Nurses remain on migration shortage list but midwives are not

The full review of the Shortage Occupation List by the Migration Advisory Committee found nursing was the number one profession recruited via the UK’s employer sponsorship route for skilled overseas workers last year.

“A significant number of stakeholders reported difficulties in the recruitment of nurses”

SOL review report

More than 5,100 nurses from outside the European Economic Area (EEA) came to work in the UK in 2018 under the Tier 2 visa system representing 21.8% of all workers using the work migration route that year.

The scheme allows 20,700 high-skilled workers into the UK each year with priority given to professions on the Shortage Occupation List.

Other advantages of being on the list include lower visa application fees for workers and their families and there is no requirement to meet a £35,800 salary threshold in order to stay in the UK after five years.

Nurses have featured on the list since 2013 and in June 2018 were removed from the cap on numbers following pressure from employers struggling to fill vacancies.

Figures included in the report show a surge in applications from 2,780 in 2017 to 5,106 in 2018. Another advantage of being on the list is the fact employers are not required to advertise jobs to UK workers.

However, since November 2016 this has not applied to nursing meaning trusts wishing to recruit overseas nurses still have to carry out a “resident market labour test”.

In considering whether nurses should remain on the Shortage Occupation List, the committee looked at evidence from nursing and care organisations who highlighted widespread shortages linked to increased demand, falling student numbers and “the collapse of the European nursing supply” in the wake of the UK’s decision to leave the EU.

The report showed nursing ranks in the top half of professions with the worst shortages coming 47th out of 105 occupations.

“On balance, we do not recommend adding midwives to the Shortage Occupation List”

SOL review report

It flagged up efforts to try and address shortages including the creation of new routes into nursing such as nursing degree apprenticeships and nursing associates.

“However, both these routes will take time to increase the registered nursing workforce supply and will take longer than the established three-year degree route,” said the report.

While the Royal College of Nursing told the committee international recruitment of nurses was “vital to the workforce in the short-term”.

“However, in the long-term effective workforce planning, training and recruitment needs to improve to solve shortage issues,” said the report.

The committee concluded nursing should stay on the Shortage Occupation List.

“A significant number of stakeholders reported difficulties in the recruitment of nurses. Vacancy rates have been rising, even with increased employment and they rank highly in the shortage indicators, therefore we recommend retaining nurses on the SOL,” said the report.

The review recommended expanding the list to include a wider range of health and care occupations including psychologists, occupational therapists and paramedics.

All types of medical practitioner will now also be included whereas before only doctors from certain specialities such as emergency medicine and elderly care featured on the list.

“The health and social care sector is faced with a number of workforce shortages”

Danny Mortimer

However, the committee concluded midwives should not be added despite concerns about shortages amid increasing demands on maternity services.

The report shows the Department for Health and Social Care wanted to see midwives added to the list because of the increased complexity of births and need for skilled midwifery professionals.

However, the committee pointed to an increase in the number of overseas midwives coming to work in the UK and plans to boost the number of home-grown midwives with an increase in university places.

It found “almost no use of the current work migration route” to employ midwives with just one midwife recruited in this way in the past five years.

Meanwhile, midwifery was found to rank way down the list of occupations with the worst shortages coming in at 101st out of 105.

“On balance, we do not recommend adding midwives to the Shortage Occupation List,” said the report.

The Long Term Plan for the NHS in England set out the need to ramp up international recruitment of key staff including nurses.

While the Migration Advisory Committee said overseas workers would continue to make “an important contribution” to the UK healthcare workforce, it stressed this was not the solution to shortages.

“Ultimately it will take more effective workforce planning and efforts to increase the flows into health professions (and decrease flows out) to meet growing demands,” said the report.

The report was welcomed by sector bodies including the Cavendish Coalition of leading health and social organisations.

“The health and social care sector is faced with a number of workforce shortages, which are affecting the delivery of services. The analysis and recommendations by the MAC clearly reinforce that position,” said coalition co-convener Danny Mortimer.

“We urge the government to enact these recommendations quickly to ensure continued recruitment into shortage occupations,” he added.

In particular the committee highlighted pressures on social care including the fact the number of nurses working in the field has continued to fall with an 18% decline since 2012.

danny mortimer

danny mortimer

Dany Mortimer

“Respondents in the residential and social care sector were overwhelmingly more likely to report difficulties in recruiting and retaining staff, this is coupled with a growing demand for the sector and a tight labour market,” said the report.

The report highlighted the fact there is currently no direct work route for non-EU workers to come and take up lower-skilled but much-needed support worker roles in the sector.

Mr Mortimer said international recruitment of social care staff was a “huge concern”.

“The government will need to look closely at this sooner rather than later for the sector to be able to recruit and retain staff at the levels required to meet the level of need,” he said.

While a dedicated route for employ migrants in social roles could be established the committee said it was concerned this would be “at best, a short-term fix and would perpetuate the poor terms and conditions that are the underlying cause of the shortages”.

Instead, it hoped the government’s much-anticipated Green Paper on social care would set out measures to boost the workforce.

“We hope that the government’s forthcoming Green Paper on social care provides more clarity on the future of social care in the UK and contains concrete proposals to improve terms and conditions for the workers in the sector that do such an important job,” said the report.