Immigration is vital to British nursing. Foreign nurses comprise almost 15% of the UK workforce, and the UK has long relied on overseas nursing expertise. The NHS in England directly employs 1.7 million people (equivalent to 1.5 million full-time staff), with employee expenses accounting for around two-thirds of NHS providers’ expenditures.
The NHS is the UK’s largest employer and one of the most significant employers globally by headcount. According to the NHS Long Term Workforce Plan, the projected demand for the NHS workforce by 2036/37 will be 2.3-2.4 million 3 in the region. If this is fulfilled, an assessed 1-in-11 of all workers in England will be part of the NHS, compared to 1-in-17 now. Nurse migration from the UK could worsen the NHS crisis.
Minorities as nurses in the UK
One quarter (25%) of NHS staff report being of Asian, black or another minority ethnicity, compared to 13% of all working-age adults in the UK. However, these proportions vary considerably according to the staff group. For example, while 39% of nursing staff report being of a minority ethnicity, only 7% of ambulance staff do.
However, staff reporting being from ethnic minorities as a whole stay less well represented at senior levels, have worse day-to-day work experiences – including being more likely to experience harassment, bullying or abuse from either colleagues or others – and face more challenges in progressing their careers.
Nurse migration from the UK
Nearly 9,000 foreign nurses leave the UK annually for better-paying opportunities abroad, exacerbating the existing understaffing crisis within the NHS. The UK is grappling with significant workforce challenges in both the nursing and social care sectors in its National Health Service (NHS), with both sectors relying heavily on migrant workers.
According to official numbers, the number of UK-registered nurses moving to other countries doubled in just one year between 2021/22 and 2022/23. Most departing nurses are heading to other English-speaking countries like the US, New Zealand, or Australia, where pay scales are substantially higher. According to OECD data, a nurse in the UK earns on average £36,500 a year (€43,070). While the median annual wage for the equivalent role in New Zealand is $57,000 (€53,100), in Australia $71,000 (€66,463) and in the $84,900 (€79,060). This could easily lead to Nurse migration from the UK.
UK government response to workforce crisis
cannot stop brain drain in source countries. The combined challenges of nursing shortages and exploitation of migrant care workers underscore the urgent need for comprehensive solutions in NHS, away from a primary focus on labour migration, which not only is costly and unsustainable but also results in low retention rates.
NHS bosses have briefed medical groups and health service care providers on the plan, which they hope will address one of the many frustrations that some doctors – especially recently qualified doctors – have about working in the service, alongside pay, constant pressure and poor working environments. The review is one of a series of measures NHS England is set to unveil intended to improve the working lives of its 1.4 million-strong workforce in an attempt to improve recruitment and staff retention. Before 2020, the NHS in England experienced increasing demand and declining performance on its main waiting time measures. Nurse migration from the UK could worsen it.
The pressure on the NHS has increased following the Covid-19 pandemic.
The number of people going to A&E was slightly above pre-pandemic levels in summer 2023. The ratio of patients spending more than 4 hours in hospital A&E rose substantially between 2015 and 2020. A recent record high of 50.4% was reached in December 2022.
The number of patients waiting over 12 hours for admission after a decision to admit has grown substantially over the past two years. NHS staff numbers have advanced, with doctors up 24% and nurses up 22% over the five years to July 2023. The NHS vacancy rate was 7.6% in December 2023, down from 9.0% in December 2022.
UK getting older
The NHS has been in trouble for as long as we can remember. New targets missed, new records of underachievement hit; these, too, are familiar alarm bells. The emergency siren is now background noise. The NHS crisis is now a chronic one. It has stretched into a slump.
Pressure on the NHS will likely become even more intense due to the anticipated continued enlargement in the UK’s population and number of older people. New Office for National Statistics predictions published on Tuesday demonstrated that the population could achieve almost 74 million by 2036, and the number of individuals of pensionable age could grow by 1 million by 2039.
NHS leaders have welcomed the £6bn budget boost
Jeremy Hunt handed the beleaguered service to help it meet rising demand, tackle the care backlog and overhaul its antiquated IT system. The chancellor gave the NHS in England an extra £2.5bn to cover its day-to-day running costs in 2024/25 after the Institute for Fiscal Studies warned on Monday that it was set to receive less funding next year than this.
The top-up means NHS England’s budget next year will be £164.9bn, compared with this year’s £163.2bn. This means Hunt—a former health secretary—should avoid the politically awkward position of cutting the budget for the country’s most popular public service. However, these measures seem insufficient to avoid Nurse migration from the UK.
The state of the NHS can impact how voters feel about a governing party.
Labour’s strategy this time isn’t to make the NHS the centrepiece of its campaign, although it will use it as a device in its more comprehensive argument that the Tories have broken public     services. If Labour can’t fix it, maybe the health service will be broken correctly for the present day and will need to retire. At the moment, there is still a belief among the public that higher taxes and spending could fix it. If that belief goes, the whole experiment could start to fall apart after 75 years of people predicting it.
Conservatives who have been always complaining internally about their government’s failure to meet the manifesto commitment to spend 2.5% of GDP on defence have been given a riposte from those around Chancellor Jeremy Hunt to the effect that defence doesn’t win elections, but the health service does. This kind of argument always winds up Conservative backbenchers, who point out that defence is one of the few areas where their party out-polls Labour.
