NHS’s reliance on foreign nurses has reached ‘unsustainable level’, experts warn

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The NHS’s over-reliance on nurses and midwives from overseas is ‘not sustainable’, officials warned today.

Figures suggest that the number of UK-trained nurses registered to work in Britain has risen by 22,000 since 2019.  

Yet, this is half the increase seen in staff trained abroad over the same time-frame, which sits closer to 44,000. It means that international recruits make up two-thirds of the growth. 

Health bodies said the figure signals that the NHS is leaning on foreign recruits too heavily to plug vital staffing issues.

And they issued fresh calls for the Government to tackle the workforce crisis.

India and the Philippines account for the lion's share of international nurse recruits for 2021-22 but a fifth came from 'red listed' countries where the NHS is banned from actively poaching nurses. These were Nigeria, Ghana, Nepal, and Pakistan. This data, from the UK's Nursing and Midwifery Council, covers the period before Britain struck a special deal with Nepal to allow the NHS to recruit nurses from the country

India and the Philippines account for the lion’s share of international nurse recruits for 2021-22 but a fifth came from ‘red listed’ countries where the NHS is banned from actively poaching nurses. These were Nigeria, Ghana, Nepal, and Pakistan. This data, from the UK’s Nursing and Midwifery Council, covers the period before Britain struck a special deal with Nepal to allow the NHS to recruit nurses from the country 

Analysis of the Nursing and Midwifery Council figures by the Nuffield Trust found international recruits account for two-thirds of all new nursing and midwifery staff in the three years since September 2019. Despite falls in the number of staff from the EU, some 43,736 recruits were non-UK staff, while just 22,226 had been trained in the UK

Analysis of the Nursing and Midwifery Council figures by the Nuffield Trust found international recruits account for two-thirds of all new nursing and midwifery staff in the three years since September 2019. Despite falls in the number of staff from the EU, some 43,736 recruits were non-UK staff, while just 22,226 had been trained in the UK

While the headcount of full-time-equivalent adult nurses, who account for most nurses in the NHS in England, has gone up the number of total nursing vacancies has remained stubbornly high, official figures show. This has left the NHS essential treading water in terms of addressing staffing shortages

While the headcount of full-time-equivalent adult nurses, who account for most nurses in the NHS in England, has gone up the number of total nursing vacancies has remained stubbornly high, official figures show. This has left the NHS essential treading water in terms of addressing staffing shortages 

Miriam Deakin, director of policy and strategy at NHS Providers, told MailOnline today: ‘Chronic staff shortages have meant that the health service has become increasingly over-reliant on nurses and health workers from across the world to deliver care to patients.

‘The contribution these staff make is invaluable but an over-reliance on international recruitment is not sustainable.’

She added: ‘We need to significantly invest in expanding the number of staff trained within the UK alongside ongoing recruitment of colleagues from abroad.

‘It’s vital that the Government publishes the fully-funded long-term workforce plan for the NHS so that we can make real progress towards tackling severe staff shortages and boosting education and training. We cannot afford to delay any longer.’ 

Meanwhile, Dr Billy Palmer, senior fellow at the Nuffield Trust, said: ‘Turning off the taps to international recruitment is just not feasible nor desirable for the NHS. 

‘Our health services rely on overseas nurses, who on average stay longer with the NHS than their counterparts trained in the UK.

‘But we know international recruitment can’t be the answer to ensuring we have the staff we need to keep services going.’

He added: ‘Even now, the NHS is competing with other health systems for overseas staff and in some cases, our working conditions, pay and career prospects are looking unfavourable to other countries.

‘Employing more homegrown NHS staff is rarely a quick process, but there are immediate steps the government should focus on including making public services a more attractive prospect for graduates and pushing to reduce the record numbers of staff choosing the leave the NHS.’

Latest data from the Nursing and Midwifery Council shows almost half of all nurses and midwives (23,408) who joined its register in 2022 trained outside the UK. 

Currently, around a fifth (19 per cent) of the UK’s nursing and midwifery workforce is accounted for by those trained overseas. 

Some 23,444 people who trained outside the UK joined the register between April 2021 and March 2022, almost double the previous year (9,884). 

Of these recruits, two thirds were from India and the Philippines alone.

Caroline Waterfield, director of development and employment at NHS Employers, told MailOnline today: ‘NHS leaders are hugely appreciative of the commitment of all of our staff, including the talented individuals who decide to leave their home country to work in the NHS.

‘As a result of the government’s commitment to grow the workforce, leaders have seen an increase in the numbers of nurses joining the NHS, mainly in hospitals with smaller numbers in social care and community settings.

She added: ‘However, we know the growing numbers of staff recruited from overseas highlights the overall gap between supply and demand. This needs urgent and sustained attention including long term funding linked to a long-term workforce plan.’

The number of internationally trained nurses joining the NHS has skyrocketed over recent years. Numbers have increased year-on-year, minus a blip of the Covid pandemic which hampered immigration, data from the Nursing and Midwifery Council shows. The number of international nurse recruits is now almost equal to the number of British nurses joining the profession for the first time

The number of internationally trained nurses joining the NHS has skyrocketed over recent years. Numbers have increased year-on-year, minus a blip of the Covid pandemic which hampered immigration, data from the Nursing and Midwifery Council shows. The number of international nurse recruits is now almost equal to the number of British nurses joining the profession for the first time

NHS data shows efforts to get more nurses into the health service are only barely keeping pace with the number of experienced nurses quitting

NHS data shows efforts to get more nurses into the health service are only barely keeping pace with the number of experienced nurses quitting

It comes amid a widespread staffing crisis across the health service, which saw the Government consider drastic proposals earlier this month to allow aspiring doctors and nurses to start working in the NHS without going to university. 

It could see school-leavers enroll in an apprenticeship scheme to ‘earn while they learn’, with officials hoping up to a third of all nurses could eventually be trained through this radical new approach to recruitment. 

These plans are expected to be laid out in full in the long-awaited long-term workforce plan, which could come within weeks.

For years, health secretaries have turned to the foreign sector as an easy quick-fix solution to shore up staff numbers.

Internationally trained nurses must register with the NMC to work in the UK and have to sit an English language exam before being allowed to practise, if their qualification was not taught in English.

They also have to sit a test of competence. 

In 2019, the Government pledged to recruit 50,000 extra nurses for England by the end of March 2024.

While it is expected to meet this target, heavy international recruitment has played a critical role in this. 

In March, the Department of Health and Social Care (DHSC) again updated its code of practice for the international recruitment of health and social care personnel in England.

The code prohibits ‘active recruitment’ from ‘red list’ countries designated by the World Health Organisation. 

But the code does not prevent individual health workers from ‘red list’ countries from seeking employment independently.

UK employers however should not be actively recruiting from those countries, the DHSC warns. 

Experts have estimated there will be a global shortage of 13million nurses by 2030, with levels particularly short in South East Asia and Africa. 

It comes as Nursing union leader Pat Cullen this week called on Health Secretary Steve Barclay to restart pay negotiations with a proposed rise in double digits. 

Hundreds of thousands of Royal College of Nursing (RCN) members will begin to vote next week on whether to hold strike action, after the existing six-month mandate ran out at the start of the month. 

This could see nursing strikes rumble on until Christmas, forcing thousands more operations and appointments to be cancelled.

The majority of nursing unions opted to accept the government’s offer of a five percent pay rise plus a one-off payment worth up to £1,600 in England earlier this month.

But nurses in the RCN rejected the deal by a slender majority, leading the general secretary to admit she had ‘underestimated’ members after she advised them to vote in favour of it. 

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