• Numbers could be boosted if trusts raise recruitment to mean levels
  • ‘Deep dive’ on international recruitment has highlighted differing views
  • “Hard-pressed” providers reluctant to invest in international recruitment

Even “optimal delivery” of international recruitment efforts would leave the NHS short of nearly 19,000 nurses by 2023-24, according to analysis carried out by the Department of Health and Social Care, HSJ has learned.

However, the gap could be even larger, as achieving this performance requires the NHS to deal with the financial barriers to effective international recruitment. It must also improve the quality of international recruitment drives.

There are currently 46,000 nursing vacancies in the English NHS. Increased international recruitment efforts are being combined with an increase in nursing clinical placements, a review of return to practice processes and attempts at improving retention in an effort to drastically cut that number.

The DHSC analysis, seen by HSJ, shows that, if all trusts achieved the mean level of international recruitment, the NHS could hire 5,431 “additional nurses”. This would take the annual total arriving from overseas to 8,953 and leave a “remaining gap of 18,716 by 2023-24”.

Health Education England’s director of global engagement Ged Byrne acknowledged the “earn, learn and return” programme – where overseas staff spend three or four years in the UK before returning with enhanced skills – created a “a pump-priming financial burden” for trusts.

Professor Byrne told HSJ: “We have to find new ways of overcoming the reluctance of some hard-pressed providers to invest upfront.”

HSJ understands a cross-Whitehall discussion has recently taken place on how and who should pay for international recruitment drives and whether central financial incentives should play a role for areas of the country which were particularly struggling.

Professor Byrne would not comment on the details of the discussions but confirmed HEE had been meeting regularly with colleagues in NHS England and Improvement and the DHSC to raise these issues and look at possible solutions.

Professor Byrne said this group has been meeting informally to inform the workforce implementation plan, which is being led by Baroness Dido Harding, as well as speaking to regulators and the Home Office.

The new international recruitment strategy is in part a response to significantly increased competition from countries such as Australia and Canada, which offer benefits such as more relaxed language requirements and better comparative pay.

HSJ reported earlier this year that the DHSC had undertaken a ‘deep dive’ on where best to focus its international recruitment efforts.

HSJ understands its most significant finding was the uncertain picture arising from the views of stakeholders, who expressed different opinions on the same countries. For example, some saw the Philippines as a stable market for nurse recruitment whereas others warned the opportunity could be short-lived due to the country’s planned introduction of universal healthcare.

However, the Philippines, along with the Caribbean, India, Pakistan and the UAE, are among the countries selected for recruitment drives.

Exclusive: Hiring 5,000 extra overseas nurses a year still likely to leave NHS short-staffed