Report shows NHS could be short of 51,000 nurses by end of Brexit transition period

By agency reporter
November 7, 2018

A new  report from the National Institute of Economic and Social Research (NIESR) reveals the NHS could be short of 51,000 nurses – enough to staff 45 hospitals – by the end of the Brexit transition period.

The report, Brexit and the Health and Social Care Workforce in the UK, commissioned by the Cavendish Coalition representing 36 health and social care organisations, also highlights the increasingly crucial role EEA nationals are playing in UK social care services. 

It forecasts a potential shortfall of around 5,000 to 10,000 nurses in the NHS in England by 2021. That is on top of existing vacancies, which stood at 41,722 (11.8 per cent of all positions) at the end of June, the latest period for which NHS Improvement figures are available.

To put these figures into context, the small to medium-sized Royal Surrey County Hospital NHS Foundation Trust employed 1,141 nurses in June.

Meanwhile, between 2011 and 2016, the number of EEA nationals employed in social care grew by 68 per cent, or 30,600 people. There were 42,000 registered nurses working in adult social care in England in 2017, with almost a third of registered nurses (32.4 per cent) estimated to have left their role within the past 12 months. It meant a vacancy rate of 12.3 per cent, equivalent to around 5,000 vacancies at any given time according to Skills For Care.

While it is anticipated there will be provision for doctors and nurses coming to the UK after Brexit, if the government follows the guidance of this autumn’s Migration Advisory Committee report, as it has indicated it will, there could be significant implications for the social care workforce in particular. The sector relies on lower paid colleagues who would be effectively cut off by a salary threshold of £30,000 and with no special allowance like that recommended for seasonal agricultural workers.

Health and social care relies heavily on staff from the EEA and the rest of the world. In the UK, a little over five per cent of the regulated nursing profession, 16 per cent of dentists, five per cent of allied health professionals and around  nineper cent of doctors were from inside the EEA. 

Dr Heather Rolfe, Associate Research Director at NIESR, said: “Our research findings highlight the fact that migrants are an essential part of the health and social care workforce, often found in shortage specialties and localities where it is hard to recruit.  
 
“Measures designed to increase recruitment from within the UK like ‘return to work’ schemes have potential to help fill gaps left by falling migration to the UK. However, they will take some time to take effect and are very unlikely to produce sufficient numbers to make up for a shrinking EU workforce.”
 
Dr David Nguyen, economist at NIESR and one of the co-authors of the report, added: “We need to account for the fact that the share of EEA nationals differs considerably across regions as well as job roles, which can lead to bottlenecks and potentially lower quality of care in some places.
 
“For example, while half of the NHS in England staff from the UK works in clinical roles, this figure increases to two-thirds for EEA nationals. Similarly, some regions have twice as many doctors or nurses from inside the EEA than others.”

Early evidence is not promising. In the 12 months since the referendum, before the UK has formally left the bloc, the number of EEA nurse joiners to the NHS in England fell by 17.6 per cent while the number of leavers rose by 15.3 per cent.
 
Among the recommendations in the report are:

  • Any future immigration system needs to be uncomplicated to operate. It should also be transparent and cost effective for applicants, and responsive to the changing health needs of the population. At present, many social care and health jobs do not fulfil the requirements for the minimum skills or salary levels of the current non-EEA immigration system. If a future immigration system is to be modelled on the current non-EEA system, it will need to acknowledge the value and contribution of the health and social care workforce and adjust skill and salary levels accordingly to minimise any further detrimental impact to workforce supply. 
  • The UK and devolved governments’ must urgently review their workforce planning approaches across the health and social care sector. International recruitment should form part of a costed workforce strategy. Occupations in health and social care should be acknowledged as being in shortage in a future immigration system. 
  • The Home Office should guarantee that its settled status programme for EU nationals will be honoured in the event of a no-deal Brexit.
  • All levels of Government should work together to review career routes within social care.
  • Professional regulators should regularly review their processes for registering international professionals.
  • The UK and devolved Government should introduce measures to monitor and address the decline in the number of applications to medical schools.

* Read Brexit and the Health and Social Care Workforce in the UK here

* National Institute of Economic and Social Research https://www.niesr.ac.uk/

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