The NHS in England is increasingly dependent on doctors and nurses recruited from outside the UK and the European Union, according to a new analysis. Last year, 34% of doctors joining the health service came from overseas, up from 18% in 2014. This reliance on international recruits is double the average seen in other developed nations, prompting concerns about sustainability.
Unions have warned that this approach is unsustainable in the long term. Patricia Marquis, director for England at the Royal College of Nursing, said ministers must reduce the 'disproportionate reliance' on international staff. The government, however, maintains that overseas recruitment has always been part of its strategy and is funding an additional 1,500 undergraduate medical school places each year for domestic students.
Despite these efforts, a report by MPs last week concluded that the large number of unfilled NHS vacancies—about 110,000 in total—poses a serious risk to patient safety. Danny Mortimer, chief executive of NHS Employers, called for a fully-funded, long-term workforce plan to tackle 'chronic workforce shortages'.
The British Medical Association noted that while the NHS recruits more from abroad, it also struggles to retain them due to 'punishing workloads' and visa costs. The percentage of non-UK and EU doctors leaving the NHS rose from 15% in 2015 to 25% in 2021. Dr Amit Kochhar, deputy chair of the BMA's international committee, highlighted that medical graduates face fees of up to £2,400 for indefinite leave to remain, with dependants charged the same.
Dr Hajra Usmani, a former A&E consultant who left the NHS after 18 years to work in Saudi Arabia, cited visa costs as a key factor. She said many colleagues are following a similar path, describing it as an 'exodus'. Meanwhile, the share of recruits from the EU fell from 11% in 2015 to 6% last year, partly attributed to stricter language tests introduced by the Nursing and Midwifery Council.
