The recruitment of nurses from poor countries by rich countries like the UK is getting ‘out of control’, a global nursing body has warned.
The International Council of Nurses (ICN) said six or seven high-income countries are driving “intensive recruitment” from places that “cannot afford to lose their nurses.”
Ghana is one of the hardest hit countries. Hospitals warned their staff numbers have been cut as staff scramble to fill NHS posts they found on social media.
Data from NHS England, which has 112,000 vacancies, suggests around two-thirds of the increase in staff hired since 2019 has been trained abroad.
Officials have warned that the healthcare system is becoming increasingly reliant on foreign medics and that the practice is ‘unsustainable’.
India and the Philippines account for the lion’s share of international nurse recruitment for 2021-22, but a fifth came from ‘red list’ countries where the NHS is prohibited from actively poaching nurses. These were Nigeria, Ghana, Nepal and Pakistan. This data, from the UK Nursing and Midwifery Council, covers the period before Britain entered into a special agreement with Nepal to allow the NHS to recruit nurses from the country
While the workforce of full-time equivalent adult nurses, who account for most nurses in the NHS in England, has risen, the number of total nurse vacancies has remained stubbornly high, official figures show. This has made the NHS essential when it comes to tackling staff shortages
Howard Catton, CEO of the ICN told the BBC: ‘I have the feeling that the situation is no longer under control at the moment.
“We have intensive recruitment mainly driven by six or seven high-income countries, but with recruitment from countries that are among the weakest and most vulnerable and cannot afford to lose their nurses.”
The latest data from the NHS England shows the service is recruiting more nurses from abroad than ever before, with 44,000 joining the healthcare service since 2019, compared to 22,000 UK-trained nurses.
Most of the recruits came from India, the Philippines, Nigeria, Zimbabwe and Ghana.
Nurses in Ghana, who spoke to the BBC, say making extra money is the main draw, with salaries seven times higher in Britain than in Ghana. Medics also mentioned poor working conditions.
Gifty Aryee, head of nursing at Greater Accra Regional Hospital, told the BBC her intensive care unit has lost 20 nurses to the UK and US in the past six months.
She said: ‘Care is being compromised because we can no longer take in patients. There are delays and it costs more in mortality – patients are dying.”
Patients are facing delays in emergency departments due to the shortage of nurses, she said.
A hospital nurse told the broadcaster that half of the nurses she had studied with had since moved abroad, which she planned to do.
Caroline Agbodza, deputy director of nursing at Cape Coast Municipal Hospital, told the BBC that 22 of her fellow nurses had moved to the UK in the past 12 months.
This includes all of the hospital’s critical care and experienced nurses, meaning only newly hired staff are left, she said.
“Even if the government recruits, we have to go through the pain of training nurses again,” Ms Agbodza said.
Two experienced nurses from Ewim Health Clinic in Cape Coast have also left for the UK, impacting patient care.
Dr. Justice Arthur, the clinic’s chief physician, said: ‘Let’s take services like the immunization of children. If we lose nurses, the babies who need to be immunized won’t get their immunizations and babies will die.”
Adults are also at risk because there are too few nurses to monitor patients after surgery, he warned.
Perpetual Ofori-Ampofo, head of the Ghana Registered Nurses and Midwives Association, called on the Ghanaian government to take action to keep nurses employed in the country.
It is “not ethical for the UK to recruit from Ghana” due to the low number of experienced nurses, she added.
An analysis of Nursing and Midwifery Council figures by the Nuffield Trust found that two-thirds of all new nursing and midwifery staff in the three years since September 2019 have been international recruits. non-British personnel, while only 22,226 were UK-trained
The number of internationally trained nurses joining the NHS has skyrocketed in recent years. The number has risen year on year, minus an outbreak of the Covid pandemic that has hampered immigration, data from the Nursing and Midwifery Council shows. The number of international nurse recruits is now almost equal to the number of UK nurses entering the profession for the first time
NHS data shows efforts to get more nurses into healthcare are barely keeping pace with numbers of experienced nurses quitting
The World Health Organization (WHO) has labeled Ghana a ‘red list’ nation, which means nurse shortages are severe, so rich countries shouldn’t be stripping their staff.
But the code does not prevent individual health workers from ‘red list’ countries from seeking self-employment.
UK rules prevent ‘active recruitment’ from Ghana, but medics can apply for vacancies, which trusts can share on social media.
Last month, the UK gave £15 million to support healthcare workers in Ghana, Kenya and Nigeria.
The UK is now seeking a formal deal with Ghana to recruit its nurses in exchange for a fee of £1,000 per medic hired. It already has a similar deal with Nepal.
But Mr Catton said these deals “try to create a veneer of ethical respectability” and do not reflect the true cost to the countries losing nurses.
WHO’s director of human resources, Jim Campbell, told the BBC that Brexit is one of the reasons the UK has turned to African countries to fill the gaps in its workforce.
He said the UK has ‘shut off’ the labor market from the EU and is therefore attracting people from the Commenwealth and other countries.
Pat Cullen, managing director of the Royal College of Nursing, previously warned that while internationally trained nurses are a ‘vital and valued part of the NHS’, there is an over-reliance on staff from abroad which is ‘unsustainable’.
Experts estimate that by 2030 there will be a global nurse shortage of 13 million, particularly in Southeast Asia and Africa.
Currently around a fifth (19 per cent) of the UK nursing and midwifery workforce is made up of those who have been trained abroad.
Health authorities said the figure indicates the NHS is relying too heavily on foreign recruits to solve vital staffing problems.
Separate figures from the Nursing and Midwifery Council (NMC) last month revealed that there are 788,638 nurses, midwives and nurses registered to work in the UK – the highest number ever recorded. More than half of the 30,000 new registrants trained abroad.
It comes as Rishi Sunak is expected to pledge £1 billion to train an additional 24,000 nurses and midwives by 2030, as well as 2,000 general practitioners in training and thousands more dentists.
An NHS staffing plan, which has been repeatedly delayed, is being finalized by Mr Sunak and could be announced on 5 July – the 75th anniversary of the NHS.
Chancellor Jeremy Hunt negotiated the plan directly with NHS England chief executive Amanda Pritchard.
Health Secretary Steve Barclay has demanded the NHS improve productivity and efficiency in return for the budget increase.