UK short of almost every type of health and care professional, review concludes

Previously only consultants in clinical radiology, emergency medicine and old age psychiatry, certain emergency medicine trainees and core trainees in psychiatry were on the list, but the Migration Advisory Committee has recommended all medical practitioners be added. 

The MAC also recommended that nurses should remain on the shortage occupation list, after first being added in 2015, as a “significant number of stakeholders reported difficulties in the recruitment of nurses”.

Other recommendations made by the MAC include:

• Paramedics will also remain on the list, following significant evidence suggesting there are still shortages.
• All medical radiographers should be added. This was previously limited to certain specialists.
• Psychologists, occupational therapists, and speech and language therapists have all been added to the list for the first time
• All social workers have been added to the list.
• ‘Health professionals’, which includes prosthetists, orthotists and healthcare scientists are to be removed from the list because there is “limited evidence” of nationwide shortages and decreasing use of tier 2 visas.

A Home Office spokesman said: “We are grateful to the Migration Advisory Committee for a very comprehensive report. We will consider it carefully and respond in due course.”

The MAC said factors driving the shortage of medical practitioners were “too few people studying medicine” and “high vacancy numbers, poor workforce planning and high leaving rates”.

“Combined with this, increasing demand from a growing and ageing population is creating a widening labour shortage,” the MAC report said.

However, MAC chair Alan Manning said the difference this would make for NHS trusts was “not very much in practice”, mainly that doctors will become eligible for “slightly lower visa fees”.

“There was this period in 2017-18 when a lot of doctors were being turned down and that is not happening now,” Professor Manning said. “But only some sorts of doctors are on the shortage occupation list.”

He said while he does not detect any government plans to “turn [doctors] down”, the removal of doctors from the tier 2 visa cap was “temporary” but “unclear how temporary”.

The report said that psychiatry roles were reported numerous times in the call for evidence and in particular in child and adolescent mental health services around half of vacancies are unfilled.

It recognised that migration was not a “sole or long-term solution” for medical workforce shortages but that it could “alleviate some difficulties”.

While nurses will be included employers will need to carry out a Resident Labour Market Test.

Professor Manning said when they were first drawing up the short occupation list the MAC “thought it was important that trusts were making some effort to recruit nurses locally”.

“One of the reasons for that which remains is that there is a tendency for migrant nurses to be recruited at the bottom of the pay scale and so to be paid less than nurses of a similar age who are UK born,” Professor Manning said. “Because we are slightly concerned how this is used to recruit some nurses… we think [employers should] continue to use the RLMT.”

The MAC’s report also said there “might be a case” for replacing the shortage occupation list with a different approach for assessing “whether and how immigration policy should vary by occupation”.

“In case the shortage occupation list does continue in some form our report outlines the medium-skill jobs where we think shortages may be emerging, but specific recommendations should wait until nearer the time when the new immigration system is clearer,” the report said.

Professor Manning added the labour market is “very different” from when they did the last few six years ago as “freedom of movement is no longer working in exactly the same way”.

“There is also considerable uncertainty surrounding Brexit and high level of employer concern”, he said.

The government commissioned the MAC to review the shortage occupation list last June and in December the Home Office published its immigration white paper, in which it accepted the recommendation made by the MAC earlier this year to remove the cap on numbers in the existing tier 2 visa route.