The RCN's international work 

Welcome to the RCN's international webpages. The RCN Policy and International Department works closely with members through the RCN International Committee. Find out more about the committee and the RCN's international work (PDF 382 KB)You can also read in more detail more about the Policy and International Department in what we do.

Policy and international news

The Buurtzorg Nederland Community Care Model  

The Buurtzorg model has attracted significant international attention in recent years. Founded in the Netherlands in 2006, this unique community nursing programme has won acclaim for being both nurse-led and cost effective. 

On 16th July 2015, the RCN hosted Jos De Blok - Buurtzorg’s founder and director, in collaboration with Public World. This short film captures some of what Jos said about the critical role of autonomous, self-directing teams of nurses in delivering better care for their patients at lower costs.

Play this video

To complement this video, the RCN has also developed a briefing which looks at the development and successes of the Buurtzorg model, while also identifying some of the challenges which would need to be addressed if the UK were ever to adopt a similar system approach.  This briefing can be accessed here. 


Transatlantic Trade and Investment Partnership (TTIP) - Update on developments and RCN activity

Since the RCN published its original position statement on TTIP in October 2014, the level of interest and concern about TTIP has continued to grow. This briefing seeks to provide an update on developments in the UK, EU and US in relation to TTIP as well as set out RCN activity and future priorities. Please follow the link to read - http://www.rcn.org.uk/__data/assets/pdf_file/0007/634381/8.15-Transatlantic-Trade-and-Investment-Partnership-TTIP-Update-on-developments-and-RCN-activity.pdf

 To learn more about TTIP and why you should be concerned, please follow the link to hear from RCN President, Cecilia Anim and RCN EU/International Adviser, Matthew Hamilton, on why nurses should be aware of TTIP -  https://audioboom.com/channel/theRCN

Click on the links to hear what our MEP panel and stakeholder panels had to say on the Impact of TTIP on Health Services and Public Health. 

A Guide to TTIP

What is TTIP?

The Transatlantic Trade and Investment Partnership (TTIP) is a trade agreement that is being negotiated between the European Union and the United States. The stated aims of TTIP are to remove trade barriers to make it easier to buy and sell goods and services between the EU and the US. As part of TTIP, public service standards between the US and EU will be harmonised, with a lowest common denominator approach to make trading easier. Without a carve out for health services, TTIP will further open up the NHS to American private businesses. There is very real concern that this will adversely affect patient care and members’ terms and conditions of work.

Follow the link to hear from RCN President, Cecilia Anim and RCN EU/International Adviser, Matthew Hamilton, on why nurses should be aware of TTIP -  https://audioboom.com/channel/theRCN

Why does this affect you?

There are widespread concerns that TTIP is being negotiated in secret, with a purely economic focus and with little attention to the impact on public services. Without knowing what exactly is being negotiated, the general public and public service stakeholders are being kept at a significant disadvantage with little democratic opportunity to challenge the content of the agreement.

The RCN is concerned about the threat TTIP poses to the NHS. The wording of the 2012 Health and Social Care Act opens up the NHS to increased competition from private providers. If the finalised agreement includes a provision for utilising the investor-state dispute settlement (ISDS) procedure, this could allow corporations to sue the state if it chose to repeal or introduce new legislation which serves to harm their ability to generate profit.  This could act as a deterrent to governments for adopting progressive legislation
The RCN is also concerned about the dangers from TTIP for the wider aspects of health, such as health and safety, food and environmental standards, public health initiatives and costs and standards of pharmaceuticals and medical equipment. 

What is the RCN doing about it?

Following last year’s Congress resolution to lobby against the inclusion of health services in the Transatlantic Trade and Investment Partnership, the RCN released a position statement which sets out five priorities for ensuring that health services are removed from TTIP as well as a call for more transparency around the negotiations. The full statement can be viewed here . 

The RCN also recently hosted an interactive seminar on TTIP at its London HQ on Friday 27th March. The purpose of this seminar was to increase awareness on TTIP amongst RCN members and provide attendees with the opportunity to engage directly with a panel of politicians comprised of MEPs from the Conservative, Labour and Green parties as well as a separate panel of health stakeholders including the British Medical Association and the European Public Health Alliance. The discussion focused on the potential impact of the agreement on health service delivery and public health in general.

View The Impact of TTIP on Health Services and Public Health MEP panel and stakeholder panel discussions on YouTube.

The RCN are lobbying both at EU and domestic level to ensure that health services are removed from any future TTIP agreement, contacting MPs and MEPs to set out our concerns and we encourage individual members to do the same. We are also working closely with other EU alliances and UK stakeholders who share similar views to ensure that health services are removed.

For more information about how you can get involved and support our work, please contact international@rcn.org.uk

RCN publishes position statement on Transatlantic Trade and Investment Partnership

The RCN has developed a position statement on the Transatlantic Trade and Investment Partnership (TTIP) treaty currently being negotiated between the EU and the US, calling for health services to be removed from any agreement.

Members at RCN Congress 2014 voted overwhelmingly to lobby against the inclusion of health services within TTIP, and the RCN has subsequently identified five key lobbying objectives to ensure that health services are protected from the agreement.

RCN members are concerned that unless health services are removed from any agreement, future governments will be unable to pass laws to remove legislation that encourages the marketisation of health services, or to introduce progressive public health policies.

The position statement calls for greater transparency, a cast-iron guarantee that health services will be exempted and the removal of the investor-state dispute settlement (ISDS) mechanism from the agreement.   

