Exclusive: change to registration process will pave way for thousands of staff trained overseas to come to UK, says government
Ministers will introduce legislation as soon as parliament returns on Monday to tackle the NHS’s worsening staffing crisis by making it easier for overseas nurses and dentists to work in the UK.
The move is part of a drive by the health secretary, Steve Barclay, to increase overseas recruitment to help plug workforce gaps in health and social care.
Barclay believes thousands of extra health professionals will come as a result of new rules making it easier for medical regulators to register those who have qualified abroad. If the change proves successful it will help pave the way for more nurses and dentists coming to work in Britain from countries such as India, Sri Lanka, Kenya, the Philippines and Malaysia.
However, critics claim the policy is a stop-gap that is no substitute for ramping up the supply of homegrown staff and risks worsening the lack of health workers in other countries that are struggling with shortages of their own.
The initiative comes days after new figures showed that the number of unfilled posts in the NHS in England jumped by more than 25,000 in three months earlier this year to a record 132,139 – one in 10 of the entire workforce. That included 46,828 vacancies for nurses alone – 11.8% of the total.
Brexit has significantly reduced the number of nurses coming to work in Britain from the EU.
Barclay, NHS England and organisations representing health service personnel are worried that acute shortages of staff are contributing to patients’ now routine long waits for care and increasing the risk that some services will fall over this winter.
A Department of Health and Social Care (DHSC) memo seen by the Guardian shows that it will lay a statutory instrument in the House of Commons on Monday intended to enable the bodies that regulate nurses and dentists to approve the arrival of more foreign-trained staff.
The secondary legislation, which does not need a full parliamentary process to pass it, will be called the Dentists, Dental Care Professionals, Nurses, Nursing Associates and Midwives (International Registrations) Order 2022.
It makes clear that the DHSC intends to simplify what it regards as unnecessarily cumbersome procedures that restrict overseas staff coming to work in the NHS.
It says that “aspects of the current legislative requirements for registering international dentists make it difficult and time-consuming for the General Dental Council (GDC) to make changes to its registration.
“Similarly, excessive detail on the process that the Nursing and Midwifery Council (NMC) must follow to assess international applicants makes it difficult for the regulator to explore alternative registration routes to its test of competence.”
The memo adds that the order “would provide the GDC with greater flexibility to make changes to its Overseas Registration Exam (ORE) process and to explore other registration routes for international applicants, for example, recognition of programmes of education delivered outside the UK on a unilateral basis.”
It will also remove “prescriptive detail on the process that the NMC must follow in relation to qualification comparability and the assessment of international applicants, providing the NMC with greater flexibility to change these processes in future.”
The number of doctors and nurses from outside the EU working in the NHS in England has soared since Britain voted in 2016 to leave the bloc.
A DHSC source said: “These legal changes will free up the regulators to carry out thousands more checks each year on dentists and nurses from overseas, giving the NHS much-needed capacity. The NHS has always called on overseas staff when in need.
The changes would not lead to a glut of less-qualified staff arriving, the source said. “We’re making sure we recruit ethically and without weakening standards, and these extra checks will help deliver that. Patients should be reassured that we will bring in extra staff able to deliver care to the same high standards as the staff we have already.”
However, the overseas recruitment push has generated controversy about the ethics involved, such as the decision to recruit 100 nurses from Nepal over 15 months to work in hospitals in Hampshire. The Health Service Journal reported last week that NHS and nursing bosses are concerned at what they see as the over-reliance on luring staff from abroad.
The Royal College of Nursing has warned that “our health system is already over-reliant on international nursing staff and we must ensure recruitment is ethical”.
James Buchan, a senior fellow at the Health Foundation thinktank, said the acute shortage of nurses is likely to see already historically high levels of international recruitment of members of the profession go up further.
“While international recruitment [of nurses] can plug the gap short-term, it should not distract from the need to train and retain more nurses in the UK. In order to attract more homegrown people to the profession nursing must be made an attractive career choice and that means improving pay, terms and conditions.”
The British Dental Association said government action to enable a bigger supply of dental staff from overseas was welcome but the new push would not end the growing shortage of NHS dentists, which has left millions of patients facing serious difficulty accessing care.
“Action here is long overdue, but will not address the scale of the crisis facing this service,” said Eddie Crouch, the BDA’s chair.
“NHS dentistry is haemorrhaging talent by the day because of the dysfunctional system it’s built on. Ministers need to do more than try to fill a leaky bucket. They need to actually fix it.”