desire to experience working in a different environment

Experience a different work environment [35, 50, 51]

Career progression opportunities

Opportunities to gain clinical experience through short-term employment

Opportunity for research

Opportunity for networking

Opportunities to gain clinical experience through short term employment [43, 48]

Source country

Training and employment opportunities

Shortage of postgraduate training opportunities

Shortage of posts in a particular speciality/profession

Natural progression of training

[26, 49, 53]

Career progression opportunities

Lack of promotion

[30, 41, 49, 50, 53]

Micro-level

Individual circumstances and attitudes through which macro- and meso-level drivers are viewed by individuals therefore influencing individuals’ migration decision

 

Personal fulfilment

Desire for life change

Adventure

Better quality of life

Desire for life change

Adventure [52]

Better quality of life [25, 29, 37, 40, 46, 48]

 

Financial gain

Financial gain for self

Financial gain for family

Financial gain for extended family

Desire to increase comparative income

Financial gain for self and family [26, 27, 29, 33, 35, 38, 42, 48, 55]

 

Family factors

Better quality of life for family

Better education for children

Desire to give children the cultural experience

Partners decision to work in the UK

Travel to the UK to marry

Travel to the UK to escape marriage

Better quality of life for family

Better education for children

Desire to give children the cultural experience [25]

Partners decision [35, 50, 51]

 

Networks

Access to social networks in the UK

Access to professional networks in the UK

Influenced by family mentor

Influenced by professional mentor

Access to networks and mentors [37, 38, 42, 51]

Role of mentor or mentoring [28]

 

Language

Knowledge of English language

Desire to improve English language

[25, 29, 39, 47, 48]

 

Window of opportunity

One off opportunity

[25]

 

Migrating stepping stone

Working in the UK is seen as a potential stage in onward migration, primarily to the United States, Gulf countries and Australia

[27]