What is actually happening in NHS International Workers?
How Much Does the NHS Depend on Staff From Overseas?
One in three NHS nurses trained outside the UK — the highest proportion on record, raising concerns about global health equity.
In 2024, 33.4% of NHS nurses and 31.9% of doctors were internationally trained — the highest proportions on record — as intensive recruitment from India, the Philippines, Nigeria, Zimbabwe, and Pakistan filled vacancies that domestic training has consistently failed to meet.[1] The NHS has recruited from several WHO “red list” countries — 47 nations facing severe healthcare workforce crises from which ethical guidelines recommend avoiding recruitment.[2] The 2023 NHS Long Term Workforce Plan commits to doubling domestic medical school places and achieving greater self-sufficiency, but that pipeline takes a decade to deliver qualified staff.[4]
The ethical and geopolitical burden is concentrated on the source countries least able to absorb the loss. When a Nigerian-trained nurse or doctor joins the NHS, the investment made in their training by Nigeria’s health system is transferred to one of the world’s wealthiest economies — a structural subsidy flowing in the wrong direction. Within the NHS, internationally educated nurses (predominantly Black African) report the highest rates of bullying and harassment at 31%, and face disproportionate disciplinary proceedings, compounding a system that has become dependent on their labour without fully protecting them.[3]
- [1]NHS Digital — NHS Workforce Statistics, 2024. 33.4% of nurses and 31.9% of doctors internationally trained — record highs
- [2]WHO — Global Code of Practice on International Recruitment of Health Personnel — Health Workforce Support and Safeguards List, 2024. 47 red-list countries; NHS still recruits from 13
- [3]NHS England — NHS Staff Survey — Bullying and Harassment Data, 2023. 31% of internationally educated nurses report bullying/harassment
- [4]NHS England — NHS Long Term Workforce Plan, 2023. Commits to doubling domestic medical school places
Sources & Methodology
NHS Digital — NHS Workforce Statistics. Published monthly. digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics
World Health Organization — WHO Global Code of Practice on the International Recruitment of Health Personnel. who.int/publications/m/item/who-global-code-of-practice-on-the-international-recruitment-of-health-personnel
International trained staff figures are based on country of nationality as recorded in the Electronic Staff Record (ESR). Country of nationality is used as a proxy for country of training as direct country-of-training data is not consistently available. Red-list country data from WHO Health Workforce Support and Safeguards List, updated 2024. NHS recruitment figures from NHS England international recruitment reporting.