Striking the right staff balance

Northumbria NHS Foundation Trust is one of a number of trusts across England currently seeking to recruit nurses trained overseas.

Trust executive director of nursing Rosemary Stephenson says nurses who have trained overseas and moved to the UK form an important part of the workforce.

‘Our prime concern when recruiting any new nurse is making sure we employ people who share our values, show compassion, and care about putting patients first,’ she says.

‘We have many long-standing members of staff who have built their careers with us over the years, making a much-valued contribution to patient care.’

Jenny Locsin joined the trust from the Philippines in 2002 as a staff nurse, and is now a ward manager. ‘Although it is different to working as a nurse back home, the skills I learned there remain unchanged, and have stood me in good stead for my career here,’ she says.

In its position statement on international recruitment, the RCN warns that the UK has a responsibility to invest in effective long-term planning and retention of its own nursing workforce, as well as considering the effects of targeted recruitment on health systems in the countries where nurses are recruited from.

According to an RCN report published in June, the UK’s reliance on internationally recruited nurses peaked in 2001/02 with the recruitment of more than 16,000 nurses. Numbers then declined, but have been steadily rising since 2013, and with NHS trusts facing difficulties finding permanent nursing staff in the UK, they are likely to increase the search for registered nurses overseas.

In 2014/15, a total of 8,183 internationally recruited nurses joined the Nursing and Midwifery Council register; 7,518 from within the European Economic Area (EEA) and 665 from outside the EEA.

But changes to immigration rules in 2011 mean that, from next year, workers from outside Europe, including nurses, will need to earn at least £35,000 a year – the salary of a senior nurse – to settle in the UK for longer than six years.

The RCN estimates that up to 3,365 nurses working in the UK may have to leave the country from 2017 as a direct result of the changes. If levels of recruitment stay the same, 6,620 nurses will be impacted by 2020.

A Home Office spokesperson says that although there are exemptions to this threshold for occupations where the UK has a shortage, the independent Migration Advisory Committee recommended against adding nurses to the Shortage Occupation List after taking evidence from groups, including the RCN.

RCN senior immigration solicitor Julie Moktadir says the college has been contacted by directors of nursing who are worried about how the immigration rules are going to affect their organisations, and will be liaising with the NHS and others to lobby the government to add nursing to the Shortage Occupation List.

Unite professional officer Jane Beach says: ‘It is hard to see what the government hopes to gain from implementing such a policy, which would have a detrimental impact on staff numbers in the NHS.

‘A proportion of those that fall under the policy will be from black and minority ethnic backgrounds. They are much less likely to be on £35,000, so there is an obvious equality issue. The fact that they have lived in the UK for six years means that children and families will potentially be uprooted.’

A staff nurse from a trust in the north of England, who wishes to remain anonymous, has been working in the UK for 17 years.

‘I qualified in Kenya as a nurse, then a midwife, and worked as a healthcare assistant before I got my registration with the NMC. It has been tough, but the trust has been good at making an effort to integrate me with the existing workforce.

‘I know many nurses who have been here for ten years or more, and do not earn anywhere near £35,000.’

If nursing was added to the list before settlement restrictions begin in April 2016, nurses would be exempt from the £35,000 minimum pay threshold for settlement.