أداة الإبلاغ الوطني (2024)

The UK continues to be a popular destination country choice for internationally mobile health and social care professionals and there has been a significant growth in the numbers of internationally trained doctors, nurses and care workers joining the workforce over the last three years. NHS Internationally trained staff have been part of the NHS since its inception in 1948. Over the past three years the NHS reliance on international recruitment to fill vacancies has increased. Latest professional regulator data shows that half of newly registered nurses in the UK and almost two thirds of newly licenced doctors are coming from overseas. This has been because of a combination of factors, including: - Focussed national efforts to build international recruitment capability and capacity within employers specifically to deliver the International Recruitment of Nurses Programme to contribute to the previous government’s commitment to increase the number of nurses working in the NHS by 50,000 (England). - All-Wales International Recruitment programme has been running since 2022, recruiting over 1,000 internationally educated healthcare professionals to date (Wales) - An International Recruitment project for nurses has been in place in Northern Ireland since 2016 with more than 1,670 nurses recruited in total and 973 of these being recruited in the last three years. (Northern Ireland) - In Scotland, the international recruitment of Nurses, Midwives and Allied Health Professionals has been taking place since 2021 with well over 1,100 recruits in posts across Health Boards. - Exemptions and simplifications in the visa process to make it cheaper and quicker for health and care staff to get visas than any other profession (UK wide) - Streamlined Nursing and Midwifery Council (NMC) regulatory processes (UK wide) Health and Care Worker visa data shows significant growth in visas granted between 2021 and 2022 with growth slowing in 2023. There were 19,842 nurse visas granted in 2021 increasing to 25,267 in 2022, reducing to 21,897 in 2023. For doctors, there were 5,775 visas granted in 2021, growing to 8,489 in 2022 and 8,832 in 2023. Looking forwards, the NHS Long Term Workforce Plan (published in 30 June 2023 under the previous Government) sets out how investment in domestic education and training will support the NHS to become less reliant on international recruitment for workforce supply in the medium to long term. However, international recruitment will continue to form an important part of our workforce, balanced against expanded domestic routes of supply (such as apprenticeships and traditional degree routes) and improved rates of retention. Adult Social Care (ASC) Growth in the international adult social care workforce was made possible following changes to the immigration system in 2022, making senior care workers and care workers eligible for the Health and Care Worker Visa. Latest data from Skills for Care shows that in year ending March 2024 there were 1.705 million filled posts in the adult social care sector, an increase of 4.2% (70,000 posts) from year ending March 2023. Skills for Care monthly indicative data shows continued improvement since then. It is likely that this overall growth depended on international recruitment with 105,000 recruits into care worker or senior care worker roles in 2023/24. In addition, there are ongoing challenges with domestic recruitment with Skills for Care data showing the number of posts in adult social care filled by people with a British nationality in 2023/24 decreasing by 70,000 since 2021/22 (-40,000 in 22/23 and –30,000 in 23/24) It is clear, international recruitment has played a valuable role in helping grow the adult social care workforce. It gives the health and care sectors the benefit of the skill and commitment of overseas workers who wish to work in England. During 2024 there have been several changes to the immigration system. Whilst the visa route for healthcare workers remained largely unaffected by the changes, there were specific changes to the care worker and senior care worker routes. In England, international recruitment of care workers and senior care workers is restricted to providers regulated by the Care Quality Commission. From March 11th 2024, care workers and senior care workers have no longer been able to bring dependants to the UK. Alongside these changes, UK Visas and Immigration implemented operational changes to strengthen controls to make sure only legitimate care providers with appropriate vacancies were able to recruit internationally. This is one of a number of factors which may have impacted visa application volumes. Data from the Home Office shows the number of health and care visas for care and senior care workers has decreased, with 3,300 visas granted in quarter one of 2024 compared with an average of 26,000 per quarter throughout 2023: Why do people come to the UK? To work - GOV.UK (www.gov.uk) The government recognises the scale of reforms needed to make the adult social care sector attractive, to support sustainable workforce growth and reduce the reliance on international recruitment. We want it to be regarded as a profession, and for the people who work in care to be respected as professionals. The government has set out a clear plan to bring down legal migration. The government’s new joined-up approach will see the newly formed Skills England, the Labour Market Advisory Board, and the Industrial Strategy Council work closely together with the independent Migration Advisory Committee to support and develop a structured and evidence-based approach to skills, migration, and labour market policy. This will reduce the need for international recruitment and ensure businesses are recruiting primarily from the homegrown workforce, boosting economic growth and providing quick responses to labour market changes. This approach will form a core part of the new government’s growth mission, supporting key industries in the process. Ethics The UK maintains a strong ethical approach to international recruitment. The Code of Practice for International Recruitment which promotes effective, fair and sustainable international recruitment practices. It is updated regularly as required and the Code red list – countries where active international recruitment is prohibited – is aligned with the latest WHO Health Workforce Support and Safeguards List. There is an Ethical Recruiters List of agencies and other recruiting organisations who have committed their adherence to the Code. We conduct regular checks of recruiters on this list, through NHS Employers, to ensure no proactive recruitment is taking place from red list countries and we are confident in this system. Following the WHO Global Code, our Code balances our duty to protect the most vulnerable health systems against the right of individuals to choose to migrate. Individuals in red list countries can therefore apply for UK vacancies if they do so directly and of their own accord. We know that the proportion of direct applications from red list countries is high. This is a concern for us. We know that people who migrate without support are at greater risk of exploitation, and we do not wish to deplete vulnerable countries of their health and care staff. However, domestic equality legislation enshrines the right for people to be treated equally during recruitment processes, regardless of where they are from. We have published guidance to address the risks facing international candidates with regards to scams and workplace exploitation when seeking a health or care job in the UK. The guidance ensures prospective candidates are well informed about the international recruitment process, benefits and challenges of seeking a health or care job in the UK. The guidance raises awareness of scams, sets out working rights and standards, details how to identify and deal with exploitation and signposts to further help or support. The guidance is published alongside an easy read leaflet which aims to engage international candidates and summarise the key messages. We are working with Foreign, Commonwealth and Development Office (FCDO) in-country health advisors and diaspora organisations to ensure the guidance is disseminated widely and reaches potential international candidates before they have taken the decision to move to the UK.

We are conscious of the attraction of other health economies trying to attract UK trained staff. This is something we are continuing to monitor, while also improving working conditions for NHS staff and competitive pay offers. More information about this is provided in the answer to question 2.2.3.

The scope of the WHO Global Code of Practice should be expanded to include social care personnel. In the UK international recruitment has been vital to workforce supply in the social care sector. Many health professionals such as nurses and physiotherapists work in the social care sector, and the care worker role is one of the most straight forward ways for people to migrate to the UK as it requires low language and skill level. This has made it an attractive option for people from low-to-middle income countries, but also ripe for exploitation. In 2021 the UK Code of Practice was updated to include the social care sector, recognising that ethical international recruitment is just as important for workers in this sector. This needs to be recognised at a global level.