50,000 extra nurses pledge met mostly via overseas recruitment

Only 3,500 of those in government’s target figure came from domestic retention or recruitment, while NMC notes ‘concerning trend’ in recruiting from red list countries

Only 3,500 of those in government’s target figure came from domestic retention or recruitment, while NMC notes ‘concerning trend’ in recruiting from red list countries

Six smiling nurses stand in a line, with the nearest one most in focus
Picture: Somos

Almost all of the 50,000 additional nurses in the health service promised by the government have been sourced through international recruitment, according to England’s chief nursing officer (CNO).

Speaking at an NHS England board meeting earlier this month, Dame Ruth May told colleagues that while domestic supply, retention and international recruitment was all part of meeting the 50,000 extra nurses pledge, 93% of the target was achieved through international recruitment.

‘Rebalance’ needed to reduce England’s over-reliance on international recruits

It means just 3,500 of the nurses were sourced from domestic retention or recruitment. Dr May added: ‘It does show the need to have the NHS Long Term Workforce Plan so that we can rebalance domestic and international supply.’

A head and shoulders photo of Dame Ruth May
England's chief nursing officer Dame Ruth May

Senior fellow at the Health Foundation James Buchan said while the 93% is very high, it’s not altogether surprising. He said: ‘It was clear that international recruitment was going to be a significant source of nursing target, particularly with a five-year window. It’s your best quick turnaround to increase numbers.

‘But while these top-down targets concentrate minds to drive recruitment, they generally don’t address the supply and demand issues. International recruitment is generally helpful for hospital nurses and care of older people, but not for community, mental health and learning disability nurses where vacancies remain persistently high.’

London South Bank University (LSBU) chair of workforce modelling Alison Leary warned that the figures revealed by Dr May raise ‘serious’ concerns.

She said: ‘Relying on international recruitment, in particular from World Health Organization red list countries, along with recent changes to immigration legislation, raises serious concerns regarding the sustainability of the workforce and the ethics of policy.’

Recruitment from red list countries in breach of WHO ethical code

Latest Nursing and Midwifery Council data show that half of new registrants in the past six months (15,000) trained overseas. Its latest report cites ‘concerning trends’ in the number of people joining the UK register from red list countries, where active recruitment is not permitted, including significant rises in joiners from Ghana, Zambia and Nigeria.

Data from the Migration Advisory Committee annual report 2023 also show that 20% of nurses recruited from overseas were from countries on the World Health Organization (WHO) red list. The report flagged the potential use of social media to target recruits in red list countries – a breach of the WHO ethical recruitment code.

International Council of Nurses chief executive Howard Catton called the government’s 50,000 nurses policy a ‘quick fix option’, adding it is unsustainable and ethically questionable.

‘Over 6,000 of the UK’s recently recruited international nurses come from countries identified by WHO as having the weakest and most vulnerable health systems on the planet,’ he told Nursing Standard.

‘Retention is now of even greater urgency than recruitment and that means acting on a very simple and incontrovertible truth – that improved working conditions for all nurses is essential to the health of the nation and the world.’

Drive to ‘convert applications to acceptances’

Speaking at the board meeting, Health Education England chief executive Navina Evans said that alongside stepping up recruitment drives, health leaders are working with universities to ‘convert more applications to acceptances’ for courses in health professions including medicine, nursing, midwifery and dentistry.

The Department of Health and Social Care has been contacted for a comment.

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