NHS managers must undergo ‘cultural intelligence training’ says watchdog

NHS managers should receive “cultural intelligence training” to tackle issues such as “the legacy of the British Empire” and improve the experience of overseas recruits, the National Guardian’s Office has recommended.

The NGO’s report examined the experience of international recruits to the NHS, with a particular focus on their willingness to speak out about concerns.

It found overseas staff face disproportionately higher scrutiny, are given limited support and are often penalised before they have had time to settle into their role. International recruits often felt “invisible”, the report concluded.

The report states the responsibility for adapting, including the implications for speaking up, was often on overseas-trained staff and “a lack of cultural intelligence” was a “repeated theme”, according to the body which leads, trains and supports a network of Freedom to Speak Up Guardians in England. It said this highlighted the need for better understanding and outreach by employers.

The NGO calls for “a meaningful approach to cultural competence” which goes “beyond superficial gestures like cultural exchange days”.

It stated that: “A two-way process of cultural intelligence is needed, where organisations actively seek to understand and adapt to the experiences and perspectives of overseas-trained workers.”

Most FTSU Guardians said training on speaking up was available in their organisations, however, only 16.9% surveyed said their organisations provided training to managers on how to support overseas-trained workers. More than half said they did not know if any such training existed.

The report recommends NHS England includes “cultural intelligence training” for NHS staff, managers and leaders as part of its Leadership and Management Framework programme by April 2026.

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Source: HSJ, 1 May 2025