Four of UK's top countries for nurse recruitment on WHO 'red list' – Nursing Times

‘This is a situation that cannot go on indefinitely’
04 October, 2022 By
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Three of the top seven countries from which the UK recruits overseas nurses are on the World Health Organization’s (WHO) ‘red list’ where active recruitment should not be used.
Nigeria, Ghana and Nepal are the third, fifth and seventh highest respectively in the list of countries that provided the largest number of overseas staff joining the Nursing and Midwifery Council (NMC) register between April 2021 and March 2022.
All three were on the red list during this period, which is derived by the WHO and identifies countries facing the most pressing health workforce shortages, meaning they should not be targeted for systematic recruitment by international employers.
Nepal has since moved off the red list following of a government-to-government agreement between the Department of Health and Social Care (DHSC) and the Government of Nepal in the summer.
But the agreement has raised concerns among health leaders, including those reported in The Observer which suggested Nepali recruitment agencies carried out abusive practices, such as charging illegal fees.
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Pakistan, another red list country, also features in the UK’s top 20 countries it recruits from.
The data comes in a new report by the NMC which has analysed the large growth in international recruits to its register.
In total, all red list countries accounted for a total of 4,151 (or 19%) nurses and midwives recruited from abroad in the last financial year, out of a total of 22,411 recruits from overseas.
As previously highlighted by the NMC, two thirds of international joiners between April 2021 and March 2022 came from India and the Philippines.
The regulator also said there had been “significant growth” in the number of joiners who trained in red listed Nigeria – accounting for 13% of last year’s total.
The findings come as NHS England last month confirmed health service trusts in England would be given additional funding to recruit nurses from overseas amid record staff shortages and increased demands.
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Data from the NMC report also shows that 84% of international joiners are Asian or Black, and almost one in five overseas nurses and midwives are men. This compares with 9% of new registrants from the UK who are men.
The NMC said this was important because its own research has found that professionals who are men and those who are Black are referred into the NMC fitness to practise process disproportionately by employers.
Other figures included in the report showed that just 76 midwives, less than half a percent of the total, joined the register from abroad.
In terms of specialty, while 22,637 people registered as adult nurses, just one person registered as a learning disability nurse. A total of 508 joined the register as mental health nurses and 176 as children’s nurses.
The NMC said this reflected most international training practices, which use a registered general nurse qualification.
Royal College of Nursing general secretary and chief executive Pat Cullen said the “overreliance” on international recruitment showed that the government had “no grip on the nursing workforce crisis”.
“It’s deeply concerning that four ‘red list’ countries appear amongst the top 20 most recruited from countries”
Pat Cullen
“It’s deeply concerning that four ‘red list’ countries appear amongst the top 20 most recruited from countries,” she said.
“This approach is unsustainable. Ministers must invest in growing the domestic nursing workforce.
“They need to give nursing staff the pay rise they deserve to retain experienced nurses and attract new people to the profession.”
Meanwhile, Unison deputy head of health Helga Pile said the NHS could not function properly without overseas health workers.
“But that doesn’t mean it’s fair game to plunder healthcare professionals from other countries ​that have their own pressing needs,” she said.
“There must be ​robust monitoring in place to ensure the government’s code for international recruitment isn’t breached.”
She added that nurses and colleagues recruited from overseas “have to be treated fairly”.
In recent months, there have been several concerns raised around the poor treatment of internationally educated nurses and the lack of support they receive when moving to the UK.
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“​Health staff that choose to work in the UK should expect to be treated ​well when they make their lives here,” said Ms Pile.
“​That must mean an end to the hostile environment and workplace discrimination.”
Also commenting on the findings, NMC chief executive and registrar, Andrea Sutcliffe, stressed it was important that internationally trained nursing and midwifery staff were fully valued and supported.
She reiterated how the analysis showed international professionals were “more likely to be men and they are much more likely to be ethnically diverse” when compared to their counterparts. Again, she said the “matters” because of the “disproportionately high referrals of Black people and men” to its regulatory processes.
“Our data also shows that four ‘red list’ countries were among the top 20 countries of training last year,” added Ms Sutcliffe.
“The Department of Health and Social Care has a code of practice to make sure employers recruit ethically in the NHS and in the private sector.
“We’re calling on employers to be mindful of this, although we appreciate that people from across the world want to come and work in the UK.”
The DHSC code does not stop individual professionals from seeking employment independently.
The code was updated earlier this year to urge employers to consider waiving controversial repayment clauses for internationally recruited nurses in certain situations.
The DHSC was contacted for comment.
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