Initial savings made by using agency nurses over recruiting internationally could be cancelled out in as little as six months, according to a new Nuffield Trust analysis.
The research has revealed that although the upfront cost of recruiting a nurse from overseas could be between £10,000-£12,000, the “cumulative costs of using agency/bank nurses start to exceed [international recruitment] within six months to two and a half years”.
The Nuffield Trust analysis, shared exclusively with HSJ, argues that trusts must consider the “broader affordability and costs to the wider health service and taxpayer” when recruiting nurses and said overseas recruitment would have to be a “major contributor” if the government’s nursing numbers target is to be met.
There is currently a 10 per cent nursing vacancy rate in the English NHS and a key ambition of the 2019 long-term plan was to reduce this to 5 per cent. In 2019 the government also set an ambition for the NHS to have 50,000 more nurses by 2024.
The analysis said that although the upfront cost of employing a domestically trained nurse was low, this would be “significantly more expensive to the public purse”.
“The government, typically spends at least £26,000, sometimes far more, on a single nurse training post and not all trainees will necessarily graduate or join the NHS,” the report said.
It described domestic recruitment as “not a feasible solution in the short-term”, because of the time taken to train new recruits, and the cost of the training process. The report also said postgraduate or apprenticeship nursing degrees were “significantly more expensive and not a plausible solution to addressing the nursing shortfall”.
The analysis also looked at the length of time nurses remain working in the NHS. When comparing data from October 2018 to October 2019, nurses from outside the UK or EU were more likely to still be working in their NHS organisation.
Overseas nurses were also found to work in the NHS for longer on average: 12 years compared to six for an EU nurse or nine for a UK national.
Nuffield Trust senior fellow and report co-author Billy Palmer stressed the “crucial” need for ethical international recruitment.
“The NHS has long relied on overseas nurses and continues to need them today. Those recruited from outside the EU are more likely to stick with the NHS and their organisation than both UK and EU nationals,” Mr Palmer said.
“If the government is to meet its ambitions to boost the number of nurses in the NHS, then international recruitment should and will continue to be something the NHS needs to do. However, given the pandemic and pressures on health systems across the globe, the NHS will be recruiting from an increasingly competitive international market,” he warned.
“Individual NHS organisations can do more to learn from each other, their own experiences of recruiting overseas trained nurses, and arguably, most importantly the experience of overseas nationals already working in the NHS. The NHS must capitalise on the draws of a career in the UK,” Mr Palmer said.
This week the chief executive of Health Education England said the NHS must having an increasingly global outlook when it comes to service and working planning and must start to learn from “resource poor” countries.