NHS staffing crisis: Plans to halve number of medics being recruited from abroad
The government plans to more than halve the number of NHS staff being recruited from abroad in the next 15 years, according to its long term workforce plan.
On Thursday, a preview of the plan announced the intention to funnel £2.4bn into solving the severe staffing crisis in NHS England.
The full document, which was published this morning, said the service aims to train more NHS staff domestically to “reduce reliance on international recruitment and agency staff”.
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“In 15 years’ time, we expect around 9-10.5% of our workforce to be recruited from overseas, compared to nearly a quarter now,” the NHS plan said.
The report also says:
• Half a million trainees will begin clinical training over the next six years
• The NHS hopes to recruit 300,000 new staff and retain 130,000 extra healthcare workers
• Training places will be expanded across the sector including: GPs (50%), adult nurses (92%), pharmacists (29%), dentists (40%), dental therapy and hygiene professionals (28%), healthcare scientists (13%)
• From autumn, recently retired consultant doctors will be given the option to return to work across England through the NHS Emeritus Doctor Scheme
• Almost a quarter of NHS staff (22%) will be trained via apprenticeship by 2031/32
• New medical degree apprenticeships will train 2,000 doctors by 2031/32
• Staff will be supported to access the new childcare measures announced in the recent budget
• The shortfall in mental health nursing is of “particular concern”, with plans to boost this by 73%
NHS ‘reliant on overseas staff’
The NHS, the report said, is “particularly reliant on international recruitment” to fill workforce gaps. The total proportion of NHS workers with non-UK nationalities – across all professions – has grown to more than 17%.
Since 2017, there has been a 2% increase in UK-trained medical graduates joining the workforce. By comparison, in the same time period, there has been a 121% rise in international medical graduates.
Of the doctors who joined the UK workforce in 2023, 50% were international medical graduates.
And, in 2022/23, about half of new nursing registrants in England were trained overseas.
“This leaves the NHS exposed to high marginal labour costs and risks the sustainability of services in the longer term given the growing global demand for skilled healthcare staff,” the report said.
But achieving the productivity improvements outlined in the plan is depending on ” a sustained increase in capital investment in the ageing NHS estate” and investing in digital infrastructure to allow the NHS to make the most of new technologies.
This includes replacing equipment that has passed its recommended lifespan and expanding “capacity to accommodate the increased demand for healthcare from an ageing population”.
“This would enable staff to function more efficiently, and shorten diagnosis and treatment times in areas such as cancer,” the report said.
New roles will be ‘trained and regulated properly’
Vacancies currently stand at 112,000, and there are fears shortfalls could grow to 360,000 by 2037.
Shorter medical degrees, apprenticeships so staff can “earn while they learn” and more medical school places in the areas of greatest need were among the previous headline announcements.
The Prime Minister has insisted people being brought into new roles in the NHS will be “trained properly and they’ll be regulated properly”.
Rishi Sunak said the General Medical Council (GMC) will bring new roles like physician associates into its remit as regulator.
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As the Conservatives have now been in power for 13 years, critics – including Labour’s shadow health secretary Wes Streeting – have been asking why the party hasn’t acted sooner.
He said governments from all parties had “ducked” the workforce challenge for decades but said “overcoming this won’t be quick or easy”.
He added: “It’s only possible because of the difficult decisions we’re taking elsewhere to cut the debt and by prioritising the NHS there will be other things that we can’t afford.
“But the NHS is too important. So we’re making the tough calls, and doing things differently, to protect the long term future of the NHS and this country.”
No mention of pay
And while the plan focuses on retention and training, as waves of strikes continue across the health service, the preview contained no mention of pay other than to say: “Everyone working in the NHS should be recognised and rewarded fairly to help ensure we attract and retain the staff we need to provide the best possible care for patients.”
In response to questions about this, the prime minister said everyone would like to be paid more, but the government’s job is to “make sure that we reward people fairly and well for the work they are doing” but also bring down inflation.
He said he is “really pleased” the NHS staff council, which represents over a million NHS workers, voted to accept the government’s pay offer, adding: “I think they did recognise that it was fair and reasonable and rewarded their members for their hard work.
“”And I’m very grateful to all them for doing that because I know that fundamentally what they care about is working really hard, to deliver excellent healthcare.”
Unite General Secretary Sharon Graham said: “This looks like a bold plan to transform the training of new staff in the NHS. But the devil is in the detail as usual. There is a promise of funding for training for three years, but nothing about money for current staff.
“If there is not enough money to pay NHS staff a decent wage now, and transform current wage structures, then all the aspirations for more staffing in the training plan will fail to address the current crisis in the recruitment and retention of staff. That is what is at the heart of the current staff exodus”.
It has become almost impossible to book a driving test on the government website due to bots on the booking system, driving instructors have told Sky News.
The only official way to book a practical car driving test is through the Driver and Vehicle Standards Agency (DVSA) website.
New test slots are released by the DVSA at 6am every Monday, but “no matter how fast I am, there’s nothing available”, said Aman Sanghera, a driving instructor based in west London.
Driving instructor Aman Sanghera wants ‘stronger oversight and regulation’ from the DVSA
When asked about the cause, she said: “All of the tests are taken by bots, they are definitely taking over the booking system.”
