One in three doctors and nurses who joined the NHS in England last year were recruited from abroad, raising concerns that the health service is becoming too reliant on foreign recruits.
Data from NHS Digital shows that the proportion of healthcare staff recruited from abroad nearly doubled between 2014 and 2021, according to an analysis by the BBC.
Several unions said it was a sign that the NHS is relying on foreign recruits to tackle staffing problems as they made fresh calls for the government to tackle the staffing crisis.
This is almost double the share of overseas recruits in 2015, when the figure was just 18 percent. The government has downplayed the turnout, saying foreign recruitment has always been part of its workforce strategy.
A total of 39,558 UK-trained doctors and nurses joined the NHS in 2020-21, which is about 3,200 more than in 2014-15.
However, the number of British-trained health workers is increasingly shrinking as a percentage of new entrants into NHS England’s million-strong workforce.
The analysis found that only 58 percent of doctors who joined the NHS last year were trained in the UK, down from 69 percent in 2015.
For nurses, the proportion of UK-trained carpenters was 61 percent last year, down from 74 percent in 2015.
In the same time, the percentage of new entrants who qualified outside the UK and the EU has almost doubled and in some cases quadrupled.
These graphs, based on NHS staffing data, show the proportion of doctors and nurses joining the NHS in England based on where they were originally trained. In both professions, the number of carpenters trained in the UK has decreased over time (red lines), while the number of non-EU trained professionals has increased (yellow lines). The proportion of EU professionals joining the NHS has declined over time, taking a sharp plunge in the years following the 2016 Brexit vote
India and Pakistan are the two largest non-UK countries where doctors are currently registered to work in Britain originally trained with approximately 30,000 and 17,000 respectively. This is followed by Nigeria, Egypt, Ireland, South Africa, Greece, Sudan, Italy and Romania
Nurses recruited from abroad made up just 7 percent of the workforce in 2015, compared to 34 percent last year.
Most nurses who have registered in the UK in the past five years, but did not originally receive training here, have come from countries such as India, the Philippines and Nigeria.
Staffing problems have plagued the NHS for years, as evidenced by a damning report led by an MP last week. It concluded that health care in England is currently short of 12,000 hospital doctors and more than 50,000 nurses and midwives.
That report, from the Health and Social Care Committee and led by former Health Minister Jeremy Hunt, also predicted that England’s health system will need 475,000 additional jobs by the beginning of the next decade.
Health unions have been concerned for some time about the UK’s over-reliance on overseas recruitment, both because Britain may not always be able to attract these workers and because we may be taking them out of health systems in developing countries.
Commenting on the BBC’s analysis, Patricia Marquis, England director of the Royal College of Nursing union, said ministers should do more to reduce the ‘disproportionate dependence’ on internationally trained recruits.
This chart shows the country of education of all newly registered nurses and midwives in the UK over the past five years. Unsurprisingly, British-trained nurses make up the majority with around 120,000 carpenters. India (around 21,000), the Philippines (nearly 18,000) and Nigeria (nearly 5,000) are the largest providers of overseas-trained nurses and midwives registered to work in the UK
Danny Mortimer, chief executive of NHS Employers, said it was ‘high time for the government to commit to a fully funded, long-term staffing plan for the NHS’ to tackle ‘chronic staff shortages’.
The British Medical Association (BMA) has warned that UK-trained medics are increasingly moving abroad to countries where pay is higher and immigration costs lower.
A health and care worker visa to work in the UK costs up to £479 per person every three years, with a worker’s partner and children also having to pay this amount.
There are also additional costs, such as mandatory memberships from the UK health regulators, that these professionals have to pay.
BMA officials have said medical graduates will be charged up to £2,400 to apply for permanent residence leave, with each of their family members also having to pay the same fee.
The BBC analysis found that the percentage of doctors originally trained abroad who left the NHS in 2021 rose to 25 per cent in 2021, from 15 per cent in 2015.
While the number of NHS recruits from non-EU countries has increased, the number coming from the European bloc has fallen.
Last year only 6 percent of NHS participants came from the EU, up from 11 percent in 2015.
Some blame the drop on Brexit, making it more difficult for EU-trained professionals to come and work in the UK.
But the Department of Health and Social Care suggested instead that the problem was that the UK’s nurses’ regulator introducing tougher language tests could be the backslide.
These increased language checks have not deterred nurses from elsewhere in the world from coming to the UK. The number of nurses and midwives trained abroad has risen to 113,579, according to NMC data, a 23.1 percent increase from last year.
At the same time, the number of registrants trained in the EU decreased to 28,864 last year, from 35,115 in 2017/18.
Internationally trained nurses and doctors must pass an English language exam before being allowed to practice in the UK, if their qualification has not been given in English.
Nurses also need to pass an aptitude test to register in the UK, while doctors may have to go through a similar process depending on where they were trained and their specialty.
Staff shortages on the NHS are a factor that experts have blamed for rising A&E waiting times this summer, leaving some Britons waiting for hours in ambulances while medics struggled to find extra beds.
GP crisis in England deepens: staff numbers fall to lowest level ever
The number of qualified GPs has fallen to an all-time low with only one in four GPs working full-time, according to official data highlighting the ‘catastrophic’ crisis in GP practice.
There were around 27,500 fully qualified, permanent GPs for NHS England last month, down from around 28,000 in June 2021 and 1,500 less than five years ago.
The figure comes despite Boris Johnson’s 2019 promise to increase the number of GPs by 6,000 by 2024. Ministers have since admitted that the target will not be met.
Health chiefs have warned that crippling staff shortages, combined with unprecedented demand for a GP after the pandemic, has created an intolerable situation that threatens patient safety.
Meanwhile, just 23 percent of regular NHS GPs work 37.5 hours or more per week, a drop of a third in five years. It follows from research showing that most GPs now only work three days or less a week.
Patients have trouble making appointments or seeing a doctor in person, leading some desperate people to resort to showing up in the ER.
Separate figures suggest that other NHS staff are increasingly taking on the burden as GPs struggle with staffing issues.
June data shows that less than half of all appointments were performed by qualified doctors. The rest were seen by other staff, including nurses, physiotherapists and even acupuncturists.
Nearly one in five appointments nationwide lasted five minutes or less last month, which campaign groups say was a sign that GP practices have turned into ‘revolving doors’ in an effort to get patients in and out as quickly as possible to get through the massive workload.
Appointments are intended to last no less than 10 minutes according to NHS best practice, while unions have pushed for the time to be extended to 15 minutes to ensure ‘quality of care’.
Meanwhile, about 65 percent of appointments were made in person during the month, up from nearly 80 percent before the pandemic.