The ‘major role’ that overseas recruitment will need to play in order to meet the ‘bold’ goals of strengthening the nursing workforce has been reaffirmed in new research commissioned by NHS England.
Political commitments have been made in England to increase the NHS workforce by 50,000 nurses through improved recruitment and retention by 2025 and to reduce the vacancy rate for nurses to 5% by 2028.
However, by mid-2021, the vacancy rate for nurses remained at 10%, equivalent to 39,000 full-time positions.
In a series of reports published today, the researchers said: “Recruitment from abroad, while not the only lever, will have to play a major role if these gaps are to be filled and the ambitions of 50,000 nurses are to be met. additional by 2025. “
However, they warned that the international market for recruiting nurses was becoming more competitive and that the comparatively poor wage supply in England could make other countries more attractive to nurses.
The Nuffield Trust health think tank was commissioned by NHS England and NHS Improvement to analyze the ‘business case’ of recruiting nurses from overseas, including costs and ‘return on investment’.
Researchers acknowledged that recruiting from overseas comes with “considerable up-front costs”, which were estimated to be between £ 10,000 and £ 12,000 per nurse.
But they said these “must be seen in the context of national funding to support such activities, and the longer-term or broader costs of alternative routes to increase the number of nurses.”
Relying on local nurses alone was “not a feasible short-term solution” because of the costs and the fact that it takes three years to train a nurse, the researchers said.
“The NHS must effectively support nurses abroad, fight discrimination and provide good opportunities”
“While the initial costs of hiring a nationally trained nurse may be low for a trust, seeking to meet bold ambitions to increase numbers and reduce vacancy rates would take longer and cost significantly more. dear to the public purse, ”they said.
“The government typically spends at least £ 26,000, and sometimes a lot more, on a single nursing training position and not all trainees will necessarily graduate or join the NHS.
“This is also not a feasible short-term solution, as a pre-registration undergraduate nursing course typically lasts three years.”
Nursing apprenticeship degrees were also “potentially not a plausible solution to addressing the nursing shortage.”
The researchers noted that the cost to a nursing apprenticeship trust was around £ 140,000 “on top of the levy” that is provided to employers to cover the costs of training apprentices.
Meanwhile, they said it was also “expensive” to use temporary staff to fill vacancies.
They suggested that the initial cost of recruiting an international nurse would be waived within six months to two and a half years thanks to the savings made by not bringing in agency or bank staff to cover this position.
Researchers found that overseas nurses from countries outside the European Union (EU) worked in the NHS longer than British nationals before leaving – 12 years versus nine years.
In addition, international nurses from outside the EU were less likely to move between NHS organizations, while all nurses overseas were under contract to work longer hours than their UK counterparts.
The researchers pointed out that there were important “ethical, moral and diversity obligations” that employers should take into account when recruiting from abroad, including not raiding countries in desperate need. nurses themselves.
“This is also not a feasible short-term solution, as a pre-registration undergraduate nursing course typically lasts three years. “
Nuffield Trust Report
As part of the research, Nuffield Trust explored the ‘push and pull’ factors that influenced a nurse’s decision to move to England.
Key factors highlighted in the report included quality of life, working conditions, career opportunities and, most importantly, compensation.
The researchers noted how the UK average salary for nurses became “less competitive than some countries”.
The salary for nurses in the UK is equivalent to $ 47,100, which is considerably lower than in Australia ($ 77,900) and the United States ($ 77,700).
Meanwhile, researchers cited “perceived levels of discrimination and visa restrictions on reuniting with family” as potential deterrents for nurses who choose England as a migration location.
They warned that the market for talented nurses was becoming “increasingly competitive,” with the number of foreign-born nurses more than doubling in high-income countries in the 15 years to 2015-16.
In the UK, nearly one in five nurses (18.5%) in the NHS hospital and community services is an overseas national from more than 140 different countries.
The researchers concluded: ‘There is ambition for a sustainable and local NHS workforce, and we welcome the intention to reduce our reliance on international recruitment over time.
“Nonetheless, recruitment from abroad will have to be a major contributor if the objectives of increasing the number of nurses are to be achieved in the short and medium term.”
Nuffield Trust principal investigator Dr Billy Palmer, who worked on the reports, described ethical recruitment from overseas as a “key lever to achieve better and more secure staffing levels.”
Another author, Claudia Leone, added: “Overseas nurses come from 141 different countries and contribute to a vibrant and diverse workforce.
“However, other countries are also keen to attract migrant nurses, and the NHS must effectively support foreign nurses, fight discrimination and provide good opportunities to build rewarding careers.”
Breastfeeding time has contacted NHS England for comment.