A report from the Nuffield Trust has tracked the impact that leaving the EU is continuing to have on the NHS and its workforce.
The NHS in England is increasingly relying on workers from countries with significant healthcare staffing shortages since EU recruitment became more difficult post-Brexit.
By November last year, around one in eleven (9%) of all NHS doctors in England were from so-called red list countries – one of the countries listed by the World Health Organization (WHO) as having such a shortage of staff that other countries should not actively recruit from them.
Red list countries include Nigeria, Pakistan and Ghana.
Between 2023 and 2024, the number of NHS staff in England from WHO red list countries continued to grow rapidly. More than 20,000 clinical staff from these countries were added to the workforce.
“The UK’s approach to health post-Brexit is diverse and contradictory,” said Tamara Hervey, Jean Monnet professor of EU law at the City Law School. “Our immigration policies don’t offer the consistency needed to build a health and social care workforce. In some areas, we are tracking the EU’s regulations. In others, we have adopted a different approach. The ‘reset’ of relations should prompt an honest and evidence-led public discussion about the pros and cons of divergence.”
A reliance on migration
A report from the Nuffield Trust think tank and a group of academics, funded by the Health Foundation tracks the impact leaving the EU is continuing to have on the NHS and its workforce. It finds that following Brexit, all UK countries have relied heavily on very high migration of health care staff from outside the EU – rather than training and retaining enough domestic workers to fill staffing gaps.
In England, two-thirds of the increase in registered nurses since exiting the single market in 2020 has come from staff trained outside the UK or EEA.
Since 2018, 46% of the increase in red list nurses was from Nigeria, 21% from Ghana and 16% from Zimbabwe – the main contributing red list countries for nurses. The number of Zimbabwean nurses in the UK is now more than one in ten of the number who are practising in Zimbabwe.
“This strategy for filling staffing gaps is also risky for the UK because changes to immigration policies can cause sudden and unpredictable changes to the flow of staff into the NHS. Outsourcing the training of the most critical NHS staff leads to a boom and bust where staffing numbers swing back and forth based on migration policies and the global labour market, rather than based on any plans for the NHS,” said Nuffield Trust policy analyst and Brexit programme lead, Mark Dayan.
