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Warning overseas recruitment is only a 'stop gap' for nurse shortages


Widespread nurse shortages across England that have led to thousands of vacancies will not be solved long-term by overseas recruitment, a report by an independent body that advises on NHS pay has warned.

Such a strategy could only provide a short term “stop gap” to help fill the estimated 12,500 full-time equivalent nurse vacancies, said the group’s latest report.

But the underlying problem causing the shortage is due to previous underestimations of the future demand for nurses, in addition to “an unclear projection of supply”, the NHS Pay Review Body report noted.

“The problem [of shortages] has developed from an earlier underestimation of demand and an unclear projection of supply”

Pay Review Body

It highlighted that, although staff turnover was gradually increasing, it was still “manageable” for the time being, further underlining that current shortages were largely related to a lack of staff being trained.

In addition, it said it “remains to be seen” how effective the recently introduced caps on the hourly rates paid to agency workers would be in bringing down spending, due to the fact trusts can override the rules to ensure safe staffing.

For its latest annual assessment of pay rates in the health service, published yesterday, the NHS Pay Review Body received evidence from a survey by the NHS Employers organisation of trusts that showed 93% had a shortage of nurses.

More than 60% said they had recruited nurses from outside the UK in the past 12 months, to help fill a gap in the number of nurses which it estimated to be around 12,500 whole-time equivalent posts.

“It is unclear how effective a strategy focused on cost caps and use of mandatory frameworks will be, when the demand for staffing cover remains high”

Pay Review Body

Almost 80% of all vacancies that had remained vacant for more than three months were for adult nurses, with the vast majority being band 5 posts. This “immediate gap” could only be filled by overseas recruitment and use of temporary or agency staff, said NHS Employers.

The PRB’s report said: “Whilst recruitment from overseas (via inclusion on the Migration Advisory Committee shortage occupation list) provides a short term stop gap, it is not a long term solution. The problem has developed from an earlier underestimation of demand and an unclear projection of supply.”

In its review of the use of hourly rate caps for agency staff to reduce spending, it reiterated that in the long-term ensuring “adequate supply” was the way to control these costs.

“We were told that work is progressing in each country to control and reduce agency spend and this is encouraging,” said the PRB.

“However, it is unclear how effective a strategy focused on cost caps and use of mandatory frameworks will be, when the demand for staffing cover remains high and training new supply takes a number of years,” said the body.

“The rise in agency spend is an example of a labour market in operation when the current level of demand is outstripping supply. This results in higher rates of pay through the agency, with workers consequently deciding where to work and on what terms,” it added.


Readers' comments (4)

  • Already the nurses brought in 2 years ago on my ward, from Europe are moving off to greener pastures.
    I have spent time and effort not in the least appreciated by management on guiding and helping on the ward the overseas nurses and for no extra pay I worked extra, only to be left behind to keep up the ward when these nurses move on.
    As an experience older nurse I am just used and kicked about as management see fit.

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  • More home grown nurses should be supported especially the newly qualified rather than overseas nurses being given more preferences as they move on after a short while. With revalidation, I hope more home grown nurses will be appreciated and afforded training and opportunities to develop otherwise overseas nurses will continue to take away opportunities from newly qualified or home grown nurses with less experience.

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  • I'm from overseas but I came straight after my A levels and trained here in London and stuck to my field! It's been a traditional way of recruiting and retaining great nurses....3 generations in my bloodline! We are committed to the field. Why change it? It worked so well!

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  • I have been a Registered Nurse in New Zealand ( & Australia)for over 30 years. Most of my experience has been in Emergency and Acute settings. Like many I have looked at working for a few years in the UK. However the difficulty getting a work permit allied with the expense involved in getting my registration recognised has put this out of contention. Sadly the UK does not recognise New Zealand as being any different to say a country in South America. We recognise the Queen but UK does not recognise NZ. Without that we cannot work there.

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