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NHS hugely dependent on workers from overseas

Concerns post-Brexit for sustainable workforce

Jo Carlowe

Wednesday, 04 December 2019

People born outside the UK account for almost a quarter of all staff working in hospitals and a fifth of health and social care staff in the UK.

In an election briefing published today, the Nuffield Trust looks back at how migrants and migration policy have shaped the care workforce across the UK in recent decades, drawing on new figures obtained from the Office for National Statistics.


The analysis of the new figures shows workers born outside the UK have accounted for 50% of the increase in care staff over the last decade. Their numbers have risen by 221,000 out of a total increase of 446,000.

Reliance on migration is greatest in hospitals, where the proportion of workers born outside the UK has now reached one in four.

The NHS in England is facing around 100,000 vacancies for permanent posts in trusts alone, notes the Nuffield Trust, with the problem particularly concentrated in nursing, which has nearly 40,000 vacancies.

The Nuffield Trusts shows that even if more staff are trained or convinced to stay in services, including measures such as grants for nursing students and restoring funding for professional development policies  — that have been taken up in election manifestos — the shortfall will worsen over the course of the next parliament without additional overseas recruitment of at least 5,000 nurses a year.

“There is a risk that policies by the main parties to end the current system of free movement from the European Economic Area [EEA] after Brexit will cause a slowdown in migration, with no alternative way remaining to recruit these much-needed staff. If the effect was similar to the crackdown in immigration from outside the EEA around 2010, health and care could have 6,000 fewer extra staff each year,” the report warns.

Commenting, Dr Chaand Nagpaul British Medical Association (BMA) council chair said: “The NHS is nothing without the people who work in it, and it’s clear from this analysis how much our health service relies on staff from abroad - put simply, we wouldn’t be able to function without them.

“The BMA has long been concerned about the potential fallout from Brexit, but it poses a particular risk to an already dwindling NHS workforce and could see talented, experienced healthcare professionals decide to leave the UK.

“In fact, our own survey of European Economic Area doctors working in the UK revealed that almost half are considering leaving following the EU referendum result, with almost one in five having already made plans to relocate elsewhere.

“There are few credible and detailed plans about how we will continue to recruit from abroad and ensure we have a sustainable workforce after Brexit, and it is this – showcasing our health service as a welcoming place to work - that urgently needs to be addressed if we ever stand of a chance of solving the NHS and social care crisis.”

Dame Donna Kinnair, chief executive and general secretary of the Royal College of Nursing said: “Nursing colleagues from overseas have long been an invaluable part of the health and social care workforce in the UK.

“Continuing over-reliance on staff from abroad in this way is both unsustainable and unethical in the long-term. Instead we need urgent measures to increase the size of our domestic workforce. The policy that would make the biggest difference would be to restore financial help, both tuition fees and maintenance grants, for nursing students in England - we are calling for at least £1 billion of funding to be reinvested in nurse higher education in order to increase the supply of tomorrow’s nurses.”

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