The International Podiatry Pilot Programme

There were whispers and reassurances - almost a pre-emptive-cushion that ‘this is unlikely to be possible, but the process itself will be good for understanding the global picture, and it needs to be explored’. We felt some relief, knowing that the ‘ask’ was more of a scoping project than a concrete reality. With the Podiatry community and profession in general being quite small and ‘niche’, expectations of recruiting were low. However, we felt a sense of determination that surely, we could make this work! From the first exploration of this programme, (Choucri, 2022, p.35) success and opportunity were created with our Spanish counterparts. Due to time and financial constraints, once the partnership between Health Education England (HEE) and the University of Malaga had been established, we had to mobilise the operational aspects quickly.

The sequence of the scoping review was organic in that, like dangling a carrot to tease movement out of a donkey, the process itself became more tangible, evolving each step of the way, until I had a fuller and clearer picture of how the pathway should look. I use the word ‘organic’ because, although DGHP in HEE has a great wealth of international recruitment experience, and clear processes in place to guide, it had not been done before for the Podiatry profession. It was tip toeing into the unknown, but we had to try. We did this with transparency and honesty. We advised our stakeholders that this was new territory, and that we had to work together, be patient, and be open to whatever may present itself, be it positive or challenging. The scoping review was guided by the following questions (not exhaustive):

• Does the Spanish Podiatry degree match that of

• Is there a history of Health and Care Professional’s

• Are there enough candidates for a surplus to be

• Do the candidates have an interest to work in

• What is the NHS/UK pull for them to leave

• Would the NHS Trust’s be interested in

• Will the candidates’ English language be good

• Is the podiatry workforce in Spain in a healthy

Each question, each step of the way, we were met with ‘yes’, so we implemented the strategy and kept moving forward. We felt dubious - is this too good to be true? We proceeded with a ‘believe it when we see it approach’.

Quite rightly the HCPC have strict English Language requirements for allied healthcare professionals. We screened the candidates to establish their current level of language. We were able to further gauge this and get a feel for the candidate’s language ability in our whistle stop, planes-trains-and automobiles style interview trip. This led us across the borders of Spain with little sleep but, with satisfied bellies full of Spanish culinary delights, to conduct face-to-face interviews.

We experienced fantastic, proud, hospitality and were pleased to experience some state-of-the-art Podiatry clinics within the universities. The interviews generated

doubts but fostered a great sense of confidence for others. We bit the bullet and offered band 5 Podiatry positions to the successful candidates. Collating the initial screening language scores along with successful interviews, we partnered with Occupational English Test (OET) to create custom language learning. In order to give candidates the best chance of success to meet the HCPC standard, candidates were filtered into groups according to baseline ability. This ensured those candidates with the highest scores could access programmes quickly and we hoped this would reduce attrition from the programme. The candidates were in for a long journey, summer arrivals turned into winter and beyond. Thankfully the organic process, and the risk of what the unknown could bring, was familiar to all stakeholders, and although we lost a few candidates along the way, because they were unable to commit to the study hours required, everyone accepted the plan. I fast forward to where we are now. With fondness and respect, I think of the candidates, they have put their lives on hold, declined jobs, sometimes felt frustrations at the pace of progress, but have persevered and dedicated themselves to their English courses.

The first cohort successfully achieved the required results and have completed their HCPC applications. Our first candidate should arrive in December, just in time for the Blackpool illuminations! The middle and lowest scoring cohorts have shown significant improvement in their baseline tests, meaning that they will progress to the next English course to prepare them for their final OET exam. If successful, depending on the HCPC registration process- which can be up to 8 weeks and more in some cases, they should arrive early 2023.

The process, learning, research, relationships, and opportunities that have come from this project are unique, and quite special. From liaising with academics in America, Canada, South Africa, and being invited to attend the ENPODHE (European Network of Podiatry in Higher Education) conference in Belgium; and countless opportunities with so many individuals, have allowed for rich knowledge exchange. This learning and insight could not have been obtained without the appetite to find out who are the people behind the services and institutes, trying to sustain and build up the Podiatry profession. We have witnessed great passion and learned about innovative ideas, but the international recruitment of Podiatrists is a long-term ambition. The scope for ‘long term’ ideas was not part of the initial brief, but there is absolutely space and enthusiasm for collaboration across the globe. It struck me that one of the largest barriers for Podiatrists in Europe is scope of practice. Podiatry degrees in the UK, include the use of Local Anaesthetic, theoretically and practically. However LA is not part of some European degrees. The inclusion or development of modules for LA, for international students, could shape the future of podiatry for the benefit of the NHS, and the globe more widely. Consequently, that was why we were unable to collaborate within those countries despite the provision of Podiatry. The journey has not been easy, but we have all learnt a great deal. The HEE research team has already begun to collect data via interviews and surveys from the Spanish candidates and our NHS partners. The timeline for the evaluation remains flexible according to the English language course and the HCPC registration process, but lessons learnt, and recommendations will be produced in due course.