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BRIEFING PAPER
Number 7783, 7 February 2018
NHS staff from overseas: statistics
By Carl Baker
Contents: 1. Nationality of NHS staff 2. Doctors 3. Nurses 4. Clinical support staff 5. Infrastructure support staff 6. GPs
2 NHS staff from overseas
Contents Summary 4
1. Nationality of NHS staff 5 1.1 Changes since the EU referendum 6 1.2 Changes since 2009 7 1.3 Joiners and leavers to the NHS 8 1.4 Differences between English regions 9 1.5 NHS Trusts 10
Map: EU staff in NHS Trusts 11
2. Doctors 12
3. Nurses 14
4. Clinical support staff 16
5. Infrastructure support staff 17
6. GPs 18
Data sources and limitations
The data analysed here is taken from supplementary information data releases by NHS Digital. A range of data downloads on NHS staff nationality can be found on their website here. Quarterly data also accompanies the routine workforce data publication, as part of the ‘HCHS staff in NHS trusts and CCGs’ file. This document concerns NHS staff in England only. No equivalent data on staff nationality has been published for Scotland, Wales or Northern Ireland. The data here relates to staff in the NHS’s hospital and community health services, CCGs, and support organisations.
Cover page image credit: Flags Collage by AlexR.L. Licensed under CC-BY 2.0. Image modified.
3 Commons Library Briefing, 7 February 2018
British 976,288 Swedish 679 Congolese 153
Indian 18,348 New Zealand 612 Eritrean 153
Philippine 15,391 Bangladeshi 598 Libyan 153
Irish 13,016 Trinidadian 594 Syrian 148
Polish 8,477 Sierra Leonean 503 Afghan 144
Spanish 6,781 Ugandan 489 Jordanian 144
Portuguese 6,725 Sudanese 469 Tanzanian 141
Italian 6,044 Zambian 465 Guyanese 140
Nigerian 5,405 Latvian 451 Slovenian 132
Zimbabwean 3,899 Cypriot 428 Nigerien 119
Romanian 3,775 Finnish 380 Barbadian 108
Pakistani 3,375 Danish 371 Colombian 108
Greek 2,952 Brazilian 360 Korean 104
German 2,400 Belgian 359 Albanian 100
Ghanaian 2,345 Singaporean 359 Central African 89
Malaysian 2,201 Iranian 341 Serbian 88
Australian 2,040 Austrian 334 Ethiopian 87
Jamaican 1,708 Maltese 329 Hong Kong 85
South African 1,628 Thai 294 Algerian 81
Dutch 1,580 Iraqi 289 Saint Lucian 71
French 1,553 Burmese 273 Israeli 68
Nepalese 1,539 Cameroonian 260 Indonesian 67
Sri Lankan 1,244 Croatian 256 Bruneian 57
Mauritian 1,221 Somali 253 Moroccan 57
Hungarian 1,187 Japanese 239 Fijian 55
American 1,179 Norwegian 238 Grenadian 51
Lithuanian 1,117 Mauritanian 235 Lebanese 51
Egyptian 1,078 Gambian 213 Rwandan 50
Bulgarian 990 Malawian 202 Motswana 49
Canadian 840 Russian 185 Ivorian 47
Chinese 807 Turkish 166 Peruvian 46
Slovak 806 Estonian 162 Mexican 43
Kenyan 684 Ukrainian 160 Venezuelan 42
Czech 681 Swiss 157 Caymanian 40
ONE NHS, MANY NATIONALITIESNumber of NHS staff in England reporting each nationality, September 2017
Data: NHS Digital. Graphic by @commonslibrary - read more at tinyurl.com/nhsnationality
Top 102 nationalities shown of 202 total. Total number of staff: 1,193,107. For 6.6% of staff (78,269), nationality is unknown. Nationality is self-reported & might sometimes reflect cultural heritage instead of country of birth. FAQ: Nigerian & Nigerien are separate nationalities. 'Motswana' is the singular term for a person from Botswana. 'Congolese' covers Congo and DRC. British
includes English, Scottish, Welsh and Northern Irish. Flags: © 2017 Go Squared Ltd. http://www.gosquared.com/
Nationality of NHS staff: summary
87.5% of NHS staff in England are British. 5.6% are nationals of other EU countries - just under 62,000 staff.
This varies in different parts of the country. In London, 12% of staff are nationals of other EU countries. In North East England the proportion is 2%.
The percentage of EU staff has changed little since the EU referendum. However, EU staff as a percentage of all NHS joiners fell in 2016/17.
10% of hospital doctors and 7% of nurses are nationals of other EU countries.
12% of doctors and 6% of nurses report an Asian nationality.
