NHS strikes deal to poach foreign nurses from Nepal in bid to plug staffing gaps

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Nurses will be flown in from Nepal to fill NHS staff shortages despite a global ban on recruitment from the country due to its own workforce struggles. 

Initially Up to 100 nurses from Nepal are set to work at Hampshire Hospital NHS Foundation Trust under a pilot scheme running until the end of next year.

But ministers hope it will pave the way for thousands more Nepalese nurses to join the NHS and for the scheme to be widened across the nation. 

Britain has agreed to recognise their qualifications, giving the medics the automatic right to work in the NHS. However, their skills and knowledge will be tested.

Their flights, visas and registration fees will also be paid for.

It comes as part of an international hiring spree to fill around 50,000 nursing and midwifery vacancies in time for winter, when the NHS crisis is expected to worsen.

The Nepalese Government said all nurses aged 20 to 45 can apply to the scheme, which will see them earn a salary between £27,000 and £32,000.

The move comes despite Nepal being on a World Health Organization ‘red list’ to prevent health workers from countries with shortages from being poached.

Unions have hit out at officials who are ‘over-relying’ on foreign medics and failing to recruit and retain British staff.

The show the proportion of doctors and nurses joining the NHS in England based on where they originally trained. In both professions the number of UK trained joiners has decreased over time (red lines) whereas the number of non-EU trained professionals has increased (yellow lines). The proportion of EU professionals joining the NHS has declined over time, taking a sharp dive in the years after the 2016  Brexit vote

These charts, based on NHS workforce data, show the proportion of doctors and nurses joining the NHS in England based on where they originally trained. In both professions the number of UK trained joiners has decreased over time (red lines) whereas the number of non-EU trained professionals has increased (yellow lines)

India and Pakistan are two largest non-UK countries that doctors currently registered to work in Britain originally trained in with about 30,000 and 17,000 respectively. This is followed by Nigeria, Egypt , Ireland, South Africa, Greece, Sudan, Italy, and Romania

India and Pakistan are two largest non-UK countries that doctors currently registered to work in Britain originally trained in with about 30,000 and 17,000 respectively. This is followed by Nigeria, Egypt , Ireland, South Africa, Greece, Sudan, Italy, and Romania

This graph shows the country of training of all newly registered nurses and midwives in the UK over the past five years. Unsurprisingly, British trained nurses make the majority with about 120,000 joiners. India (about 21,000), Philippines (nearly 18,000) and Nigeria (nearly 5,000) are the biggest providers of overseas trained nurses and midwives registered to work in the UK

This graph shows the country of training of all newly registered nurses and midwives in the UK over the past five years. Unsurprisingly, British trained nurses make the majority with about 120,000 joiners. India (about 21,000), Philippines (nearly 18,000) and Nigeria (nearly 5,000) are the biggest providers of overseas trained nurses and midwives registered to work in the UK

HOW MUCH DOES THE NHS RELY ON FOREIGN MEDICS? 

One in three doctors and nurses who joined the NHS in England last year were recruited from overseas.

Data from NHS Digital show the share of healthcare staff recruited from overseas almost doubled between 2014 and 2021.

Unions warn it is a sign the NHS is leaning on foreign recruits to plug staffing issues.

Analysis shows 34 per cent of doctors who joined the health service in 2021 came from outside the UK, with India, Pakistan, and Nigeria the most popular countries.

This is almost double the proportion of overseas recruits in 2015, when the figure was just 18 per cent. The Government has played down the rise, saying foreign recruitment has always been part of its workforce strategy.

In total, 39,558 UK trained doctors and nurses joined the NHS in 2020-21, which is about 3,200 more than in 2014-15.

However, British trained health professionals are increasingly shrinking as a proportion of new joiners in NHS England’s million strong workforce.

The analysis found only 58 per cent of doctors joining the NHS last year trained in the UK, a fall from 69 per cent in 2015.

For nurses, the proportion of UK trained joiners last year was 61 per cent, a fall from 74 per cent in 2015.

Over the same time, the percentage of new joiners who qualified outside of the UK and EU has almost doubled and in some cases quadrupled.

New Health Secretary Steve Barclay revealed plans earlier this month to ‘significantly increase’ overseas recruitment of NHS staff to prepare for the looming winter crisis.

