The NHS will undertake a global recruitment drive targeting thousands of foreign nurses over the next five years to fill gaps, a leaked staffing strategy has suggested.
According to the documents, seen by The Times, NHS Improvement has set a target of recruiting 5,000 foreign nurses every year until 2024 to fill a 40,000 shortfall of skilled workers.
The interim report said the NHS would need to rapidly increase international recruitment to bolster staffing while British nurses were being trained. It added that recruitment undertaken by individual hospitals would be centralised on a regional level, with national guidance offered on hiring staff from abroad.
However, the plan conceded there was little chance of ending staffing shortages in the next five years, estimating that with the planned changes the present shortfall would only be reduced to 38,800 by 2024. This would increase to 68,500 if no action was taken.
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The report also said NHS leaders recognised that doctors and nurses were being driven out of the profession by a failure to plan for the extra staff needed to meet public demand, and that more staff would be needed to implement better GP and mental health care.
Baroness Dido Harding, chair of NHS Improvement, confirmed the reports were accurate, but said the interim plan was still being written and would be published shortly.
“Staff are the NHS’s biggest asset and to deliver on the promises of the Long Term Plan, the whole NHS must do more to support the frontline as it faces record patient demand,” she said.
“Focusing on our people, their working environment, career development and ways of working isn’t a nice to have, its critical to the success of the NHS."
Speaking to People Management, Billy Palmer, senior fellow at the Nuffield Trust, said a global recruitment drive to fill NHS posts was necessary for the short term, but he cautioned that any overseas recruitment must be done in an ethical manner so as not to destabilise the number of healthcare workers in other countries.
“It is necessary to recruit workers from abroad as we can probably start to bolster our domestic supply of workers in the next 10 years, but this should be seen as only a short-term solution,” Palmer said.
He added that healthcare employers should focus on how best to retain their current staff rather than only on how to bring in new workers. “This could include making work-life balance more accessible to healthcare workers, supporting them through development and making sure their role is still applicable to their career development,” Palmer said.
The NHS employs more than 1.3 million people but had almost 108,000 vacancies at the end of June 2018. Nurses are currently on the shortage occupation list for non-EU immigration, however healthcare leaders have raised concerns the government’s post-Brexit plans for a £30,000 salary threshold for skilled workers could negatively influence recruitment in the sector.
NHS leaders said in January they would fund an extra 5,000 clinical training places and were investing in increasing the number of undergraduate nursing degrees, as well as improving retention. But applications to study nursing in England have fallen in recent years, with Ucas reporting in September 2018 that the numbers were down 13 per cent year on year.
Speaking to The Times, Dame Donna Kinnair, chief executive of the Royal College of Nursing, said it was sad to see nursing in England had “been allowed to get to this state through a lack of accountability”.
“We were a part of writing this plan and it is right to acknowledge the difficulties and focus on finding solutions,” Kinnair said.
She called for “serious investment” in the NHS and care services to ensure they can continue to deliver treatment, but warned this can only be done by "increasing the number of student nurses here in the UK and supporting the nurses we already have".
Plans were included in the NHS Improvement report for a professional register of NHS managers and a "values test" for seniors leaders to stop a “revolving door” for failed bosses and make the NHS a “better place to work”.
The plan acknowledged staff were leaving the health service because they were overworked and subjected to workplace bullying, and said NHS management culture had to change to root out harassment.
“It cannot be right that there are no agreed competencies for holding senior positions in the NHS or that we hold so little information about the skills, qualifications or career history of our leaders,” the plan said.
“A series of reports over the last decade have all highlighted a ‘revolving door’ culture where leaders are quietly moved elsewhere in the NHS, facilitated by ‘vanilla’ references. These practices must end.”
The plan also promised support on work-life balance, whistleblowing protection and equal opportunities.
The health secretary pledged last month to outlaw the use of non-disclosure agreements (NDAs) in the NHS that silenced healthcare workers who raised safety concerns or made complaints of harassment or workplace bullying.
Matt Hancock said he was “determined to end” the injustice of making NHS staff choose between speaking out or keeping their jobs, saying whistleblowers “perform a vital and courageous service for the NHS” by speaking out.