36% of doctors gained their medical qualification outside the UK. Over half of these qualified in Asia. 9% qualified in other EU countries.
There are 37 NHS trusts where over 10% of staff are estimated to be nationals of other EU countries. 30 of these are in London and the South East.
There are 44 trusts where less than 2% of staff are nationals of other EU countries. 32 of these are in the North of England.
At nineteen NHS trusts, more than a quarter of staff report a non-British nationality.
BRITISH
OTHER EU
AFRICAN ASIAN
EU NATIONALS IN DIFFERENT NHS JOB ROLES
13,336
7,162
7,714
21,237
CLINICAL SUPPORT
DOCTORS
NURSES & HEALTH VISITORS
SCIENTIFIC, THERAPEUTIC &TECHNICAL
INFRASTRUCTURE SUPPORT
10,599
3.9%
4.1%
5.3%
7.1%
9.6%
Royal Brompton and Harefield 19%Oxford University Hospitals 19%Imperial College Healthcare 17%St George's University Hospitals 16%University College London Hospitals 16%Great Ormond Street Hospital 14%West Hertfordshire Hospitals 14%Chelsea and Westminster Hospital 14%Royal Free London 13%Brighton and Sussex Univ. Hospitals 13%Surrey and Sussex Healthcare 13%Tavistock and Portman 13%
NHS TRUSTS WITH THE HIGHESTPERCENTAGE OF EU STAFF
The figures on this page are calculated as a percentage of those staff for whom nationality is known. For 7% of staff, nationality is unknown. See the full briefing for further details.
5 Commons Library Briefing, 7 February 2018
1. Nationality of NHS staff The majority of NHS staff in England are British – but a substantial minority are not. As of September 2017, 139,019 staff report a non-British nationality. This is 12.5% of all staff for whom a nationality is known. Between them, these staff report around 200 non-British nationalities. Almost 62,000 are nationals of other EU countries, of which 70% are nationals of countries which joined the EU before 2004.1 A third of the staff from pre-2004 EU countries are Irish.
The graphic on page 3 shows the most common 100 nationalities among NHS staff. Indian, Philippine and Irish are the most common non-British nationalities, followed by Polish, Spanish, and Portuguese.
The table below shows staff nationality summarised by country groups, with a comparison to figures for 2009. You should exercise caution when comparing the ‘number’ fields between 2009 and 2017, because there were around 172,000 fewer ‘unknown’ records in 2017 than in 2009. This means that some of the increases are likely due to improved data coverage - movements from ‘unknown’ to another category. It is more meaningful to compare the percentage columns, which measures the percentage of all staff for whom nationality is known.2
Nationals of ‘old’ EU countries (pre-2004 members) increased from 2.2% to 3.9% of the total between 2009 and 2017. Nationals of ‘new’ EU countries increased from 0.7% to 1.7%. Meanwhile South Asians decreased from 2.8% to 2.3%, Sub-Saharan Africans from 2.2% to 1.7%, and Brits from 88.9% to 87.5%.
1 ‘EU post-2004 members’ are: Malta, Cyprus, Estonia, Latvia, Lithuania, Poland,
Czechia, Slovakia, Slovenia, Hungary, Bulgaria, Romania, and Croatia. 2 Falls in number between 2009 and 2017 are, however, likely to be meaningful.
NATIONALITY OF NHS STAFF BY COUNTRY GROUPINGSep 2017 and Sep 2009 in England, with comparison to wider economy in Q1 2017. Headcount
Whole economy 2017
Nationality Group Number % of known estimated % Number % of known
UK 976,288 87.5% 88.3% 850,091 88.9%EU (PRE-2004 MEMBERS) 43,187 3.9% 3.4% 21,262 2.2%SOUTH ASIA 25,125 2.3% 1.2% 26,668 2.8%SUB-SAHARAN AFRICA 19,226 1.7% 0.9% 21,414 2.2%EU (POST-2004 MEMBERS) 18,791 1.7% 4.2% 6,945 0.7%SOUTH EAST ASIA 18,685 1.7% 0.2% 15,413 1.6%LATIN AMERICA & CARIBBEAN 2,833 0.3% 0.1% 3,487 0.4%OCEANIA 2,734 0.2% 0.3% 2,572 0.3%NORTH AMERICA 2,023 0.2% 0.4% 1,773 0.2%MIDDLE EAST & CENTRAL ASIA 1,566 0.1% 0.2% 1,798 0.2%NORTH AFRICA 1,643 0.1% 0.1% 1,373 0.1%EAST ASIA 1,273 0.1% 0.3% 1,432 0.1%EUROPE (NON-EU) 1,124 0.1% 0.2% 916 0.1%SOUTH AMERICA 809 0.1% 0.2% 807 0.1%
NHS 2017 NHS 2009
The data in this publication is sourced from NHS Digital. It
includes only staff directly employed by NHS trusts and CCGs in England. It doesn’t
include contracted-out staff, GP practice staff,
independent sector healthcare workers, or those
working in social care.
