Nuffield Trust research reveals NHS overreliance on doctors from “red list” countries and renewed signs of widespread medicines shortages
|
The NHS in England is increasingly relying on workers from
countries with significant health care 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...Request free trial
The NHS in England is increasingly relying on workers from countries with significant health care 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, tracks the impact leaving the EU is continuing to have on the NHS and its workforce. It finds that following Brexit, all UK countries have relied heavily on very high migration of health care 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 finds 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:
The research also takes a detailed look at how Brexit has led to an important change of course for the UK with regards to artificial intelligence (AI) in health care, with some adverse consequences. The UK has taken a fundamentally different approach to regulating AI to that of the EU's 2024 AI Act. Thisdivergence creates an additional cost from companies needing to comply twice. The costs to business of having to follow two systems will be a disincentive for bringing AI medical devices to the UK. AI in the UK might end up using EU rules by default, and the UK doesn't have an obvious way to regulate large language models being used unofficially for medical purposes.
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 the World Health Organisation believes have troublingly few staff is difficult to justify ethically for a still 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. “Sadly, we also see little sign of a recovery in the UK's relentless struggle with medicine shortages. The rate at which companies feel they should warn civil servants of possible disruption has hit its highest level since 2021, when many panicked over the Northern Ireland protocol. Action is needed both at home and in forthcoming negotiations with the EU.” Dr Nick Fahy, director of the health and care research group at RAND Europe, said: “This report highlights that post-Brexit relations between the EU and the UK are still having impacts on the NHS. The UK government also has an opportunity here. As wider events are driving UK-EU co-operation in defence and security, a "reset" for closer and better working with the EU would benefit from an ambition of also delivering concrete benefits for health." Professor Tamara Hervey, Jean Monnet Professor of EU Law at the City Law School said: “The UK's approach to health post-Brexit is diverse and contradictory. Our immigration policies don't offer the consistency needed to build a health and social care workforce. In some areas, we are tracking the EU's regulations. In others, we have adopted a different approach. The ‘reset' of relations should prompt an honest and evidence-led public discussion about the pros and cons of divergence." Ends.
Notes to Editors
|