Brexit: Crisis on the Wards: Channel 4 Dispatches

The NHS is heading for a staffing shortage bigger than it has ever dealt with before with Britain poised to leave the EU Dispatches explores the further impact this could have on our NHS. The NHS workforce is increasingly international, of the 1.2million staff, 140,000 are from abroad – 60,000 of those are from Europe.

In a specially commissioned survey via 270 NHS Trusts, Dispatches can reveal new figures from EU staff about their work in the NHS post-Brexit. The survey garnered approximately 1,000 responses asking EU staff their opinions and plans post-Brexit.

  • 70% said the referendum made the UK a less appealing place to work.
  • 66% said they were worried about their career in the UK.
  • 42% said they were considering leaving in the next five years.
  • If that is worked out across the country that is 25,000 NHS workers who could leave.

There are already 20,000 nursing vacancies. And a service which has just been hit by the busiest winter it has experienced. Dispatches discovered:

  • EU staff leaving and there’s a 90% reduction in the number of applicants from the EU
  • Home-grown recruitment isn’t delivering the target numbers
  • Trusts have to look at more expensive options, from India and the Philippines, and face a battle with language levels, immigration and VISA rules to get these people in.
  • In the months since the referendum figures from NHS Digital show that almost 5,500 EU staff left their posts in England. That’s an increase of over 25% on the same period in 2015.
  • In Leicester alone, 28 EU nurses handed their notice in the days following the vote.

Julie Smith, Head of nursing Leicester, “We did have 440 nurses from across the European countries. Following the Brexit vote, we saw 28 of those nurses leave, within probably around 6 weeks of Brexit (6.3%).”

The Department of Health told Dispatches, “Overseas workers form a crucial part of our NHS and we value their contribution immensely.”

Nursing Shortages:

The NHS has become increasingly reliant on EU staff in recent years – since new laws in 2013 said more nurses were needed on our wards to keep patients safe.

  • More than 7,000 nurses arrived from the continent in 2015, three times more than in 2010.
  • There are currently more than 20,000 nursing vacancies in England.

Julie Smith, Head of nursing Leicester,

“We recruit all of the UK nurses that we possibly can. The nurses aren’t there to recruit. So we have to go and recruit them from elsewhere.”

Morland: Which countries were you recruiting from?

Julie: Mainly Italy, Portugal and Spain, some from Greece as well.

The Nursing and Midwifery Council state that across the country, only 101 nurses from Europe joined up in December – a decrease of 90% on pre-referendum registration.

Recruitment difficulties:

Barry Pactor runs an International Recruitment firm bringing doctors and nurses from around the world into UK Hospitals, “The EU marketplace has been essential to top up the big gap in the number of nurses in the UK healthcare system.”

Morland: Has the EU referendum result had any impact on your ability to recruit nurses from European countries...?

Brian: At TTM we’ve seen a huge reduction in the number of nurses from EU countries applying to work in the UK, as much as a drop of 90%. I don’t think it’s all do to Brexit, over the past 18 months there’s been considerable number of changes, I think Brexit is another big piece on top. English language very very high, relative drop of the pound against the Euro, and competition in other countries as well, so if you factor in Brexit on top – I think it makes it really difficult to recruit the best quality nurses to a very understaffed UK healthcare system.

Julie Smith, Head of nursing. Leicester, “It’s become almost impossible for us to recruit nurses from Europe…

Post Brexit were seeing 3, 4, 5 nurses applying now, whereas before we had 100s of nurses applying.

Morland: If your current EU nurses start packing up and going home…and you can’t recruit from there, how do you think this will impact on next winter?

Julie: that will make it challenging to staff all our wards and departments which would mean we’d have to close wards. Coz we can’t run wards if the staffing isn’t safe to do so. So it could absolutely impact on next winter.

Government strategy:

The Government are promising more UK-trained NHS staff including up to 10,000 nurses. From September, students will no longer receive the £4,500 bursary which had previously been guaranteed to all students to support them through their training; instead they will receive support through the student loans system.

At Leicester’s DeMontford University the next intake of students are undergoing their training.

Chris Whitney Cooper – DeMontford University, “We train the nurses and midwives for the local workforce; about 500 nurses a year come out of university and actually work locally.”

The Government says this will allow universities to increase the number of places by up to 10,000.

But at DeMontford University they can’t increase the places, because the local hospital doesn’t have space to give them practical experience.

Chris: Tomorrow if we wanted more nurses, we could take them, but I have to ask the Trusts as well…

Morland: That seems bizarre though Chris, from the outside to think there’s a national shortage of nurses, and yet the trust aren’t able to increase the places so that you can train more students, you could train more nurses.

Chris: It’s not that we’re not trying, but quality is paramount and I don’t want to increase the volume of nurses on the course if the quality of the nurse isn’t as good.

However, since the bursary figures have been removed figures from UCAS show that applications for nursing courses in England have dropped by almost a quarter – meaning some courses will be taking on fewer students.

The Department of Health said: We are continuing to invest in the frontline – there are over 11,600 more doctors and over 13,400 more nurses on our wards since May 2010. We want to give more domestic students the chance to be doctors and nurses, given the enduring popularity of these professions as careers. There are 30,000 students training to be doctors and over 52,000 training to be nurses.

Recruiting from further afield:

With some EU staff leaving their jobs, the supply line from Europe now limited, and with no immediate influx of home grown talent, hospitals all over the UK are facing their own staffing emergency. Trusts are starting to look further afield.

Julie Smith: We’ve already been to Philippines and India, to recruit nurses.

Morland: Do you see that continuing to the future? The fact that there is this lack of British nurses. You know can’t go and get EU nurses, you’ve got to get them from somewhere. So they’re gonna come from Asia?

Julie: Absolutely. Assuming that we can actually get them into the country and they’re supported through the immigration process to come to the country.

Hiring from Asia costs about £5,000 per nurse to our NHS, twice as much as a European recruit.

And with the Government talking about curbing immigration there’s no guarantee those nurses from Asia will be allowed in!

Comments from Dispatches commissioned survey:

Comments made by doctors and nurses who took part in the Dispatches survey:

German worker - I've put 15 years into this country, always worked, always paid taxes… I'm angry, disappointed, sad and homesick for the first time.

Italian worker - I feel like I am in limbo. There is no certainty that I will be able to remain in my job.

Spanish worker – “I am planning to move out as soon as article 50 is invoked. I already have interviews in Germany.”

Hungarian worker – I don’t feel welcome in the country anymore. I’m not worried about my right to stay, but I’m still planning to move back home.

German worker – “I want to leave as soon as possible, even considering retraining to make it easier to move to mainland Europe.”

Portuguese worker – “I am planning to go back to Portugal taking my family to where we are wanted.”

Swedish worker – “Everything is in doubt. Even though I believe I will be given right to stay in the UK due to many years here I am no longer sure I want to.”


Reporter: Morland Sanders
Prod/Dir: Darrell Brown
Exec Prod: Sarah Hey
Prod Co: True North


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