In this context, bots are automated software designed to mimic human behaviour and programmed to carry out actions like searching for and reserving driving test appointments on the official government website much faster than humans can.
Individuals and companies use bots to block-book driving test slots and then resell them at a profit, which is not illegal, although it is a violation of the DVSA’s terms of use.
Recent data shows the DVSA has closed over 800 business accounts for misuse of its booking service in the past two years.
It takes five months on average for a test in England – unless you pay a middleman
Ms Sanghera, who has been in the trade for over a decade, said the usage of bots started a few months ago “but is now getting out of hand”.
She said: “I’ve actually heard about driving instructors being approached by certain individuals to then take on their IDs to log in and to run this scam.
“I struggle to actually book a test for my students, which means that by the time my students are logging in, they’ve got no chance.”
Driving instructors can book driving tests on behalf of their pupils using a dedicated service, allowing them to bypass the general queue and potentially secure test slots more efficiently.
As a result, Ms Sanghera said students are “forced to go to third-party sites” to secure “the same test dates which are then available later on during the day at a premium rate of like £200-£300”.
She added: “Given that the DVSA is a government-regulated body, one would expect a more robust and fair system to ensure affordability and accessibility for all candidates.”
The long waiting lists and high demand for tests has led some to take advantage
The standard test fee is £62, offered by the DVSA, which is responsible for carrying out driving tests in Great Britain.
The biggest concern for the driving instructors Sky News has spoken to, including Ms Sanghera, is “the fact that students are being exploited”.
When Ahmed Ali struggled to find a practical test on the DVSA website, he turned to third-party sites – a decision he now regrets.
Ahmed Ali started looking for a test two years ago
He said: “I’ve spent about £650 on driving tests, and I’ve sat zero tests. I’ve given all this money to third-parties that look for cancellations so they could try to get you a faster test.”
But the 20-year-old said that despite making the payments, he “didn’t hear back from them again”, which is illegal.
“When you lose all that money, you get to a point where you can’t really afford to find another driving test,” he said.
“I just feel very frustrated because I’ve spent all this money, all this time into driving, and I haven’t sat a single driving test.”
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The DVSA urged applicants to only book tests via the official Gov.uk website and told Sky News it “deploys enhanced bot protection to help stop automated systems from buying up tests unfairly”.
“These applications, however, are constantly evolving and changing, and DVSA’s work on this is ongoing,” it said.
From Tuesday, the DVSA will require learner drivers to provide 10 full working days’ notice to change or cancel their car driving test without losing the test fee, up from the current three days.
Also part of the DVSA’s crackdown to reduce waiting times is a consultation expected to launch in spring 2025 “to streamline the driving test booking process” and “tighten terms and conditions”.
The last blast furnaces left operating in Britain could see their fate sealed within days, after their Chinese owners took the decision to cut off the crucial supply of ingredients keeping them running.
Jingye, the owner of British Steel in Scunthorpe, has, according to union representatives, cancelled future orders for the iron ore, coal and other raw materials needed to keep the furnaces running.
The upshot is that they may have to close next month – even sooner than the earliest date suggested for its closure.
Read more: Thousands of jobs at risk as British Steel consults unions over closure
The fate of the blast furnaces – the last two domestic sources of virgin steel, made from iron ore rather than recycled – is likely to be determined in a matter of days, with the Department for Business and Trade now actively pondering nationalisation.
The upshot is that even as Britain contends with a trade war across the Atlantic, it is now working against the clock to secure the future of steelmaking at Scunthorpe.
The talks between the government and Jingye broke down last week after the Chinese company, which bought British Steel out of receivership in 2020, rejected a £500m offer of public money to replace the existing furnaces with electric arc furnaces.
The sum is the same one it offered to Tata Steel, which has shut down the other remaining UK blast furnaces in Port Talbot and is planning to build electric furnaces – which have far lower carbon emissions.
These steel workers could soon be out of work
However, the owners argue that the amount is too little to justify extra investment at Scunthorpe, and said last week they were now consulting on the date of shutting both the blast furnaces and the attached steelworks.
Since British Steel is the main provider of steel rails to Network Rail – as well as other construction steels available from only a few sites in the world – the closure would leave the UK more reliant on imports for critical infrastructure sites.
However, since the site belongs to its Chinese owners, a decision to nationalise the site would involve radical steps government officials are wary of taking.
They also fear leaving taxpayers exposed to a potentially loss-making business for the long run.
The dilemma has been heightened by the sharp turn in geopolitical sentiment following Donald Trump’s return to the White House.
The incipient trade war and threatened cut in American support to Europe have sparked fresh calls for countries to act urgently to secure their own supplies of critical materials, especially those used for defence and infrastructure.
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Gareth Stace, head of UK Steel, the industry lobby group, said: “Talks seem to have broken down between government and British Steel.
“My advice to government is: please, Jonathan Reynolds, Business Secretary, get back round that negotiating table, thrash out a deal, and if a deal can’t be found in the next few days, then I fear for the very future of the sector, but also here for Scunthorpe steelworks.”
British Steel declined to comment.
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