Expert advice

Barriers to overseas nurses and the illusion of self-sufficiency

There is no immediate likelihood of the UK achieving self-sufficiency in nursing, while the approach to international nurses has become incoherent

There is no immediate likelihood of the UK achieving self-sufficiency in nursing, while the approach to international nurses has become incoherent


Picture: Alamy

International nurses matter. About one in seven UK-based nurses was trained in another country.

Despite periodic statements by the government that overseas nurses are a short-term solution to NHS staffing problems, in reality they have been a major part of the NHS workforce for decades.

The recent reduction in the number of international nurses coming to the UK is much more serious than glib statements about the UK achieving nursing self-sufficiency would suggest.

In the current circumstances, this will not happen. Just look at the disparate and sometimes conflicting roles being played by different UK national bodies.

Plans and policies

First the Home Office, which is implementing an ever tighter immigration policy. As currently applied, this makes it extremely difficult for non-European Union nurses to come and work in the UK.

Second is the Nursing and Midwifery Council (NMC), which controversially imposed a tougher English language test that reportedly contributed to the reduction in international nurse inflow.

The NMC may have backtracked somewhat on the test, but this is still a challenging regulatory hurdle for nurses entering the UK.

Plenty of evidence

Then there is the Treasury. Always on the lookout for ways to reduce public expenditure, it has indirectly made sure there is no surge in home-based nurses. As well as capping NHS pay rates, it engineered the shift from bursaries to a loans-based approach for nursing students.

Finally, there is the Council of Deans of Health, which represents university health faculties. It supported the shift to a loan system with the aim of cashing in on expanding student numbers, but so far has failed to deliver on any nursing student growth.

The simple truth is that there is no policy, plan or immediate likelihood of the UK achieving self-sufficiency in nursing, while there is plenty of evidence that the recent approach to international nurses has been misaligned and incoherent, sometimes downright obstructive.

What we need is joined up governance. What we have is a study in chaos.


James Buchan is professor in the faculty of health and social sciences at Queen Margaret University, Edinburgh 
 

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