Almost all promised ‘50,000 more nurses’ are international recruits

Published on: 8 Dec 2023

Ninety-three per cent of the 51,245 nurses who have joined the NHS in the last four years have been recruited from overseas, NHS England’s chief nursing officer revealed yesterday.

The government’s 2019 election manifesto pledged the NHS would see “50,000 more nurses” by 2024. Ministers announced last week the ambition had been met six months early, as there were 51,245 more nurses working in the NHS in September 2023, when compared to September 2019.

The original intention  was that international recruitment would make up just a quarter of the 50,000 target, with the remainder of the total coming from domestic recruitment and retention 

However, at NHS England’s board meeting yesterday, chief nursing officer for England Ruth May said: “Of course, we did meet the 50,000 nurse target six months early [but] 93 per cent of that target was achieved by international recruitment. It does show the need to have the long-term [workforce] plan, so we can rebalance domestic and international supply.”

Nuffield Trust policy analyst Mark Dayan told HSJ: “It was never expected that international recruitment would make up almost all of the total. The figure from Ms May also suggests retention hasn’t played the part it was hoped it would do in boosting the overall nursing headcount.”

The 93 per cent figure has again prompted warnings around the sustainability and ethics of recruiting heavily from abroad.

Alison Leary, chair of healthcare and workforce modelling at London South Bank University, told HSJ: “Relying on international recruitment and in particular from WHO red list countries and recent changes to immigration legislation, raises serious concerns regarding the sustainability of the workforce and the ethics of policy.”

A further chunk of the extra nurses added to the register came through temporary registration, Professor Leary said.

Last month, the Nursing and Midwifery Council’s latest registration data also warned about the upward trends in joiners from some “red list” countries, where active recruitment is prohibited by the UK government’s code of practice. This includes significant rises in joiners from Ghana and Zambia and a steadily high number of joiners from Nigeria.

Commenting earlier this week on meeting the target, the Department of Health and Social Care said “ethical international recruitment” had been one element of the increase – but also highlighted more sustainable levers, which now appear to have played a very small role.

The statement said the commitment had been achieved through “boosting training and education routes into nursing, ethically recruiting internationally and actions to improve the retention of the existing workforce”.

“This includes a financial support package for nursing students – the NHS Learning Support Fund  – providing eligible nursing, midwifery and allied health professions students with non-repayable grants of at least £5,000 per academic year to ensure course sustainability,” it added.

Responding to this story, the department said in a statement: “There were a record number of domestically trained nurses joining the NHS in the first half of this year and that number is increasing, alongside continued international recruitment of talented and dedicated nurses from across the world.

“Building on this success, the NHS long term workforce plan, backed by over £2.4bn, will increase nurse and midwifery training places by 24,000 by 2031.”