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Recruiting for a post-Brexit world

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Published 02 October 2017


The government has ambitious plans to expand the NHS workforce, with thousands more GPs and mental health workers promised. Faced with post-Brexit staff shortages, the NHS is looking to recruit via partnerships in India, and novel collaborations closer to home.

Plans are in place for the first nurses from Apollo Hospitals in India to take up positions on wards and in outpatient clinics at hospitals in the NHS across England.

They are part of what’s hoped will be the first wave of nurses and other health professionals, including GPs, to fill the recruitment gap amid the fall-out from our exit from the EU.

Brexit recruitment dip

Health Secretary Jeremy Hunt recently announced plans to recruit an extra 21,000 mental health clinicians, support workers and back-office staff, in order to treat an extra one million patients by 2020.

A recent Freedom of Information request by the Health Foundation to the Nursing and Midwifery Council (NMC) revealed a 96% drop in nurses from the EU registering to practice in the UK since July last year.

Following a sharp decline from a high of 1,304 in July last year to 344 the following September, numbers have continued to fall. There were just 46 registrations in April this year.

Stop-gap measures

The UK has repeatedly used international recruitment as a stop-gap measure to fill staffing shortages.

Since 2008, the majority of international nurses registering in the UK have come from the EU. But the Health Foundation's Anita Charlesworth says the fall in EU nursing registrants suggests that “a more sustainable, long-term approach to workforce planning is urgently needed”.

For more than two years, Health Education England (HEE) has been in talks with Apollo Hospitals to source nurses on a fixed, two-year ‘earn, learn and return’ basis. Apollo runs over 40 hospitals in India.

According to HEE, Greater Manchester’s Wrightington, Wigan and Leigh NHS Foundation Trust will be one of the first to participate in a new “global learning scheme”.

Earn, learn and return

HEE describes ‘earn, learn and return’ as an innovative educational programme for healthcare workers wanting to spend three years in the UK gaining formal qualification, while practising on wards.

“Each recruit will have a bespoke educational plan, which will include a baseline development programme and mentorship, but with options to study for higher degrees.” At Wrightington, Wigan and Leigh, this will be in collaboration with Edge Hill University.

However, HEE stresses that this is not a long-term recruitment programme: “The nurses will not stay, but will learn and then return to an appropriate role in the Indian healthcare system.”

All recruits will meet NMC registration requirements – which include English-language skills to A-level standard – and will receive salaries equal to similarly qualified NHS staff. NHS trusts involved in the scheme will also pay any education costs.

Apollo is optimistic about the scheme. On signing a memorandum of understanding with HEE, its Chief Executive Sangita Reddy said: “The collaboration will include clinical rotation of doctors, nurses, midwives, other health professionals and undergraduate healthcare students through mutual exchange. It will explore the possibility of establishing a global healthcare school, to ensure that opportunities for global learning are available to the healthcare workforces in both countries.”

A cautious welcome

DAC Beachcroft employment law specialist Udara Ranasinghe welcomes the initiative, while sounding a note of caution.

"Any attempts to address NHS recruitment shortages are to be welcomed,” he says. 

“But it remains to be seen whether the HEE-Apollo arrangement will, for example, provide nurses in sufficient numbers to have a significant impact. Especially as applicants will still be required to comply with immigration requirements, which include passing the stringent Objective Structured Clinical Examination and International English Language Test. These have so far proven to be an obstacle to non-EU recruitment.

“What’s clear is that however successful fixes of this kind are, they must run alongside longer-term strategies to bring more people into the healthcare professions."

Don’t just look in the usual places

Facing relatively low UK unemployment (1.48m in June 2017) and a competitive labour market, the NHS Confederation is encouraging employers to look to unconventional sources of home-grown recruits – such as the armed forces, ex-offenders and people with learning disabilities.

The organisation believes that recruiting from less well represented groups in the community is an under-used strategy. It is asking trusts to ensure communities are aware of their local NHS as a potential employer – one which can offer attractive pay, and flexible employment and learning packages.

The Confederation points to the example of South Tees Hospitals NHS Foundation Trust. The Trust is working with Jobcentre Plus to offer a 12-week pre-employment programme, offering opportunities to get back into the workplace through structured learning and vocational experience.

Public Health England's Project SEARCH initiative supports young people with learning disabilities. It provides ten-month, rotating work-experience opportunities, combined with bespoke coaching and on-the-job training.

The Confederation also suggests contacting local organisations such as Nacro, which provides free advice to help employers considering recruiting someone with a criminal record. Or The School of Hard Knocks, a sporting charity that helps prepare disadvantaged groups for the workforce, and matches candidates to employers.

To discuss the issues raised in this article, please contact Udara Ranasinghe on +44 (0)20 7894 6727 or uranasinghe@dacbeachcroft.com.