The INTERNational Health Service! A fifth of NHS staff are foreign nationals; India, the Philippines and Nigeria make up the majority of the 214 countries now represented

It is estimated that a fifth of NHS staff in England are foreign nationals, while top doctors are allowed to work abroad.

Three in ten nurses and over a third of doctors are non-UK residents – the first time this milestone has been reached.

Health chiefs have warned that recruitment abroad cannot fill healthcare vacancies forever, adding that the figures reflect how reliant the NHS is on international staff to avoid ‘collapsed under pressure’.

It comes as a recent Mail on Sunday survey found that NHS staff at all levels are working remotely in countries including Australia and Japan.

Critics have warned that allowing staff to work abroad puts patients’ lives at risk.

Over the past two years, at least 335 employees from 33 trusts have been given the opportunity to work from another country, including consultants who can earn a basic salary of up to £126,000.

According to the latest available data from NHS Digital, a third of the 335,763 full-time equivalent (FTE) nurses and health visitors working in England in September and whose nationality was known were foreigners.

This figure is higher than the two in ten non-UK staff of three years earlier.

It also marks the highest percentage of foreigners working in healthcare since current data began in 2009.

The most common foreign nationality is Indian, accounting for 10.1 percent of all FTE nurses and health visitors, followed by Filipino, Nigerian and Irish.

There has been a similarly sharp increase in the proportion of doctors in hospitals and community health services who are non-UK nationals, now exceeding a third of the total.

Indian nationality was the most common non-British nationality among this group, accounting for 8 percent of all doctors, followed by Pakistani, Egyptian and Nigerian.

Danny Mortimer, chief executive of the NHS Employers organisation, said the analysis ‘shows how reliant the NHS has become on its talented international workforce’.

He also said that without such staff, the health service “could very easily have collapsed under the pressures it has been under”, including rising demand, the pandemic and strike action.

Mr Mortimer added: ‘Teams across the NHS are extremely grateful to their overseas colleagues for their support and contribution. But there is no room for complacency because we will not be able to continue to rely on international recruitment to fill NHS vacancies forever.

‘Retention is at least as important as attracting new staff to the NHS and will be crucial in the short term to prevent pressures from worsening and to ensure that the recruitment base from which we want to build is a solid one has a basis.

‘Expanding the number of staff we train here is also important, so it is vital that the continued expansion of training and education set out in NHS England’s long-term workforce plan is maintained.’

Not all NHS staff positions have seen an increase in the percentage of the workforce with foreign nationality.

The figure for consultants is largely unchanged, while that for midwives stands at 9 percent – ​​an increase on last year but a return to 2009 levels.

There are now some 214 different foreign nationalities represented in the NHS, with countries ranging from India, Portugal and Ghana – all in the top 10 – to smaller countries such as Tonga, Liechtenstein and the Solomon Islands.

Lucina Rolewicz, a researcher at independent think tank The Nuffield Trust, said the NHS has become “increasingly reliant on recruitment abroad to fill staff shortages”, with foreign nurses proving to be “crucial” for the government to fulfill its 2019 pledge to increase the number of nurses. nurses in England by 50,000.

She added: “This is far from a sustainable long-term solution. The NHS still competes with other healthcare systems for staff abroad and in some cases our working conditions, wages and career prospects may look less favorable compared to those in other countries.

‘Not only this, but of foreign workers joining the UK nursing and midwifery sector, almost two in five left within five years of joining the professional register in the last year of data.

‘The long-term workforce plan proposes a greater focus on expanding domestic training and increasing the number of home-trained graduates working in the NHS – but these plans will only come to fruition if we reduce the number of people leaving training and attract more graduates. choose NHS jobs and then stay longer.’

The workforce plan, published in 2023, set out steps to recruit thousands more NHS staff in England, which could create an additional 60,000 doctors and 170,000 nurses by 2036/2037.

Alex Baylis, deputy policy director at health charity The King’s Fund, said: ‘There are currently more than 120,000 posts vacant in the NHS in England, including 42,000 nursing posts and almost 9,000 medical posts.

‘This is largely because workforce planning has not kept pace with increasing demand over the past five years or more. This level of vacancies is rightly of great concern to the public; in last year’s UK Social Attitudes survey on satisfaction with the NHS, expanding the workforce was seen as the top priority.

‘As professional training takes several years, the NHS will be heavily reliant on recruitment from abroad and on retaining current staff over the next five years, if vacancies are to be filled.

‘Staff from abroad are absolutely essential to the NHS and should be recognized and valued as such.

‘The NHS must ensure that they are well supported as they get used to our system, that they have access to ongoing training and career development and, above all, that they are treated fairly and not discriminated against.’

A spokesperson for the Department of Health and Social Care said: ‘International recruitment plays a valuable role in helping the NHS deliver world-class care, but it is important that we boost the domestic workforce and reduce our reliance on temporary and overseas workers. reduce employees.

‘The first ever NHS Long Term Workforce Plan was commissioned by the Government to train, retain and reform the workforce, and put the NHS on a sustainable footing for the future.

‘Backed by £2.4 billion, the plan will double the number of medical training places, almost double the number of adult nurse training places and increase the number of GP training places by 50 per cent by 2031.

“With these domestic training expansions, we expect that in fifteen years, approximately 10 percent of our workforce will be recruited internationally, compared to almost a quarter today.”