‘Nationality’ as discussed here is self-reported - so it may
not always reflect the person’s citizenship or
country of birth and can instead reflect cultural
heritage. For 6.5% of NHS workers, nationality is
unknown.
The data relates to September 2017. Only staff
directly employed by NHS trusts and CCGs are counted
in the data. GPs and GP practice staff are not
included.
6 NHS staff from overseas
The table above also shows the percentage of employees in England by nationality as of Q1 2017.3 The percentage of British workers in the NHS is broadly similar to the wider economy, but other country groups differ. The NHS has a lower proportion of staff from new EU countries (1.6%) than the wider economy (4.2%). The NHS has a higher proportion of staff from South Asia, Sub-Saharan Africa & South East Asia than the wider economy. The wider economy data is based on survey estimates, so some of the differences may be due to sample error.
1.1 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%.4
Claims about changes in the number of EU staff which don’t account for the importance of ‘unknowns’ should be regarded with due scepticism.
3 Source: Labour Force Survey. The table above measures employees only. 4 Note that the percentage of known staff with EU nationality is also sensitive to rises
and falls in staff in other nationality groups, so is not a definitive way of measuring changes. It does, however, abstract from changes in ‘unknown nationality’ staff.
CHANGES IN EU STAFF SINCE JUNE 2016 (headcount basis)
ALL STAFF SCIENTIFIC, THERAPEUTIC AND TECHNICAL
Total EU nationalityUnknown
nationalityEU as % of
knownTotal EU nationality
Unknown nationality
EU as % of known
Jun-16 1,164,996 58,698 89,546 5.5% Jun-16 147,276 6,638 10,605 4.9%
Sep-17 1,193,107 61,974 78,269 5.6% Sep-17 154,923 7,714 9,463 5.3%
HOSPITAL DOCTORS CLINICAL SUPPORT STAFF
Total EU nationalityUnknown
nationalityEU as % of
knownTotal EU nationality
Unknown nationality
EU as % of known
Jun-16 110,084 10,106 5,812 9.7% Jun-16 342,470 11,563 26,726 3.7%
Sep-17 116,040 10,598 6,046 9.6% Sep-17 350,261 13,083 23,304 4.0%
NURSES AND HEALTH VISITORS AMBULANCE STAFF
Total EU nationalityUnknown
nationalityEU as % of
knownTotal EU nationality
Unknown nationality
EU as % of known
Jun-16 317,428 21,826 23,536 7.4% Jun-16 19,759 255 3,609 1.6%
Sep-17 317,980 21,237 19,696 7.1% Sep-17 21,455 422 3,350 2.3%
7 Commons Library Briefing, 7 February 2018
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 fall in the number of Italian, Portuguese, Czech and Croatian NHS staff.
1.2 Changes since 2009 The table below shows data back to 2009 on EU staff as a percentage of staff with a known nationality in three staff groups, as well as a total for all staff. Nurses and health visitors have seen the largest increase in staff with EU nationality over this period.
Date All staff DoctorsNurses &
health visitorsSupport to
clinical staffSep 2009 3.0% 6.8% 2.8% 2.2%Sep 2010 3.1% 7.0% 3.1% 2.3%Sep 2011 3.3% 7.5% 3.3% 2.4%
Sep 2012 3.5% 8.0% 3.5% 2.5%Sep 2013 3.8% 8.6% 4.0% 2.7%Aug 2014 4.3% 9.1% 5.0% 2.9%Sep 2015 5.0% 9.4% 6.5% 3.4%Dec 2015 5.2% 9.5% 6.8% 3.5%Mar 2016 5.4% 9.7% 7.1% 3.7%Jun 2016 5.5% 9.7% 7.4% 3.6%Sep 2016 5.5% 9.7% 7.5% 3.6%Dec 2016 5.5% 9.8% 7.4% 3.6%Mar 2017 5.6% 9.9% 7.4% 3.8%Jun 2017 5.6% 9.8% 7.3% 3.9%Sep 2017 5.6% 9.6% 7.1% 4.0%
PERCENTAGE OF STAFF WITH EU NATIONALITY SINCE 2009 The 2009-2014 and 2015-2017 data in this table are taken from two separate NHS Digital publications. As a result they may differ in calculation and methodology. This break is marked by a dotted line.
