The NHS in England relies more and more on workers from countries that are themselves experiencing a shortage of health care professionals. The UK’s health is vulnerable to sudden changes in immigration policies because of this reliance.
In order to retain enough staff in the UK, NHS policy has seen the hiring of workers from countries listed on the Red List by the World Health Organisation.
The shortage of medical personnel in these countries makes it impossible to recruit from them. Recruitment from countries on the amber-list is allowed, but only with agreement between governments.
According to a new study by Nuffield Trust, Health after Brexit in the UK, approximately one in eleven (9%) NHS doctors in England has nationality from a country on the red list, including Pakistan, Nigeria Ghana and Tanzania.
According to the report, between 2023-2024, the number of NHS employees in England who are from countries on WHO’s red list will continue to increase rapidly. The workforce increased by more than 20,000 clinical workers from these countries.
The Nuffield Study, which examined the impact of leaving the EU on the NHS, was conducted by academics from City St George’s University of London and Rand Europe. Queen’s University Belfast and the University of Michigan also contributed.
The report found that all UK countries rely heavily on a high level of migration in the health care sector following Brexit. Since the UK exited the single market in 2020, the majority of registered nurses in England have been trained by staff outside of the UK and EEA.
Mark Dayan is a Nuffield Trust policy expert. “This strategy to fill staffing gaps can also be risky for UK, because changes in immigration policies may cause sudden and unexpected changes in the flow of NHS staff”
The NHS announced a record number of international workers in February.
The report found that the red-list trained nurses made up around a fifth (or a little more) of the increase in NHS England nurses from the time the country left the single market, at the end 2020 to the date of September 2024.
Out of the 70,541 nurses who were added, 15,151 trained in these countries. Between 2021 and 24 the number of registered nurses in countries on the red list more than doubled, respectively, in Wales, Scotland and Northern Ireland.
Since 2018, the majority of red list nurses have come from Nigeria. 21% came from Ghana, and 16% were from Zimbabwe. More than 1 in 10 Zimbabwean nurses are now working in the UK.
Mark Dayan is a Nuffield Trust policy expert and Brexit programme leader. He said that the use of workers who come from countries on the red list was unethical. Mark Dayan said that “yet again the British failure to adequately train healthcare staff was bailed out” by overseas trained workers. It is great that these people are coming in to fill the gap of skills that we have, but it is also important to acknowledge that this is not sustainable. The health and care minister has recently stated that the situation is no longer sustainable. It is hard to justify recruiting at this level from countries that the World Health Organisation considers have a worryingly low number of staff. This is true even for a much richer country.
Our immigration policies do not provide the consistency required to develop a workforce in health and social care. In some areas we follow the EU regulations. In other areas, we have taken a different approach.
This strategy of filling in staffing gaps can also be risky for the UK, as changes to immigration policy could cause unexpected and sudden changes to the flow into the NHS. Outsourcing the training for the most important NHS staff can lead to a boom-and-bust situation where staffing numbers fluctuate based more on global labour markets and migration policies than on plans for the NHS.
Professor Tamara Hervey of the City Law School, Jean Monnet professor of EU law, said that a reset was necessary with the EU. She stated: “The UK approach to health post Brexit is diverse and inconsistent.” Our immigration policies do not provide the consistency required to develop a workforce in health and social care. In certain areas, we follow the EU regulations. In other areas, we have taken a different approach. “The’reset of relations’ should lead to an honest, evidence-based public debate about the pros and con of divergence.”
The research also looked at how Brexit led to a significant change in the UK’s approach to artificial intelligence and health care. The UK’s approach to AI regulation is fundamentally different from that of the EU 2024 AI Act. The UK’s approach to AI regulation is fundamentally different from that of the EU’s 2024 AI Act. Businesses will not want to bring AI medical devices into the UK because of the costs involved in following two different systems.
The study revealed that AI in the UK could end up using EU regulations by default. It also found there was no obvious way for the UK to regulate the use of large language models unofficially, such as those used for medical purposes.
Subscribe to our weekly HR news and guidance
Every Wednesday, receive the Personnel Today Direct newsletter.
