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Brexit will hit ‘squeezed and ageing nurse workforce’


The ongoing uncertainty over Brexit is likely to hit the health service’s pipeline of European Union nursing staff, potentially exacerbating the current shortage of nurses, a report has warned.

The report, on the UK labour market for nurses, highlighted the health service’s heavily reliance on countries like Spain, Portugal and Ireland, with EU staff comprising 4.5% of the nursing workforce.

“The recruitment pipeline from the EU is likely to be hit hard”

Rachel Marangozov

But uncertainty over the status of EU workers in the UK could lead to European nurses returning home and far fewer able to work here, warned the report by the Institute for Employment Studies.

The report, published today, provides a gloomy overall picture of the scale of challenges facing the NHS nursing workforce, with one in three nurses due to retire in the next 10 years and a lack of “home-grown” nurses to fill the impending gap.

It was written for the Migration Advisory Committee, which provides the government with recommendations on professions that should be on the shortage occupation list and, therefore, subject to reduced immigration controls.

As reported by Nursing Times, the MAC recommended last year that the government grant up to 15,000 visas over the next three years to international nurses from outside the EU in order to ease the current shortage.

The new report recommended that the government must go further and ensure the UK had a domestic supply of nurses that can meet the future healthcare demands placed on the NHS.

It concluded that to achieve this would require an adequate and sustained investment in workforce planning on the part of the government.

The study highlighted the key role of international and EU nurses in easing the pressures on the nursing workforce, as together they make up around 12% of nurses in the UK.

The researchers mapped trust recruitment of international nurses, finding that reliance on the overseas workforce was greatest in London and the South East.

They also found that the composition of the overseas nursing workforce had shifted dramatically in recent years – EU nurses were now increasingly prevalent, which reflected tighter immigration rules.

The report, which was written before the EU referendum, identified three key causes of the current nursing shortage:

  • The government had not funded enough student nursing places
  • The nursing workforce was ageing and there were not enough nurses entering the system to fill the gap or offset the loss of skills and experience that will take occur when a third of nurses reach retirement age in the next 10 years
  • Since the Francis Report, safe staffing levels and increasing healthcare demands on NHS services have pushed up the demand for nurses, while at the same time trusts have faced greater financial difficulties that have made the recruitment of nurses more challenging

The report’s lead author, Dr Rachel Marangozov, said: “With one in three nurses due to retire in the next 10 years, there is now an urgent question for the government around who will replace them.

“With the uncertainty around Brexit, the recruitment pipeline from the EU is likely to be hit hard, and even the additional 15,000 visas for international nurses recommended by the MAC will not be sufficient to plug this gap in the workforce,” she said.

Danny Mortimer cut out masthead

Danny Mortimer cut out masthead

Danny Mortimer

“The government needs to act now to ensure that the UK has a domestic supply of nurses to fill these future posts,” she said. “This will require adequate and sustained investment in workforce planning.”

Danny Mortimer, chief executive of NHS Employers, welcomed the findings and message in the report.

“There are significant concerns that the shortage of nurses in the UK will not be helped by the uncertainty felt by EU staff,” he said, adding: “It is clear that the ongoing shortage of nurses is not a short-term issue.

“The report identifies very clearly the complex factors which have led to the shortage of nursing, not least the need for more effective service planning to drive our workforce plans,” he said.

“Staff from EU countries who work in the UK must be given reassurance over their future”

Janet Davies

Mr Mortimer said he hoped similar reports would be published about other sectors affected by the shortage occupation list to help form a “post-Brexit approach to skilled migrants entering the UK”.

Meanwhile, the Royal College of Nursing said the institute’s report made “sobering reading” and warned of a major nursing shortage if action was not taken.

“Thanks to years of short-term thinking, the UK is completely unprepared to deal with the challenges posed by an ageing workforce, increasing demand, and now the uncertainty caused by leaving the European Union,” said RCN chief executive and general secretary Janet Davies.

janet davies

janet davies

Janet Davies

“In the near future, this uncertainty threatens the international recruitment which the NHS will rely on for many years to come,” she added.

“Staff from EU countries who work in the UK must be given reassurance over their future,” she said. “This will make longer term workforce planning easier, but more importantly it is the only fair and moral way to treat staff who are making a vital contribution to the UK’s health service.”


