Dip in number of international nurses should ‘sound alarm bells’

A fall in the number of foreign nurses coming to work in the NHS should ring “alarm bells” for patients and health leaders, experts have said.

New figures from the Nursing and Midwifery Council (NMC) show a sharp fall of internationally educated nurses and midwives joining its register, which allows them to work in the UK.

Commentators pointed out that the health and care system has relied on international recruitment “for generations” and warned that plans to tighten visa rules and cut immigration could “deepen” workforce shortages.

Meanwhile, the nursing regulator said black, Asian or minority ethnic nurses and midwives are being “held back” by experiences of racism.

NMC figures show that from April 1 to September 30, some 6,321 international workers joined the register for the first time – a 49.6% drop compared with the same period last year when 12,534 joined the register.

This means that only 31.1% of new joiners were from outside of the UK during this period – a figure which is usually around 50%, the NMC said.

Factors could include better earning potential in different countries, visa changes and a plan to increase domestic recruitment, the NMC said.

Paul Rees, NMC chief executive and registrar, said: “The high-growth era of international recruitment appears to be ending. At the same time, domestic recruitment is steady.”

Lynn Woolsey, chief nursing officer at the Royal College of Nursing, said: “International recruitment is collapsing, even before further hostile immigration policies come in, while the number of domestic joiners continues to stall.

“At a time of already widespread nursing staff shortages, with tens of thousands of nursing jobs remaining unfilled, the dashboard is flashing red for the future of services and patient care.

“At the current rate, the numbers of domestic nurses joining will nowhere near make up for the collapse in overseas nursing staff coming to the UK.

“We now need to see a serious, detailed and fully funded plan to grow the domestic workforce and an end to the pursuit of hostile immigration policies.”

‘Dramatic fall’

Suzie Bailey, director of leadership and organisational development at The King’s Fund, added: “The dramatic fall in international nurse and midwife recruitment and retention should be sounding alarm bells for politicians, health and care leaders, and people who rely on health and care services.

“Our health and care system has relied on international recruitment for generations.

“Recent proposals to cut immigration, tighten visa rules, and even deport those living here legally risk deepening workforce shortages and putting patient safety at risk.

“These changes don’t just create workforce gaps, they can create fear and run the risk of talented and dedicated staff being made to feel unwelcome.

“That could lead to longer waits for patients as staff become increasingly overstretched and feel undervalued.”

Overall, the NMC said there was a record number of 860,801 nurses, midwives and nursing associates on its register.

But it pointed out a slowdown in the rate of growth between April and September compared with the same time frame last year.

‘Ethnically diverse’

Mr Rees added: “Overall growth of the UK’s nursing and midwifery workforce has slowed sharply.

“Nonetheless, there are now more nurses, midwives and nursing associates on the register than ever.

“The register has also continued to become more ethnically diverse – a third of nursing and midwifery professionals are now black, Asian or minority ethnic.

“However, these professionals are often held back by their experiences of racism and other forms of discrimination that sadly appear to be growing again in our society.

“Some of our registrants see the situation as being worse now than at any time in the last 30 years, suggesting we have reached a crisis point.

“The whole health sector must do more to confront racism wherever it occurs, so that every nurse, midwife and nursing associate can feel safe, valued and able to deliver the high-quality care that we will all rely on at some point in our lives.”

Gill Walton, chief executive of the Royal College of Midwives, said: “Any slowdown in growth of the midwifery workforce is deeply concerning.

“Services are already under significant pressure and a reliable flow of new midwives is essential to ensure safe, high-quality care for women and babies.

“The rise in midwives leaving the profession is a warning sign we cannot ignore. Improving working conditions and addressing burnout must be central to any workforce plan.

“The collapse in international recruitment adds further strain to an already fragile system.”