Redefining Resilience & belonging in a shifting landscape

By: Angela Kumah

Friday 6th March 2026 marks Overseas NHS Workers' Day, a celebration of the extraordinary contributions migrant health workers make to the NHS and to the United Kingdom and to honour the deep commitment, expertise, strength and diversity they bring to the health and social care workforce.

Many accounts of immigration and migration are underpinned by stories of sacrifice, strength and resilience, many holding home and memories close while searching for belonging in a new land. Quotes from immigrants and migrants across the world highlight the complexity of negotiating identity, as we work out the nuance between holding on to national and cultural roots while adapting to a new society and attempting to redefine home (Watson, 2025). For many overseas health workers, the resilience required to make this transition is not simply a personal strength or badge of honour. It becomes an expectation and, over time, an identity rather than a choice.

Resilience is commonly understood as the capacity to recover and manage effectively during stressful circumstances without psychological collapse, often described as a dynamic interaction between environmental conditions and internal protective mechanisms that buffer responses to adversity (Rutter, 1985). It is often associated with strength, endurance, optimism, aspiration, faith and spirituality, and social support from family/friends. Ungar (2014) & Dahl et al (2022) remind us that the resilience of individuals and families is inseparable from the resilience of the society in which they are situated.

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Navigating belonging and resilience in the current political climate

If resilience is shaped by environment as much as by individual values and traits, then we must examine the environments migrant health workers are navigating. The current political climate surrounding immigration has become a significant national conversation, with direct implications for healthcare workers, particularly those who’s right to remain is tied to employment sponsorship. This creates uncertainty, affects the everyday workplace experience and shapes how security, a sense of belonging and value are perceived within the NHS.

Belonging, therefore, is no longer simply an emotional attachment to a place of safety but becomes conditional, negotiated by politically mediated definitions of what it means to earn the right to be a part of this society. This shifting goalpost for what constitutes belonging is bound to contribute to internal tensions that affect not only individuals, but their professional identity and practice.

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Bending without breaking

Within this context, resilience may often be framed as bending without breaking, a narrative of endurance, survival and innate toughness. It is portrayed as an inherent trait, something one is born with and must rely upon to survive and while resilience does function as a protective factor, it can simultaneously discourage help-seeking. When resilience becomes internalised as identity, vulnerability may feel like an afront to identity and the ability to shape narratives about self. In the case of minoritised groups (such as overseas nurses) these feelings are further amplified in the face of adversity.

The Workforce Race Equality Standard Report (NHS England, 2024) states that domestically and internationally recruited nurses and nursing assistants from Black and Minority Ethnic backgrounds, alongside white nurses recruited internationally report less favourable workplace experiences within the NHS. In the case of overseas health workers, particularly those navigating migration-related tensions, many may feel pressure to and stay resilient without complaint. In the context of ongoing work on suicidality in nursing, it becomes increasingly clear that resilience narratives, especially those embodied by overseas nurses, can unintentionally silence distress.  What this highlights, is that two realities can coexist: while overseas NHS workers are deeply resilient, they face systemic barriers that impact mental wellbeing and consequently necessitate the embodying of resilience as an identity. Holding space for both truths is imperative, if we truly want to foster a culturally humble and safe environment that truly celebrates their contributions to our health and social care system.

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Cultural Safety

Contextual and structural protective mechanisms shape how cultural safety is practiced, and organisational culture, inclusive leadership and equitable policy frameworks play a key role in determining whether resilience is supported collectively or demanded individually. Ungar (2014) identifies protective factors including meaningful relationships, strong identity, personal agency, social justice, access to resources, cohesion and cultural continuity as key to supporting resilience. These are not simply personal attributes; they are socially constructed and need to be sustained in a context that appreciates not only the contributions overseas NHS workers make to the very systems that sustain this nation, but wholly embrace the individuals, who make up this workforce.

Recognising the influence of political discourse on the health and wellbeing of overseas workers and ensuring safe environments, not only in conversation, but for policies that protect these essential service providers, is the first step towards truly acknowledging their value. Secondly, supporting culturally safe environments where overseas workers can navigate the delicate balance between affirming resilience and intentionally seeking support should underpin efforts to strengthen belonging. While family networks, community structures and national diasporic associations continue to sustain the health and wellbeing of many overseas healthcare workers, they often end up sharing the burden of distress caused when navigating the current hostile political climate, in an already emotionally tasking profession. This is counterproductive to any efforts towards fostering a resilient society.

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Creating ‘fully belonging’ environments

As such, in a multicultural society like the United Kingdom where identity, hope and expectations shape meaning, it is imperative that we adopt a culturally humble approach that recognises, respects and safeguards the value our culturally diverse workforce contribute to the success of our nation. Resilience should, therefore, not be demanded as individual toughness within complex political and organisational landscapes, but it must be supported collectively, so that bending toward help happens before breaking becomes the only option.