Readers' comments (9)

  • Celle

    I wish all this Brexit scaremongering would stop! There is no reason whatsoever, that nurses from the EU and wider would be prevented from working here. No different to USA/Canada/Australia/Saudi Arabia etc. etc. with their recruitment campaigns here over the years. What this Government should have done is paid nurses (and doctors/allied professions) decent wages in the first place to attract them into the profession. In stead they have reduced our pensions, given us a pathetic 1% pay rise (in effect a pay cut) and underfunded the NHS to such an extent the workforce is being run into the ground trying to provide safe and effective care to patients with minimum staff. In addition, Trusts are having to make cuts in services to save money (rebranded 'reconfiguration of services'). Many nurses have been made redundant or downgraded or left the profession totally disillusioned with the NHS. This is nothing to do with Brexit but the Governments fault in running down the NHS and its staff!

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  • I agree with 'Celle'@5:32pm.
    I think this is the 3rd Brexit headline I've found in my Spam folder this week. As if poaching trained staff from Greece during one of the worst periods in their recent history was not bad enough, the NHS is now freaking out that the EU-flow may now slow. Britain is an historic world trading island. The NHS would do well to take a pro-active not negative approach to sourcing staff in the spirit of enterprise and an outward-looking optimism.

    If nurses are needed, then it is a shortage occupation and would be placed on that list. Perhaps the NHS might try to broaden the recruitment prior to Brexit, rather than collapsing from the shock when faced with new challenges.

    Why are the Nursing Times acting like the BBC and all the other bores? Why not surprise me with an outward-looking, solution-based piece?

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  • Celle

    Is that your kitten in the photograph? Gorgeous! It looks one of those long eared foxes

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  • If there is a shortage of nurses and other health staff make being a Nurse etc more rewarding and better paid. Every time I look at our trust news I see nurses and other members of staff retiring in droves. These are not old people they are in just 55 plus. They are the cream of the profession with experience and skills that the younger staff should be learning from and with experience of real care and commitment that we are no longer able to provide in the NHS. They are not leaving cos they are no longer fit [I know 2 who deep sea dive and one is a serious cyclist] they are leaving because they are fed up with the poor conditions and management attitudes and the fact that with our pay "awards" over the last 5-10 years pension and nhs charges the real difference between pensionable pay and their wage is negligible In real terms once my lump sum pays off my small mortgage I am working 37.30 hours for £125 a week !! Just shipping more and more staff who struggle with the language and systems and need more support from these experienced but leaving in droves staff is not the answer and asking the existing work force to get behind the current approach is like asking turkeys to vote for Xmas. We need a major rethink about valuing and rewarding our staff and the problem of recruitment will go away after all their is never a shortage of candidates to be MPs, Chief executives of the NHS or for that matter the very well paid heads of our professional bodies.

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  • As stated people need to wake up to the fact that the NHS is unattractive to work in!
    Pay has gone down in real terms
    Pension benefits have worsened
    Conditions are poor
    I left the NHS in my mid 30's due to poor conditions, from what I see these have only got worse since
    Recently my private healthcare company was talking about redundancies, did I consider the NHS for 1 minute, NO!!
    Instead I looked at retiring at 46, in my opinion I could potentially provide a good 21 years further service to the NHS but would only do so if I was valued and remunerated in an appropriate way!
    Although the large number of age related retirees is causing a problem many people are choosing to leave healthcare way before the age of 67!
    I wish people would realise that no one knows the effects of Brexit yet, I do hope it increases the scarcity of staff, then people may treat indigenous staff well and pay them a sufficient wage

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  • Anonymous (9:40) You have written exactly what I was thinking. 100% accurate. I know so many nurses who retired just because they want to maintain their sanity and peace of mind the NHS is very poor at caring for the their staff.

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  • I hope recruitment from overseas becomes more difficult. Ultimately it's the ability to do this which has kept wages low for nurses working here.
    Stop poaching nurses from other countries and think about why the profession struggles to atract, and as importantly retain staff ?
    low pay and poor working conditions now hardly make it a sensible choice.

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  • Agree with much of the above re treatment of NHS staff and the workforce will not be helped by removal of student nurse bursary

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  • I work in a care home. I am an RN. The atmosphere is mostly tense. There is always far too much to do and not enough time to do it all in. We are always short staffed and rarely get breaks. The work is very very stressful . I'm talking here about all the documentation safety checks new protocol to follow and countless training updates and staff meetings. I rarely see an actual resident other than when I'm giving them medication. So I get paid for 11 hours work but I clock in early to get a handover and finish late after handover to the next shift. This isn't paid. We do it to help keep the residents safe by passing on vital information. All of this works out in real terms a pay rate of just under £12 an hour. Why would anyone choose to work in the environment described for the money offered? Staff are leaving. We find it more and more difficult to replace them. Its a very sad time for care.

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