A triple-whammy of Covid, flu and the cost of living crisis is expected to heap even more pressure on the under-staffed health service.

Nepal is one of 47 countries the WHO says faces the ‘most pressing workforce challenges’ — meaning they have fewer than 50 medics per 10,000 people.

These countries — which also include Bangladesh, Ghana and Nigeria — mean they should be prioritised for healthcare system support and international recruitment should be discouraged.

However, the WHO says countries can poach healthcare workers from red-listed countries if their Governments enter an agreement, which the UK has done.

UK health chiefs say the Nepalese medics will benefit economically and in terms of their professional development.

Some will stay in the UK but ‘many’ return to their home countries, where they can share their new skills, they say.

Before working in the NHS, the medics will need to complete the Nursing and Midwifery Council registration process, including completing its competency test, which assesses the skills and knowledge of overseas nurses.

Pat Cullen, general secretary and chief executive of the Royal College of Nursing, said internationally trained nurses are an ‘extremely valued’ part of the NHS.

But she warned the UK was increasingly leaning on foreign staff rather than building a robust homegrown workforce. 

She said: ‘Ministers must stop the overreliance on overseas staff and do more to invest in the recruitment and retention of the domestic workforce.

‘This starts with pay. Nursing staff have endured a decade of real terms pay cuts and now many are considering if they can afford to stay in the profession. Thousands have left nursing in the last year alone and patient care is at risk.

‘Government must also come up with a fully-funded long term workforce plan to ensure there are enough nurses to provide care for a growing number of patients.’

Dr Kitty Mohan, chair of the British Medical Association international committee, said international recruitment rules are in place to ‘ease the crisis in human resources for health in countries like Nepal that are lacking in doctors and nurses’.

‘As the first such country on the “red list” to enter into an agreement on managed recruitment, this is an important test for the government: we will be watching very closely that all the necessary safeguards are met, for the benefit of the individual workers, for Nepal, and for our NHS,’ she said.

A Department of Health spokesperson said foreign medics play a ‘vital role’ in the NHS and benefit from the opportunity to work in it.

Latest NHS England data for July shows that more than 29,000 sickened people waited 12 hours at A&E units last month (yellow lines) — four times more than the NHS target and up by a third on June, which was the previous record. Meanwhile, the proportion of patients seen within four hours — the timeframe 95 per cent of people are supposed to be seen within — dropped to 71 per cent last month (red line), the lowest rate logged since records began in 2010

Latest NHS England data for July shows that more than 29,000 sickened people waited 12 hours at A&E units last month (yellow lines) — four times more than the NHS target and up by a third on June, which was the previous record. Meanwhile, the proportion of patients seen within four hours — the timeframe 95 per cent of people are supposed to be seen within — dropped to 71 per cent last month (red line), the lowest rate logged since records began in 2010

Separate ambulance figures show the average wait for heart attack and stroke victims surpassed 59 minutes for only the second time ever (red bars). The yellow line shows the number of category two calls, which hit 379,460

Separate ambulance figures show the average wait for heart attack and stroke victims surpassed 59 minutes for only the second time ever (red bars). The yellow line shows the number of category two calls, which hit 379,460

The number of people in England on the waiting list for routine hospital treatment hit a record 6.7million in June — meaning one in eight are now stuck in the backlog

The number of people in England on the waiting list for routine hospital treatment hit a record 6.7million in June — meaning one in eight are now stuck in the backlog

They said: ‘We have signed a Memorandum of Understanding with the Government of Nepal on the managed and ethical recruitment of up to 100 Nepali healthcare workers to the UK.

‘This will be part of a 15-month pilot involving one NHS hospital trust, after which discussions will be held on whether to widen recruitment to other employers.’

The proportion of NHS medics recruited from abroad nearly doubled between 2014 and 2021, NHS Digital data shows.

One third of doctors recruited by the health service in 2021 came from overseas, compared to just 18 per cent in 2014. 

Meanwhile, the share of UK doctors fell from 69 to 58 per cent between 2015 and 2021, while the proportion of British nurses fell from 74 to 61 per cent over the same period.

But Mr Barclay called for more foreign recruits, especially into social care. He warned ambulance handover delays ‘manifests itself with unmet need in the community’. 

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