Read the RCN's position statement on Transatlantic Trade and Investment Partnership (TTIP) (PDF 98.0KB) 

European Commission consultation on TTIP investor-to-state dispute settlement mechanism

The RCN has responded to a consultation on the investor-to-state dispute settlement (ISDS) mechanism within the Transatlantic Trade and Investment Partnership (known as TTIP), which is currently being negotiated between the European Union and the United States.

The ISDS mechanism would be a separate international arbitration panel which could rule on whether future UK domestic legislation is compatible with the terms of the TTIP. There are concerns that if health services are included within the agreement, then the ISDS mechanism could overturn future legislation which is deemed incompatible with TTIP.

In June at RCN Congress, RCN members debated a resolution urging the RCN to "lobby against the inclusion of health services in the Transatlantic Trade and Investment Partnership". This resolution received overwhelming support, with more than 97 per cent of members voting in its favour.

During the discussion that accompanied the resolution, RCN members articulated a number of key principles that form the basis for the RCN’s position on TTIP.

Read the RCN’s position on the ISDS mechanism within TTIP (PDF 71.1 KB)

EU/International Recruitment and Nursing Shortages

Recruitment of nurses particularly EU i increased in last few years due to rising nursing shortages in healt hand social care sector in UK.

In response RCN recently issued strong position statement on EU and international recruitment to push for better workforce planning, fair treatment of nurse migrants and support for development of strong health systems in resource poor countries. Also issued practical guidance for nursing staff and employers on ethical recruitment.


RCN also continuing to press Government to recognise the breadth of shortage being faced by health and social care providers, by placing nursing on the Home Office Shortage Occupation List (SoL).  Changes to the UK’s immigration rules will also make it difficult to retain overseas nurses who have been working in the UK since 2011 as they are highly unlikely to be earning the £35,000 income threshold to apply for indefinite leave to remain. The RCN has highlighted the impact and is campaigning for Government to address this problem. 


EU legislation on mutual recognition of nursing and midwifery qualifications


EU arrangements that allow health professionals to register and practice in other EU countries were updated in 2014 and are due to be implemented in the UK by January 2016.  The new arrangements mean that the Nursing and Midwifery Council will be able to require evidence from nurses and midwives from the European Economic Area (EEA) of English language competency before they are registered to practice in the UK.  The legislation also introduces more robust measures for regulators to exchange information on health professionals who have been removed from the register or have restrictions on their practice.  The RCN supported the introduction of language controls for EEA nurses and midwives wishing to join the NMC register and has responded to a number of consultations on the implementation of the rules in the UK. 


Most recently the RCN has welcomed the system the NMC is putting in place for initial registration but has expressed serious concerns about the way the NMC is proposing to handle allegations of lack of language competency for those nurses and midwives already registered with the NMC, where the burden of proof would be very different from other grounds for questioning a registrant’s fitness to practise.  For more follow click here.


RCN partnership with Zambian Union of Nurses Organisations

The goal of the RCN  ZUNO project is to build ZUNO’s capacity to influence nursing policy and improve nursing practice in Zambia. With the RCN’s support, ZUNO will be helping theatre teams at the University Teaching Hospital Lusaka to implement the WHO safe surgery checklist (http://www.who.int/patientsafety/safesurgery/ss_checklist/en/).

In July an RCN delegation led by the Chief Executive & General Secretary Janet Davies was joined by ZUNO representatives including President Thom Dauti Yung'ana, and the Permanent Secretary for the Ministry of Health Dr Davy Chipamata at the official launch of the project at University Teaching Hospital in Lusaka. Professor Jane Reid, an RCN member, carried out intensive training on the WHO safe surgery checklist with the first two multidisciplinary pilot teams, including workshops and practical in-theatre work. The teams were very engaged and enthusiastic and are now implementing the checklist with regular support from the ZUNO project officer. The training will be rolled out to other theatre teams in September/October, and to all UTH theatre teams by January 2016.

The project is supported through the Health Partnership Scheme, funded by the UK Department for International Development and managed by the Tropical Health & Education Trust (THET).

European manifesto

Prior to the 2014 European Elections, the RCN published a manifesto on our priorities in Europe for the next five years. Our members told us we should work on championing safe staffing levels, ensuring an appropriately educated and developed workforce, supporting access to health care services - particularly for vulnerable groups, and promoting healthier lifestyles. The manifesto is still being used to lobby local MEP candidates and MEPs on issues important to nursing and patients.

Find out more about the RCN's European election manifesto.  

Briefing on the impacts of the EU’s Tobacco Products Directive

The RCN has published a briefing on the new EU Tobacco Products Directive. The RCN has a long history of supporting measures to enhance tobacco control and reduce smoking rates and health inequalities, as well as measures to protect children and young people from smoking and from exposure to tobacco promotion.

During the progress of the directive, the RCN actively lobbied MEPs and UK ministers on the content of the directive, and worked closely with the European Public Health Alliance, of which it is a member, to support lobbying in Brussels. While not all of the initial proposals were included in the final directive, the RCN supports the final text of the Tobacco Products Directive and calls on the UK Government to transpose the legislation into national law as soon as possible.

Download the RCN's briefing on the EU Tobacco Products Directive (PDF 104KB)

Contact us

For advice on working and volunteering overseas, and information on coming to work in the UK from abroad, please contact web.enquiries@rcn.org.uk 

For other international enquiries please contact international@rcn.org.uk