The Paradox of Workforce Self-Sufficiency: Policy Narratives, Professional Identity and Internationally Educated Nurses in the United Kingdom

Nwambo, JC ORCID: 0000-0002-1002-8117, Bifarin, O ORCID: 0000-0002-8247-2508 and Higginbotham, K ORCID: 0000-0003-0795-7473 (2026) The Paradox of Workforce Self-Sufficiency: Policy Narratives, Professional Identity and Internationally Educated Nurses in the United Kingdom. Nursing Inquiry, 33 (4). pp. 1-17. ISSN 1320-7881

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Abstract

The NHS Long Term Workforce Plan positions international recruitment as essential for present stability while projecting a future of reduced structural dependence on internationally educated nurses. This tension, conceptualised as the paradox of self-sufficiency, forms the focus of this study. Drawing on a critical qualitative evidence synthesis, eight UK policy documents were analysed using Bacchi's ‘What's the Problem Represented to Be?’ (WPR) framework alongside thematic synthesis of 17 qualitative studies, sensitised by Social Identity Theory and Ontological Security. Policy analysis reveals that the Plan positions international recruitment as a short-term necessity, treating domestic training as the preferred long-term pathway while leaving internationally educated nurses uncertain about their long-term place within the workforce. Three consistent patterns emerge from the qualitative evidence: prior expertise requires institutional revalidation before professional legitimacy is accorded; the burden of professional reconstruction falls disproportionately on internationally educated nurses, and belonging remains conditional rather than secure. These patterns are not incidental but are suggestive of underlying structural conditions mediated through organisational contexts but cannot be resolved by organisations alone. Sustainable workforce planning requires policy-makers and nursing leadership to recognise internationally educated nurses as permanent contributors, ensure equitable career development and build organisational cultures in which belonging is unconditional.

Item Type:	Article
Uncontrolled Keywords:	Humans; Narration; Social Identification; Qualitative Research; State Medicine; Nurses, International; United Kingdom; NHS Long Term Workforce Plan; conditional belonging; internationally educated nurses; nursing leadership; policy analysis; professional identity; qualitative evidence synthesis; workforce governance; United Kingdom; Humans; Nurses, International; Social Identification; Qualitative Research; State Medicine; Narration; 4204 Midwifery; 4205 Nursing; 42 Health Sciences; United Kingdom; Humans; Nurses, International; Social Identification; Qualitative Research; State Medicine; Narration; 1110 Nursing; Nursing; 4204 Midwifery; 4205 Nursing
Subjects:	J Political Science > JC Political theory R Medicine > RA Public aspects of medicine R Medicine > RT Nursing
Divisions:	Nursing, Public and Allied Health
Publisher:	Wiley
Date of acceptance:	20 August 2026
Date of first compliant Open Access:	29 October 2026
Date Deposited:	29 Oct 2026 14:50
Last Modified:	29 Oct 2026 14:50
DOI or ID number:	10.1111/nin.70164
URI:	https://researchonline.ljmu.ac.uk/id/eprint/29766

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