1 in 4 Hospital Staff Born Outside the UK

Nicky Broyd

December 04, 2019

Staffing analysis by the Nuffield Trust highlights the vital role of migration in the NHS workforce with nearly a quarter of hospital staff born outside the UK.

The briefing called Stopping the staff we need? Migration choices in the 2019 general election was produced to help inform the debate on future immigration policies.

Restricting immigration would have "almost unimaginable" consequences for the NHS, the health think-tank said.

It claims NHS Trusts in England already face vacancies of around 100,000 for permanent posts with the problem worse in Northern Ireland relative to the size of its workforce. The NHS in Wales it says has also seen an increased reliance on temporary nurses.

'Vital Contribution'

The report uses data from the Office for National Statistics to make its healthcare staffing estimates based on everyone who works in private and NHS health and social care across the UK. It stresses the "vital contribution" made by people born abroad – who are included in the data even if they have since gained British citizenship. It found:

  • People born abroad accounted for 19% of the health and social care workforce in 2018/19, compared with 14% of the general population

  • In hospitals, 23% of the workforce was born outside the UK

  • Of the 446,000 increase in the health and social care workforce between 2009/10 and 2018/19, staff born overseas accounted for 50% of the rise

Policy Warnings

The Nuffield Trust predicts that if restrictions on recruitment from EU countries led to a 50% fall in EU recruitment of health and care staff, it could mean 6000 fewer migrants getting NHS jobs each year.                                

In a statement, Mark Dayan, Nuffield Trust policy analyst, said: "This analysis reveals just how international the NHS truly is, and that without migration staffing shortages would be almost unimaginable.

"The Conservatives and Labour have made encouraging assurances to enable some foreign NHS staff to arrive after we leave the EU. But these pledges will fall flat if not matched with promises to recruit social care staff from abroad and expand to other vital NHS staff beyond hospital nurses and doctors too.

"With the NHS continuing to be a top priority for voters, restricting migration could backfire spectacularly given we already have dire shortages and more staff are desperately needed."

'Turning the Tide on International Recruitment'

Medical groups have issued statements commenting on the briefing.

Professor Andrew Goddard, president of the Royal College of Physicians said: "This analysis provides further evidence that international recruitment is vital to the stability of our NHS.

"With our health and social care workforce entering yet another challenging winter, we urgently need to turn the tide on international recruitment.

"The Home Office has got to change its tune and allow more international doctors to come to the UK on schemes like the medical training initiative."

He also stressed the costs of visas and immigration surcharges need to be tackled for NHS recruitment, and concluded: "It’s high time we once again made the UK a welcoming place in which to come and work."

Dr Chaand Nagpaul 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."

He said the BMA's survey of European Economic Area doctors working in the UK found that almost half are considering leaving after the Brexit result and nearly 1 in 5 have already made relocation plans.

He continued: "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's this – showcasing our health service as a welcoming place to work - that urgently needs to be addressed if we ever stand a chance of solving the NHS and social care crisis."

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