18 | Nursing in Practice | Summer 2022
COMMENT
The numbers on nurse
recruitment just don ’ t add up
Over-reliance on recruitment of nurses from overseas isn ’ t the right formula for success for so many reasons , says Marilyn Eveleigh
Marilyn Eveleigh , nurse adviser and independent trainer in East Sussex
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References 1 Price K . Rise in number of nurses leaving register , says NMC . Nursing in Practice , 18 May 2022 . bit . ly / 3azJ952 2 Nuffield Trust . Overseas nurse recruitment and the NHS . October 2021 . bit . ly / 3QhpI1s
The recent NMC report ¹ finding that more than 27,000 nurses , midwives and nurse associates left the register in 2021-22 is depressing , but not a surprise . The top reasons cited were pressures of work , retirement and personal circumstances . Interestingly , not pay .
I wonder how long that will remain the case . Galloping inflation and energy costs are expected to bite in the autumn , making the pending 2022 / 23 nursing pay award key to retention . The 3 % currently on offer will do little to help . The UK has its largest number of job vacancies for decades , with more than 39,000 registered nurse vacancies – a 10 % vacancy rate . Many other employers are offering higher salaries that may persuade nurses to take their transferable skills to a role outside nursing , despite the traditionally attractive benefits and pension schemes of the public sector .
The good news in the NMC workforce report is that the register is the largest it has ever been , with 758,303 nurses , midwives and nurse associates . In excess of 48,000 joined the register for the first time , a significant increase on the previous year . With soaring healthcare demand , the country needs more of us .
The bad news is that just 25,028 of those nurses were trained in the UK ; the other 23,000 were recruits from overseas . This indicates an unhealthy reliance on an international workforce that is vulnerable to global events – it is undoubtedly helpful in the short term but reinforces the imperative to grow our own . This quick workforce fix must not be a substitute for investment in UK nurse training .
International recruitment is part of the Government ’ s 2019 manifesto target to secure 50,000 more nurses by 2025 . Presently , 18.5 % of the NHS hospital and community nursing workforce are from overseas , with others employed in the independent and social care sectors . Overseas recruitment is big business
Could overseas recruitment and agency costs be used instead to boost nurses ’ pay ?
for large NHS trusts and private companies but is not always ethically undertaken or justified . The pandemic highlighted the need for countries to have their own workforce to meet their healthcare needs and UK overseas aid has been directed specifically towards health programmes ; it is ironic and ethically dubious that we are recruiting from countries that need their own trained nurses .
With a worldwide shortage of nurses , international recruitment is getting more competitive , with salaries to match . If overseas nurses migrate here for better pay , quality of life and career opportunities , UK nurses remain in post for the same reasons .
The Nuffield Trust found that in the short term , the upfront recruitment costs of £ 10,000-12,000 per overseas nurse represent better value than the use of agency nurses to fill vacancies .² Really ? If so , has someone done the maths ? To recruit and retain experienced nurses , could the NHS add the eyewatering agency nursing costs to the stopgap overseas nurse recruitment costs and use the total to improve nursing pay ? In the long term , might this be a better investment ? I ’ m afraid this calculation is beyond my pay grade .