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‘NHS overreliant on doctors from red list countries, since Brexit’, new research finds
The NHS in England is increasingly relying on workers from countries with significant healthcare staffing shortages since EU recruitment became more difficult post-Brexit, instead of training and retaining enough domestic staff. Medicines companies are also warning of drug shortages more often. By November 2024, around one in eleven (9%) of all NHS doctors in England held nationality from one of the countries listed by the WHO as having such a shortage of staff that other countries should not actively recruit from them (“red list” countries such as Nigeria).1 A new report from the Nuffield Trust think tank and a group of academics,2
funded by the Health
Foundation, has tracked the impact leaving the EU is continuing to have on the NHS and its workforce. It found that following Brexit, all UK countries have relied heavily on very high migration of healthcare 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, as 2020 ended, have come from staff trained outside the UK or EEA. The report also found that elevated and
troubling levels of medicine shortages are continuing, with no consistent sign of improvement in key indicators. Medicine supply notifications issued to the Department of Health and Social Care by medicines companies, to alert the government to shortages, were higher across 2024 than during 2022, or 2023. The UK has had the lowest import growth in medicines of any G7 country, driven by a reduction in EU imports.
Keys findings on NHS staffing post-Brexit l Between 2023 and 2024, the number of NHS staff in England from WHO red list countries continued to grow rapidly. Over 20,000 clinical staff from these countries were added to the workforce.
l Red list-trained nurses account for around a fifth of the total increase in NHS England nurses since leaving the single market at the end of 2020, up to September 2024. The number trained in these countries rose by 15,151, out of the total increase in nurses of 70,541.
l The number of registered nurses trained in red list countries also more than doubled in Wales, Scotland, and Northern Ireland respectively, between 2021 and 2024.
l Since 2018, the UK workforce has seen a 46% increase in nurses from Nigeria, 21% more from Ghana and 16% more 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.
Nuffield Trust Policy Analyst and Brexit Programme Lead, Mark Dayan said: “Yet again, British failure to train enough healthcare staff has been bailed out by those trained overseas. We should be grateful that they are coming to offer the skills we lack, but the Health and Care Secretary is right to have recently acknowledged that it is unsustainable to continue this way. Recruiting on this scale, from countries that the World Health Organization believes have troublingly few staff, is difficult to justify ethically, for a much wealthier country. “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.”
References 1. A list of countries on the WHO’s “red list” is available at:
https://www.nhsemployers.org/ articles/code-practice-red-and-amber-list- countries
2. The report is a collaboration between authors from the Nuffield Trust, City St George’s University of London, RAND Europe, Queen’s University Belfast, and the University of Michigan.
AfPP Symposium to explore the future of robotics in healthcare
The Association for Perioperative Practice (AfPP) has announced the ‘AfPP Robotics Symposium – Advancing Surgical Innovation: The Future of Robotics in Healthcare’, a premier event dedicated to exploring the transformative role of robotics in modern surgery. This symposium will provide an essential platform for healthcare professionals to engage with the latest advancements in robotic-assisted procedures, discuss emerging trends, and understand the impact of cutting-edge technology on surgical outcomes. It is taking place at Norfolk and Norwich University Hospital, Colney Lane, Norwich, on Wednesday 11 June 2025. AfPP is partnering with the Norfolk and Norwich University Hospitals NHS Foundation Trust to stage the event.
Thomas Maynard. There will also be a session on ‘The Role of the Wider Team in Robotic Surgery’, Speed Education Sessions, and the winner of the Symposium Poster Presentation Submission will be announced, with the submitted posters available to view at the event. This one-day symposium will provide a
Sessions include ‘Enhancing Patient Outcomes with Robotic Surgery’ by Irshad Shaikh, ‘Development of an Oesophagogastric Robotic Service’ by Nicholas Penney, ‘The Future of Robotics’ by Jonathan Morton, and ‘Anaesthetic Considerations with Robotic Surgery’ by Siew-Ling Harrison and
comprehensive platform for attendees to delve into the latest advancements in robotic-assisted surgery, evidence-based practices, and the future trajectory of this rapidly evolving field. With a focus on innovation and practical application, symposium attendees will gain valuable insights into the future of robotic-assisted procedures and their impact on surgical outcomes. Visit:
https://www.afpp.org.uk/ events/symposiums/
May 2025 I
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