63,000 NHS staff in England are EU nationals - 5.6% of all staff. Overall, 12.7% 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.Jump to full report >>
The majority of NHS staff in England are British – but a substantial minority are not. Around 144,000 out of 1.2 million staff report a non-British nationality. This is 12.7% 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 63,000 are nationals of other EU countries - 5.6% of NHS staff in England. Around 49,000 staff are Asian nationals.
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 5.9% 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.
Nationals of other EU countries make up 9.7% of doctors in England's hospital and community health services. They also make up 6.8% of all nurses and 5.6% of scientific, therapeutic and technical staff. The percentage of doctors and nurses with EU nationality grew between 2009 and 2016. Since 2016, the percentage of EU nurses has fallen.
37% 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.
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 35 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.
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).
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 71,464 (a fall of 20%), while the total number of staff employed by the NHS 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 63,065 in June 2018. But to present this as the full story would be misleading, because we know that there are over 18,000 more staff for whom nationality is known now than in 2016. So while it is likely that there has been an overall increase in the number of EU NHS staff since 2016, we cannot be sure about the scale of the change.
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. 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 6.8%. EU doctors have remained at 9.7%, having risen as high as 9.9% in March 2017. In other staff groups, the percentage of EU staff has increased.
Looking at individual nationalities, only Spanish nationals have seen a substantial recorded decrease since June 2016, from 7,240 to 6,160 (a fall of 15%). NHS staff with a known Romanian nationality have increased from 3,098 to 4,091.
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 2017/18 the figure was 7.9%. For nurses the percentage of EU joiners fell from 19% in 2015/16 to 12.4% in 2016/17, then further to 7.9% in 2017/18.
In 2017/18, 13% of nurses leaving the NHS were EU nationals, up from 9% in 2015/16.
Commons Briefing papers CBP-7783
Author: Carl Baker