Problems with NHS staff grow amid rising proportion of recruits from abroad

Concerns about NHS staffing in England have risen after an analysis of workforce data showed the health service may be becoming overly dependent on recruits from overseas.

Figures from NHS Digital show that the proportion of medical staff hired from overseas has nearly doubled between 2014 and 2021, according to a BBC analysis.

On Friday, several organizations responded with fresh calls for the government to address the NHS staffing crisis.

According to a BBC analysis, 34% of doctors entering the health service in 2021 came from abroad, up 18% from 2014.

The simple fact is that we do not have enough doctors, nurses and other medical personnel to meet the growing and increasingly complex medical needs of our population.Dr. Kitty Mohan, BMS

The broadcaster also found that the proportion of British doctors joining the health service fell from 69% in 2015 to 58% last year, while the proportion of new British nurses fell from 74% to 61% over the same period.

Meanwhile, the share of doctors employed outside the UK and the EU rose from 18% to 34%, and the share of nurses rose from 7% to 34%.

Dr Kitty Mohan, chair of the international committee of the British Medical Society, said the analysis showed that the National Health Service had “become heavily dependent” on doctors from abroad.

She said: “This has been demonstrated during the pandemic as international doctors have been at the center of a battle on the front lines of the NHS – with a disproportionate number of people who have sadly died due to the virus.

“The simple fact is that we do not have enough doctors, nurses and other medical personnel to meet the growing and increasingly complex medical needs of our population.”

Dr. Mohan also cited a number of reasons doctors are cutting their hours or planning to leave the NHS, including years of pay cuts, workload penalties, restrictive immigration rules, and verbal and physical abuse.

“We are calling on the government and NHS England to publish a long-term HR strategy as soon as possible,” she said.

“It should be transparent, publicly available, and include details of current staffing levels and future workforce needs based on patient needs.”

Danny Mortimer, chief executive of NHS Employers, also urged the government to take “urgent action” to address the “chronic staff shortage in the long term”.

While attention is also being paid to the growth and retention of the domestic workforce, we cannot escape the fact that there are 105,000 jobs in the NHS and 165,000 jobs in the social sector.Danny Mortimer, NHS Employers

He said: “Foreign recruits have always been an important component of the NHS workforce. We recognize and appreciate the contribution of our international employees to our team and the care we provide to our patients.

“International Recruitment should be seen as part of a comprehensive approach to workforce planning, and the government’s Code of Practice for International Recruitment helps employers ensure ethical recruitment practices.

“Despite the focus on growing and retaining the domestic workforce, we cannot escape the fact that there are 105,000 job openings in the NHS and 165,000 jobs in the social sector. We need urgent action and the new prime minister must commit to publishing a full cost and funding workforce plan to address the chronic staffing shortage in the long term.

Mr Mortimer added that the government needed a “reset of realism” in the NHS as “a dose of political honesty and alignment with the public about what the NHS is facing and what it needs from a future prime minister to address this issue.”

Patricia Marquis, director of the Royal College of Nursing in England, said the number of unfilled nursing vacancies in the NHS was “unsustainable”.

“Each position makes it harder to provide safe patient care,” she said.

“We are seeing a dramatic increase in the number of people leaving nursing, with 25,000 leaving the UK register in the last year.

“After a decade of real pay cuts, a growing overreliance on international recruitment, and restrictions on education funding, our members say enough is enough.”

She added that while nurses recruited abroad are invaluable to the NHS, “Ministers need to do more to increase domestic recruitment of nurses.”

“One of the easiest ways to retain employees is to pay them fairly,” she said.

The PA news agency contacted the Department of Health and Human Services for comment.