Supporting overseas workers must be grounded in an appreciation of how resilience, empowerment and social and cultural capital intersect to promote wellbeing while acknowledging the unintended barriers resilience narratives can create in relation to help-seeking. It also calls for thoughtful reflection on the wider political landscape that shapes feelings of belonging and security, recognising that the environments in which people live and work inevitably influence how safe they feel to be fully human, to fully belong.

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References

Dahl, K., Nortvedt, L., Schrøder, J., & Bjørnnes, A. K. (2022).
Internationally educated nurses and resilience: A systematic literature review. International Nursing Review, 69(3), 405–415. https://doi.org/10.1111/inr.12787

NHS England. (2024).
NHS workforce race equality standard (WRES) 2023: Data analysis report for NHS trusts. https://www.england.nhs.uk/publication/nhs-workforce-race-equality-standard-2023-data-analysis-report-for-nhs-trusts/

Rutter, M. (1985).
Resilience in the face of adversity: Protective factors and resistance to psychiatric disorder. British Journal of Psychiatry, 147(6), 598–611. https://doi.org/10.1192/bjp.147.6.598

Ungar, M. (2014).
Resilience and culture: The diversity of protective processes and positive adaptation. In M. Ungar (Ed.), Youth resilience and culture (pp. 37–48). Springer. https://doi.org/10.1007/978-94-017-9415-2_3

Watson, S. (2025).
Quotes from immigrants. Burning for Success. https://burningforsuccess.com/quotes-from-immigrants/

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We are grateful for the support of the Wellcome Trust who have funded this project.

Don’t give us a sticking plaster

by Dr Anna Conolly

About a month ago I was sitting in a packed cinema.

As the pre-film adverts played in front of me, I was distracted and I started to feel guilty about being there on a Sunday afternoon – was all my children’s school uniform ready for Monday morning or had I left some in the washing machine? Then, suddenly my attention was held by the large image of an ambulance, covered with bloody tissues, after treating a trauma, with a member of an ambulance crew, slightly removed, looking at the mess then walking away.

Still from 'Sicker than the patients' by Frontline19, 2024.

This was followed by similar scenarios such as family members on a hospital ward singing happy birthday to their father, supposedly a cancer patient, as a male member of staff watched or a nurse broke bad news to a couple in a side room. These scenarios were followed with individual shots of healthcare workers being overcome with emotion in various places, such as a nurse who broke down in a supermarket. All filmed as if taken by CCTV cameras with loud sound editing which captured the healthcare workers unsteady breathing, the film appeared very realistic and was completely effective in making you feel real empathy for healthcare workers.

I was pleased to see such a successful film had been made and was receiving widespread coverage when the jarring tag lines drifted onto the screen:

With over half suffering from poor mental health many NHS staff are sicker than the patients. Not that they would ever let you see it. Donate now so we can provide the therapy they urgently need.

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Sticking Plaster

I almost screamed No! at the cinema audience. The advert, made by Frontline 19, an organization who received backing from Boris Johnson to help healthcare workers during and after the pandemic, positioned mental health support, paid for by charitable donations from the public, as the solution for the healthcare workers mental health crisis in the UK.

I am a researcher, and I have been working on workforce wellbeing for the last 3 and half years. The images that the advert displayed did not surprise me, however, I was more than a little irritated by the messaging used at the end. Because the images shown in the advert were so emotive I was cross that such a powerful film could be used to support an agenda that only represents a ‘sticking plaster’ approach to providing support for healthcare workers in the UK. I believe that chronic underfunding has led to systemic and cultural failings within the NHS. It is the organisation that requires healing, in order for the workforce to have a healthy environment in which to do their jobs.

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Social Justice

Social justice has always provided the bedrock of the provision of healthcare in the UK. Founded in 1948 on the principle that healthcare services ‘are free for all at the point of delivery’ the NHS was, for decades, the envy of many countries. However, decades of little or no workforce planning, underfunding of the health service workforce, and massive staffing shortages have led to significant structural challenges.

Even before the pandemic, pressure in the health and care system was taking its toll on staff and was not sustainable. Reports described staff as running on empty and as the shock absorbers in a system lacking resources to meet rising demands. Excessively over-worked staff who suffer from mental distress and trauma due to not being able to provide the care they feel their patients are entitled to does not chime well with the social justice principles the NHS was founded upon.  

I would argue that the chronic underfunding has gone too far and sticking plasters are no good to those who work within the NHS. Our government must acknowledge the scale of investment and organisational culture changes that are needed to keep the NHS going and ensure the health of both our healthcare workers and patients.

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If you are a nurse or health worker who is in need of support, we have a range of support links here.