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Warning 'Obamacare' could lead to US poaching thousands of UK nurses


The NHS risks losing thousands of nurses to the US if it fails to value and support existing nursing staff, the chief executive of Health Education England has warned.

Speaking at the body’s first annual conference, Professor Ian Cumming said the NHS would be “stuffed” if UK-trained nurses left to plug a massive shortfall in staff across the Atlantic.

“If you’re offered a three-year contract on a similar salary with the opportunity to do an MA and accommodation provided… then you might be interested”

Ian Cumming

He said workforce planning had to become international in its scope, “taking into account the global movement of people”, including a surge in the number of EU nurses wanting to work in the UK.

Professor Cumming noted the “huge number” of nurses and midwives from Spain and Portugal who have been applying to join the UK register.

On the other hand, he warned the advent of “Obamacare” could prove a drain on the NHS. The resulting expansion of health provision could see the US “coming shopping” to fill a 100,000 shortfall in nurses over the next three years.

Gatwick Airport

“If you’re offered a three-year fixed term contract on a similar salary with the opportunity to do an MA and accommodation provided – and you get to live in New York, San Francisco or Hawaii, or anywhere else you like – if you’re in your 20s and a newly qualified nurse then you might be interested,” he said.

Professor Cumming highlighted the tricky balancing act needed to ensure there was the right number of nurses. “It costs £30-40,000 to train a nurse so if we train too many that is an extraordinary waste of money so we have to get the balance right between over-supply and under-supply,” he told the conference last Thursday.

He also gave a pre-view of Health Education England’s 15-year strategy, due to be launched in coming weeks.

The vision sets out key challenges in training and educating the future healthcare workforce, including the need to keep pace with changing demographics, increased patient knowledge and expectation, and technology advances.

In recognition, Health Education England is launching a campaign to educate NHS staff on how far the field of genomics has come and the impact it will have on their work – for example, hand-held devices that can test people’s genes already available.

Professor Cumming also stressed the need to explore new roles within healthcare that blurred the boundaries between professions and making the most of skilled and talented workers (see box below).


HEE conference delegates heard from Casey Brooks, a former armed forces medic who now works as “lead associate clinician” in the cardiology department at Portsmouth Hospital Trust.

Despite having a vast array of clinical skills and experience in war zones and working on oil rigs, he found he was only able to undertake support worker roles in the NHS until the job at Portsmouth was specially created for him.

However, he said he had encountered opposition and suspicion from nursing staff, who feared he was encroaching on their territory.

“The biggest barrier [to new roles] in the NHS is nursing and nursing staff,” he claimed. “When I arrived I thought it would be the doctors who’d feel I was taking their job and role but not at all – they saw I was here to help.”

Health Education England

Ian Cumming addresses HEE conference 2014


Readers' comments (18)

  • Opportunities for all? Some EU and elsewhere staff come to UK as they can't get to US directly, and will improve their language skills here before trying again.
    As likely to happen when US healthcare organizations take over parts of NHS, some staff will find it even easier to mobilise to try something new, especially well skilled and passionate staff who feel unappreciated with the way things are here.
    As patients can choose where to get treated, so can staff with where to work.
    Will UK government smell the coffee beans before they get outflanked by other countries (again). UK is great at creating (brains, games, etc) but not so good keeping them as others develop / poach talent.
    In longer term, who will lose out? patients stuck in beds

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  • Europe also offers many excellent opportunities and is nearer for any wishing to return to the UK at any time.

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  • Tinkerbell

    so US move away from US style healthcare, we move towards it. We're already stuffed in case no one's noticed. The NHS has been broken, is on its knees and just waiting for the final push over the edge unless we do something to stop it.

    So we leave our country because it's all become so dire here. Stand up and fight for what we should have here instead.

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  • “If you’re offered a three-year fixed term contract on a similar salary with the opportunity to do an MA and accommodation provided – and you get to live in New York, San Francisco or Hawaii, or anywhere else you like –This does not exist. There are no MAs in nursing in the US only BSN/MSN and PhD programs, and very few facilities are going to offer you a sweetheart deal like this - you pay for your own education and if you are lucky you may get tuition reimbursement. I am a UK expat nurse in the USA. I have friends finishing their MSN degrees and they cannot get jobs, there are very few jobs out there in the USA for staff nurses much less advanced practice nurses.

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  • This article makes interesting reading, especially the comment from Ian Cumming regarding the costs of training nurses. In the first instance, my daughter is a student nurse and on any placement she works on the staff there comment on what a fantastic difference it makes having the students WORKING with them. The super numerary idea is a myth. These students are WORKING towards their degree and the way I see it is, that the supposed costs of training them are off set by the pay these students deserve but fail to receive. Same old same old story for the nurses and prospective nurses I am afraid.

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  • I find this very hard to believe. It is a very long road to the USA (google 'nursing retrogression' and see there is a significant delay in issuance of visas for nurses). I went to the US in 2004, then there was an 18-24 month wait, now it is more like 5-6 years. I am now back in the UK after eight happy years over there, but I found nursing to be quite different. Student nurses in the US fund their training costs, usually around $40,000.

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  • I and several other very qualified and committed clinical nurse specialists were recruited to come out to work in Hamad hospital in Doha, Qatar with promises of excellent accommodation and high salaries. Unfortunately were are now
    here 20 months, of a 3 year contract, no high salaries, still in temporary accommodation, and not accepted within the medical teams as competent practitioners. Here they place such low value on nursing regardless of the level of knowledge and experience, you are just "a nurse" and the lowest of the low. Anyone considering applying for a post out here, don't do it! the accommodation is shocking, most of us cannot return as we gave up our very good NHS posts, we are daily demoralized and deskilled, as well as having either given up our homes also or renting them out. Please I urge any of you considering a job with Hamad hospital in Qatar, do not even consider it, the agencies will tell you anything just to get you out here. And everyone here is experiencing the same or worse... Also, importantly the school fees are around £10,000 yes British pounds per year and all the good schools are full and impossible to get into The constant sand storms cause dreadful respiratory problems for children and the heat is such that it is impossible to go out in the daytime, as well as very little for children to do that don't cost huge expense. Stay in the UK, no where is great, every where there are problems but at least in the UK you have policies and unions to support and help you. Can't wait to come home!

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  • michael stone

    If all of our nurses will be poached by the US, that seems to imply that prior to 'Obamacare' their wasn't anything like adequate healthcare in the US - so much for those folk who say 'we should be using the US model of healthcare, its better than the NHS' !

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  • Ahem, there are thousands of nurses sitting tight here, quietly waiting for immigration issues to be cleared...and its nothing to do with obamacare and they will be off like a shot. They have had job offers for the past few years. At least we can rest easy knowing that nurses qualified in the last ten years cant work over there, as their training isnt sufficient to allow them to meet the requirements of the NCLEX.

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  • david lowry

    Unlikely to happen I have been working here in the US for over 15 years now in case MGT in Critical Care and this health care system is more broken than the NHS. I thought about returning but very few opportunities and insentives even with a degree in Nursing from Hull and RMN / RGN project 2000 Diploma no one responsed or showed interest. I agree with previous comments no way are they going to pay for your further education and it cost a lot. Also you will still be required to go Via CFGNS and that is a night mare and expensive and after that take the NCLEX.

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