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UK still hiring nurses from ‘red list’ countries despite WHO ban

Nurses are being recruited from four red list countries – Nigeria, Ghana, Nepal and Pakistan – from which active recruitment is not permitted, says NMC
A maternity hospital in the Nigerian city of Port Harcourt

Nurses are being recruited from four red list countries – Nigeria, Ghana, Nepal and Pakistan – from which active recruitment is not permitted, says NMC

A maternity hospital in the Nigerian city of Port Harcourt
A maternity hospital in the Nigerian city of Port Harcourt Picture: Alamy

More overseas nurses coming to the UK are from ‘red list’ countries such as Nigeria, with the majority of international recruits going into adult nursing, the Nursing and Midwifery Council (NMC) has revealed.

Analysis published by the NMC shows that four of the top 20 countries for overseas recruits – Nigeria, Ghana, Nepal and Pakistan – were on the World Health Organization’s (WHO) red list in 2021-22, meaning active recruitment was not permitted from these countries.

Concerns have been raised over the NHS in England being over-reliant on recruits from abroad, with almost half of last year’s new registrants (23,444) having trained outside the UK – a rise of 135% from the previous year’s 9,962 international joiners.

The regulator has previously said that two thirds of international joiners last year came from India (42%) and the Philippines (25%). It has now confirmed that there has been ‘significant growth’ in the number of nurses and midwives who trained in Nigeria.

Majority are adult nurses, with few children’s, mental health nurses or midwives

Of all internationally trained nurses and midwives who joined the register in 2021-22, some 13% came from Nigeria.

The NMC’s analysis also showed that most international recruits were nurses, with less than half a percent being midwives. Meanwhile, the ‘overwhelming majority’ of these are registering as adult nurses, with few joining the register as children’s or mental health nurses, and just one overseas recruit registering as a learning disability nurse last year.

‘Quick fix’ approach won’t solve critical shortages in community and mental health nursing, says expert

Nursing Standard columnist and senior fellow at the Health Foundation charity James Buchan said the upsurge in overseas nurses was in part driven by the government’s target of recruiting 50,000 more nurses in England by 2024.

But he warned the ‘so-called quick fix’ of international recruitment ‘is not the solution to critical shortages in community nursing and mental health nursing’.

‘The types of recruitment activity being used to bring in nurses for these countries needs active and careful monitoring to ensure it complies with the WHO code and with the Department of Health and Social Care’s (DHSC) own code of practice,’ he told Nursing Standard.

International nursing recruits more likely to be men than those hired in the UK

The report also highlighted that 84% of such recruits are of Indian, Filipino or black African backgrounds, with international recruits more likely to be men, around 17%, much higher than the 9% of UK recruits who are men.

The NMC says this is important because its Ambitious for Change research has previously found black nurses and male nurses are disproportionately referred to fitness to practise hearings as a result of ‘insider/outsider’ culture, leaving many nurses feeling unsupported.

NMC chief executive Andrea Sutcliffe said: ‘Working with employers and our other partners, we want to make sure internationally trained nurses and midwives are fully supported. Together we must create the most inclusive environment possible – one that supports international recruits to thrive, not just survive.’

In August, the DHSC signed an ‘ethical recruitment’ deal with the Nepalese government for around 100 nurses to work at Hampshire Hospital Foundation Trust in a pilot scheme, and Nepal was moved to the ‘amber list’ on the government’s website.

A DHSC spokesperson said while internationally trained staff have always been part of the NHS, targeting healthcare workers in a red-list country is a breach of its code of practice.

‘The NHS can only use recruiters on our ethical recruiters list. Targeting healthcare workers in a red-list country with the aim of recruiting them to the UK is in breach of our international recruitment code of practice and can result in removal from the list.’


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