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Simon Stevens intervenes in debate on immigration rules for nurses


NHS England chief executive Simon Stevens has called for the government to better “join up the dots” between immigration policies and their effect on the NHS and nurse recruitment.

He pointed specifically to new rules that mean overseas nurses will have to leave the country unless they earn at least £35,000 a year.

Speaking today in London at the Institute of Directors’ annual convention, which represents company directors and senior business leaders, Mr Stevens said “most hospitals” believed the policy “clearly needs a rethink”.

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The new legislation, which comes into effect from April, requires migrant workers from outside the European Economic Area to have a salary of at least £35,000 after five years of working in the UK if they want to remain in the country.

“Most hospitals tell me the idea that we would seriously consider deporting some of our most experienced nurses solely because they’re not earning £35,000 clearly needs a rethink”

Simon Stevens

“Understandably we’re having a national discussion about how to get immigration right,” said Mr Stevens.

“My responsibility is to point out that, at a time when the need for nurses is growing, when publicly funded UK nurse training places will take several years to expand, and when agency staff costs are driving hospital overspends right now, we need to better join up the dots on immigration policy and the NHS,” he stated.

Mr Stevens also referred to a recommendation by government advisors earlier this year not to add nurses to the national shortage occupation list.

“We have written to the Home Office Migration Advisory Committee calling on nurses to be added to the shortage occupation “

Danny Mortimer

Inclusion within the list would mean the profession is exempt from certain rules that restrict immigration and would make it easier to recruit from countries outside of Europe.

“Most nurses I speak to struggle to understand why our immigration rules define ballet dancers as a shortage occupation - but not nursing,” said Mr Stevens.

“And most hospitals tell me that the idea that we would seriously consider deporting some of our most experienced and committed nurses solely because they’re not earning £35,000 clearly needs a rethink,” he added.

Danny Mortimer cut out masthead

Danny Mortimer

Responding, NHS Employers chief executive Danny Mortimer said he welcomed Mr Stevens’ comments for highlighting the value of migrant nurses and doctors working in the NHS.

He reiterated that NHS Employers had written to the Home Office calling for action over a series of immigration rules affecting nurse recruitment.

“We have written to the Home Office Migration Advisory Committee calling on nurses to be added to the shortage occupation list,” he said.

“We know there are plans to train more nurses in the UK but it takes four years to deliver the training so we will not see the benefit until 2017,” said Mr Mortimer.

Janet Davies, chief executive and general secretary of the RCN, said it was “illogical” for nurses not to be considered a shortage occupation when wards and care homes across the country were understaffed.

“Since the RCN first raised these concerns, there is now a consensus across the health service that the Home Office must make a change,” she said.

She added: “It is an irrefutable fact that rising demand for health care, a shortage of home grown nurses, and new rules limiting the use of agency staff mean the NHS is reliant on overseas recruitment to provide safe patient care.

“Health care providers are telling the government that they need these rules to change if they are to provide safe care. Ignoring this issue any longer would be irresponsible, illogical and bad for patients.”  


Readers' comments (14)

  • thanks Simon. Nice to hear someone speak sense.

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  • The answer is easy - increase nurse salaries - problem solved

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  • Guarantee newly qualified nurses 1 years work to get the experience they need

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  • There is an issue here that seems to have been forgotten. Despite the obvious advantages of recruiting from overseas, we must NOT forget our own 'home-grown' nurses, who often find it difficult to get a job simply after qualifying because all the lower grades are effectively blocked by overseas nurses who are happy to stay at lower grades. If we carry on recruiting from overseas at the rate that some trusts do, we will end up with a completely non-native English nursing force and the pre-registration education of nurses in this country will cease.

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  • This is a prime example of the Home Office showing their complete and utter lack of understanding with regard to both the NHS and immigration.

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  • I would like someone to be made responsible for allowing nurse training to drop to a level where we are not training sufficient nurses to meet the needs of the NHS. It is no surprise that the aging workforce of the last 10 years are now retiring. I have seen the problem described in this magazine years ago. We are now planning to move care to the community when we know that the majority of practice nurses in primary care will retire in the next 5 years so who will carry out the care- there is certainly no training going on my locality- speaking of which who will answer when our nurses are not allowed to reregister because they have not fulfilled their training requirements for NMC

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  • A relief to see such a senior figure is speaking sense - it was so obviously a flawed decision to regard nursing as anything but a shortage occupation (driven perhaps by denial of the market forces which would in an unregulated situation drive pay upwards). I agree that the long term solution has to include homegrown nurses as a priority, but the immediate need is to bring in skilled nurses from outside the EU if necessary and to be fair to those who have already committed themselves and moved to work in this country and who would otherwise face a rapid return.

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  • For those of us who had worked in care work for decades, and had funded a part-time degree (full-fees paid at the time!), then decided to formally train in nursing, there were few opportunities for a compressed course - so, whether, dipHE, Adv.Dip, or degree, these were mainly 3-yrs courses. A grad.dip or PgDip of 2 or 2.5 yrs was a rarity, and only available in certain parts of the Isles.

    There is no reason why a graduate could not do a 2 - 2.5yr course, or a PgDip. Whatever level you start at, academically, the difference in course-level/type relates to the depth of critical analysis or the removal of basic-level study. A&P, Pharmacology, and Law&Ethics were vital to my training, as was the clinical practice, but I question the relevance of basic-level social sciences for written assignments. I am not knocking the importance, merely the lip-service paid to some of these fields, so it felt more like a tick-box.

    A bit more innovation in training and less bureaucracy, and as well-as the vocational route, reduced-length courses were this is appropriate - credit transfer for previous study/skill does not actually reduce the length of training. Also, more part time training options. Many people are put off by the full-time scenario. Most of the people on my course were mature students with a wealth of experience, but the full-time study & work was a difficulty.

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  • michael stone

    The NHS 'not joining up the dots' - don't get me started !!!

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  • To anon 5.57

    Agreed. Doesn't research show that oversea nurses like our home grown nurses also leave at an alarming rate?

    Perhaps the longterm intention of the immigration rules without any exception for overseas nurses is to use them as a stop-gap only. Chances are they will have left by then anyway, once they've had a taste of NHS (mis)management.

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