Brexit-induced migratory hurdles and poor wages have made Britain an unattractive destination for Europe’s nurses.
The number of EU and EFTA nurses in the UK has decreased by 28 per cent from 38,992 in September 2016 to 28,007 in September 2021, forcing the NHS to recruit from ‘red list’ countries to meet staff shortages, a report from Nuffield Trust suggests.
“Before the EU referendum, the UK heavily relied on EU staff. Now we can’t get the same people due to free movement restrictions,” Mark Dayan, Brexit programme leader and author of the paper told CityAM.
(Source: Nuffield Trust)
However, it was only the termination of free movement in January 2021 that proved to be a hurdle for EU workers. Educational requirements and wages have made it difficult to recruit staff from across the channel.
In 2018, English language tests for nurses and midwives changed, requiring higher overall test scores for their writing and reading abilities, favouring English-speaking staff from beyond the EU.
As Brexit and Covid-19 reduced the number of EU workers in the country, the Government introduced a Shortage Occupation List in February 2022, offering eligible workers an average £20,480 salary per year – slightly more than the average pay for a nurse with less than one year of experience.
“Unfortunately, the pressure on the NHS may come from a lack of pay and competitiveness. We’ve tried to deal with the impact of Brexit by recruiting nurses from Africa and Asia”, Dayan said.
With fewer European nurses entering the UK, the NHS has bolstered its ranks with professionals from the ‘rest of the world’ increasing by 45 per cent, from 67,055 to 97,731 during the same period.
However, this new entourage is heavily made up of workers from ‘red list’ countries, lower and middle-income nations that are dealing with a brain drain and shortages themselves.
“We are effectively recruiting from some quite poor countries which are on the World Health Organization’s red list, they are staff that we shouldn’t recruit”, Dayan said.
As migration rules for ‘red list’ countries were placed on par with overseas countries prior to Brexit, the number of nurses from such regions increased from 600 a month before Covid-19 to 1,000 per month in the summer of 2021.
Despite the growth in international assistance, NHS digital estimated that as of June there were 46,828 nursing vacancies in England alone, with the UK’s nurse-to-patient ratio standing at 8.7 nurses per 1,000 patients – similar to that of Russia and Lithuania.
“We cannot meet staff shortages by filling roles this way. Many particular medical specialities like anaesthetics and cardiothoracic surgery relied on EU staff”, Dayan adds.
Cardiothoracic surgery saw a 100 per cent rise in the five years before the referendum, this has “slowed to nothing, with no increase in rest-of-world recruitment,” the Nuffield Trust report suggests.
(Source: Nuffield Trust)
“I think in the long term, what we need is to be generating and keeping staff domestically. It’s a real struggle to attract domestic staff “, Dayan said.
Across the UK, as many as 100,000 nurses from the Royal College of Nurses union took to the streets last Thursday, calling for a 19 per cent increase in wages.
The protests come on the back of the Government accepting an independent pay review body’s proposal for a £1,400 pay increase for more than 1 million NHS staff.
However, amid record-high inflation and a general cutting of budgets, Rishi Sunak’s Government has called the demands “unaffordable”.
In response to the deadlock, further strikes will take place tomorrow, with Great Ormond Street Children’s Hospital, Guys and St Thomas, and Imperial College Healthcare all targeted by the protestors.