Almost 9,000 foreign nurses leave the UK to work abroad each year, with nurses leaving the already understaffed NHS for better-paying jobs elsewhere.
A rise in the number of nurses originally from outside the EU moving to take up new roles abroad has led to concerns that Britain is increasingly becoming “a staging post” in their careers.
The number of UK registered nurses moving to other countries has doubled in just one year between 2021-22 and 2022-23 to a record 12,400, a four-fold increase since before the coronavirus pandemic.
Seven in 10 (8,680) of those who left last year qualified as nurses somewhere outside the UK or EU, mostly in India or the Philippines. Many had been working in Britain for up to three years, according to research by the Health Foundation.
The vast majority of those who leave go to the US, New Zealand or Australia, where nurses are paid much more than in the UK, sometimes almost double.
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Experts voiced alarm at the findings and said the NHS, already struggling with nearly 40,000 vacant nurse posts across the UK and heavily reliant on arrivals from abroad, was increasingly losing out in the global recruitment race.
“The NHS appears to be falling down the rankings as the preferred destination for overseas nurses,” said Dame Anne Marie Rafferty, professor of nursing studies at King’s College London.
“Worryingly, the UK appears to be perceived as a middle-income rather than a high-income country in terms of pay conditions, and as a staging point where nurses from abroad can acclimate to western-style healthcare systems in search of better pay and conditions. ”
Last year, 12,400 nurses working in England applied for a certificate of current professional status (CCPS), which required them to move to work in another country, according to a Health Foundation report.
The biggest increase in this group was among overseas-trained nurses who had only worked in the UK for three years or less. The think tank said this apparent trend in short stays shows that for many people hired from abroad “the UK could be a stepping stone before moving elsewhere”.
He pointed out that OECD data shows that a nurse in the UK earns an average of $46,000 (£36,500) a year; this is “significantly less than Australia ($71,000 or £56,350), New Zealand ($57,000 or £45,000) and the USA ($84,900 or £67,000)”.
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CCPS applications to work in America increased tenfold between 2021-22 and 2022-23 after a change in visa policy meant many more foreign nurses could move there.
The Royal College of Nursing said the increasing migration of overseas-trained nurses was driven by the serious wage erosion the nursing profession has experienced since 2010.
Prof Pat Cullen, chief executive and general secretary of the RCN, said: “It is extremely worrying to see more and more overseas nurses choosing to leave the UK. Employment of indigenous nurses is decreasing and services are disrupted due to labor shortages.
“There is no need to even consider the possibility of losing more international colleagues when patients’ needs are already unmet.
“The reality is that constant attacks on wages and poor working conditions make the UK’s healthcare uncompetitive on the world stage. International nurses, like all nurses, have the right to choose to work in countries that value their skills and expertise more. “It’s no joke that nurses’ salaries in the UK are the common bottom of 35 OECD countries.”
The report’s co-author, Elaine Kelly, deputy director of research at the Health Foundation, said that with an acute nursing shortage and large numbers of overseas nurses leaving the UK, “if the NHS wants to avoid becoming a stepping stone to a career elsewhere, this will be a challenge for all nurses, regardless of where they trained.” It needs to be a more attractive place to work for nurses.”
He said brain drain was particularly worrying because it cost the NHS around £10,000 to replace each foreign staff member who then moved elsewhere.
The Department of Health and Social Care said it did not recognize the Health Foundation’s figures. A spokesman said the Nursing and Midwifery Council’s latest data shows fewer nurses trained in the UK and outside the UK are leaving the NHS.
“We highly value the care provided by our wonderful nurses, which is why we have negotiated a fair and reasonable deal with the unions which provides a 5% pay rise, two additional one-off bonuses equivalent to 6% and a range of non-sequitur pay-to-support NHS workforce payment measures [in England].
“We have also delivered on our six-month-old commitment to recruit an additional 50,000 NHS nurses, and the first long-term workforce plan, backed by over £2.4bn of government funding, will deliver the biggest training expansion in NHS history, including nurses over the next 15 years.” “Up to 130,000 fewer staff will leave the NHS.”