Immigration Impact on Safe Staffing

The Government has announced changes to the UK immigration policy which look likely to have a significant impact on the recruitment and retention of nurses in the NHS.

There are currently a large number of overseas nurses from outside the EEA working in NHS trusts across the country who have come to the UK on Tier 2 (General) visas, for skilled workers, and can only remain on these visas for a maximum of 6 years. If a Tier 2 (General) migrant wishes to apply for indefinite leave to remain in the UK (which can generally be done after 5 years in the UK), they must meet certain requirements.

With a view to reducing migration to the UK from the current figure of approximately 250,000 per year to tens of thousands per year, the Government has announced plans to introduce a new minimum salary requirement for those applying for indefinite leave to remain. From 6 April 2016 those applying for indefinite leave to remain will be required to earn a gross annual salary of at least £35,000. This means that nurses from outside of the EEA who are working in the UK will have to reach the £35,000 minimum threshold within six years of coming to the UK in order to be permitted to remain here (this being the maximum timeframe they can hold a Tier 2 visa). Otherwise, they will not qualify for indefinite leave and will be forced to leave the UK.

It is proposed the figure will increase to £35,500 from 6 April 2018, £35,800 from 6 April 2019 and to £36,200 for those applying from 6 April 2020.

The Royal College of Nursing ("RCN") has suggested that this new requirement is likely to have an impact on almost half of the registered nurses from outside the EU currently working in the UK.

For a band 5 nurse, current salaries start at approximately £21,000. To achieve the £35,000 minimum requirement, the overseas nurses would need to be at the mid-point of the current band 7 earnings. Given current salaries, it seems unlikely that the overseas nurses will have reached the £35,000 requirement within six years of coming to the UK and that a significant number of overseas nurses will therefore be forced to leave as a result of the change.

By introducing the minimum salary requirement, the Government will be adding to the already existing nursing shortage in the UK and, as a result of reduced nursing numbers, potentially impacting on the safety of patients within the NHS.

The RCN has estimated that up to 3,365 nurses working in NHS hospitals could be affected when the change comes into force, and that the £20.19 million which has been spent in recruiting those nurses will have effectively been wasted. This will be on ongoing problem for the NHS. Each time nurses are recruited from overseas, the NHS will incur time and cost in recruiting them, only to have their services for a limited period of time (in the likely event that the nurses are not able to meet the minimum salary requirement). This is arguably a waste of valuable NHS resources, will be a disruption to the service provided and a waste of the experience and knowledge which the nurses will have built up during their time in the NHS.

Given the shortage of home-grown nurses, the NHS will be forced to look at alternative means of filling nursing vacancies, which cannot be overcome in the short term and will not be an easy task given the pressures which the NHS is also facing to cut spending on agency nurses.

The new requirement has been met with much opposition and calls for the Government to reconsider the £35,000 minimum requirement. It remains to be seen how the Government will react to the criticism of the new plans.  

Rachael Davidson, Specialist Immigration Unit, DAC Beachcroft