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NHS staff from overseas: statistics

Published Wednesday, February 7, 2018

62,000 NHS staff in England are EU nationals - 5.6% of all staff. Overall, 12.5% of NHS staff say that their nationality is not British. Data on the nationality of NHS staff for doctors, nurses and other categories, and changes since the Brexit vote.

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One NHS, Many Nationalities - number of NHS staff reporting each nationalityClick thumbnail to enlarge graphic: One NHS, Many Nationalities

The majority of NHS staff in England are British – but a substantial minority are not. Around 139,000 out of 1.2 million staff report a non-British nationality. This is 12.5% of all staff for whom a nationality is known, or one in every eight. Between them, these staff hold 200 different non-British nationalities. Around 62,000 are nationals of other EU countries - 5.6% of NHS staff in England. Around 47,000 staff are Asian nationals.



Of every 1,000 NHS staff in England……875 are British…56 are from other EU countries…42 are Asian			 	…19 are African			 	…8 are from somewhere else			 				 These figures vary substantially across England. In London, 114 of every 1,000 staff (11.4%) are from the EU.

Nationality as recorded by the NHS is self-reported, so it may sometimes reflect a person's cultural heritage rather than their citizenship or country of birth. For 6.5% of NHS workers, nationality is unknown. The percentages here exclude staff whose nationality is unknown. This data doesn't cover those working in social care or in the independent sector.

MOST COMMON NATIONALITIES OF NHS STAFF						 						 	British	976,288			Nigerian	5,405 	Indian	18,348			Zimbabwean	3,899 	Philippine	15,391			Romanian	3,775 	Irish	13,016			Pakistani	3,375 	Polish	8,477			Greek	2,952 	Spanish	6,781			German	2,400 	Portuguese	6,725			Ghanaian	2,345 	Italian	6,044			Malaysian	2,201

10% of doctors and 7% of nurses are EU nationals

Nationals of other EU countries make up almost 10% of doctors in England's hospital and community health services. They also make up just over 7% of all nurses and 5% of scientific, therapeutic and technical staff. The percentage of doctors and nurses with EU nationality grew between 2009 and 2016, but has changed little since the EU referendum.


36% of hospital doctors gained their primary medical qualification outside the UK. 20% qualified in Asia and 9% qualified in the EU. For GPs, 4% qualified in the EU and 13% qualified in Asia.


One-third of all EU nationals in the NHS work in London

The highest concentration of staff with other EU nationalities is in London. One-third of all EU NHS staff work in London. In North West London, those with EU nationality make up 12% of all NHS staff. There are 37 NHS trusts where over 10% of staff are estimated to be nationals of other EU countries as of April 2017; 30 of these are in London and the South East.

In all regions, there are more staff from 'old' EU countries (those which were members before 2004, such as Spain and Italy) than 'new' EU countries (those which have joined since 2004, such as Poland and Romania).


How to interpret changes since the EU referendum

Data coverage of NHS nationality data has improved over time. Because of this, comparisons of the number of EU staff in the NHS over time should be made only with caution. In June 2016 there were 89,546 staff with unknown nationality. That has now decreased by over 10,000 to 78,269, while the total number of staff has increased. This means that some apparent increases in staff numbers for particular nationalities and nationality groups is likely to be due to improved data coverage rather than genuine increases.

The data shows that there were 58,698 staff with recorded EU nationality in June 2016 and 61,974 in September 2017. But to present this as the full story would be misleading, because we know that there are over 10,000 more staff for whom nationality is known now than in 2016. One way to partially account for this is to present the number of EU staff as a percentage of all staff with a known nationality. This measure suggests that EU staff has changed little since the referendum, from 5.5% to 5.6%. Note that this measure is sensitive to changes in staff in other nationality groups, so it is still not a definitive measure of changes.

Claims about changes in the number of EU staff which don't account for the importance of 'unknowns' should be regarded with due scepticism.

Nurses and health visitors are the only staff group to record a fall in the number of recorded EU nationals since the EU referendum. EU nurses as a percentage of those with a known nationality have fallen from 7.4% of the total to 7.1%. EU doctors have decreased to 9.6%, having risen as high as 9.9% in March 2017. EU clinical support staff were static in 2016 as a percentage, but have risen in 2017. Other staff groups shown above have also increased the percentage of EU staff.

Looking at individual nationalities, only Spanish EU staff have seen a substantial recorded decrease since June 2016, from 7,240 to 6,781 (a fall of 6%). Romanian EU staff have increased from 3,098 to 3,775, though we do not know how much of this is due to improved data coverage (as explained above). Looking only at the last three months (between Jun and Sep 2017), there was also a small fall in the number of Italian, Portuguese, Czech and Croatian NHS staff.


EU nationals have fallen as a percentage of those joining the NHS

In 2015/16, 11% of those joining the NHS were EU nationals (counting those for whom a nationality was known). In 2016/17, this fell to 9%, and in the year ending September 2017 the figure was 8.4%. For nurses the percentage of EU joiners fell from 19% in 2015/16 to 12.4% in 2016/17, then further to 9.6% in the year ending September 2017.

In the year ending Sep 2017, 13% of nurses leaving the NHS were EU nationals, up from 9% in 2015/16.


Commons Briefing papers CBP-7783

Author: Carl Baker

Topics: Europe, Health services, Health staff and professions, Immigration, Medicine, Nationality

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