8 NHS staff from overseas
1.3 Joiners and leavers to the NHS The charts below show the percentage of joiners to the NHS and leavers from the NHS in recent years who were of UK, EU/EEA or Other nationality. As with all calculations this document, these charts show percentages of staff for whom a nationality is known.5 Note that being a ‘leaver’ in this data does not necessarily mean that the person has left the UK – just that they have left NHS employment.
In the year ending September 2017, the percentage of joiners with EU/EEA nationality fell, while the percentage of leavers with EU/EEA nationality rose.
This change was particularly pronounced for the Nurses and Health Visitors staff category, as the charts below show. In 2015/16, 19% of nurse joiners were of EU nationality, while in the year to September 2017 this fell to 9.6%. Meanwhile the percentage of nurse leavers with an EU nationality rose from 8.9% to 12.7%.
5 This data is taken from recently-published NHS Digital supplementary information, as well as the routine quarterly publication.
JOINERS BY NATIONALITY, ALL STAFF LEAVERS BY NATIONALITY, ALL STAFF
84.6% 83.8% 81.8% 80.4% 81.9% 82.1%
6.9% 8.4% 9.9% 10.9% 9.0% 8.4%
8.5% 7.8% 8.3% 8.7% 9.1% 9.5%
2012/13 2013/14 2014/15 2015/16 2016/17 Year toSep 2017
UK EU/EEA Other
87.0% 88.1% 86.8% 86.5% 86.1% 85.6%
4.8% 4.6% 5.8% 6.5% 7.5% 8.0%8.2% 7.2% 7.3% 7.0% 6.4% 6.4%
2012/13 2013/14 2014/15 2015/16 2016/17 Year toSep 2017
UK EU/EEA Other
JOINERS BY NATIONALITY, NURSES LEAVERS BY NATIONALITY, NURSES
83.8%78.8%
75.1% 73.4%78.5% 80.2%
7.9% 13.5% 17.9% 19.0% 12.4% 9.6%
8.3% 7.7% 6.9% 7.6% 9.0% 10.2%
2012/13 2013/14 2014/15 2015/16 2016/17 Year toSep 2017
UK EU/EEA Other
85.3% 85.9% 84.4% 82.9% 82.1% 81.1%
5.0% 5.0% 6.9% 8.9% 11.3% 12.7%9.7% 9.1% 8.8% 8.2% 6.5% 6.2%
2012/13 2013/14 2014/15 2015/16 2016/17 Year toSep 2017
UK EU/EEA Other
9 Commons Library Briefing, 7 February 2018
The percentage of leavers from the NHS with EU nationality has increased in most recent years. It is important to bear in mind that over this period, the percentage of all staff with EU nationality has risen. Because of this, some increase in the percentage of leavers who have EU nationality would also be expected over time. The reduction in joiners from the EU is, as a result, a more notable trend here.
Note that the number of leavers with unknown nationality is higher than the number of joiners with unknown nationality. As a result, any raw net change figures for particular nationalities may underestimate falls or overstate rises (depending on the trend).
1.4 Differences between English regions Data for English regions has been published up to June 2017. 87.6% of NHS staff report a non-British nationality across England as a whole – but this percentage varies substantially between English regions.6 In the North East of England, 95.2% of staff with a known nationality are British and 1.8% are from other EU countries. In North West London, 73.1% are British and 11.8% are from other EU countries. Outside of London, the percentage of staff with EU nationality is highest in Thames Valley (10.5%), Kent, Surrey & Sussex (8.1%), and the East of England (7.6%).
Just under one third of non-British NHS staff work in London, compared with 16% of all NHS staff with a known nationality. Similarly, just under one third of all NHS staff from other EU countries work in London.
The chart and table below show more information on variation between regions.
6 The regions used here are Health Education England Regions, which differ slightly from
the standard ‘Government Office Regions’.
NHS STAFF BY REGION AND NATIONALITY GROUP, JUNE 2017
91%
83%
83%
76%
73%
75%
95%
93%
90%
81%
87%
92%
93%
4%
8%
8%
11%
12%
11%
5%
10%
7%
6%
6%
6%
8%
6%
5%
4%
4%
5%
4%
5%
East Midlands
East of England
Kent, Surrey and Sussex
North Central and East London
North West London
South London
North East
North West
South West
Thames Valley
Wessex
West Midlands
Yorkshire and the Humber
UK EU Asia Africa Other
10 NHS staff from overseas
1.5 NHS Trusts The map on the following page shows estimates of the percentage of EU staff at each NHS trust as of April 2017. Note that some trusts have a substantial number of staff with unknown nationality, so comparisons between trusts should be made with some caution.
Region UK EU Asia Africa OtherEast Midlands 82,340 3,213 2,874 1,199 439East of England 79,738 7,253 6,140 1,985 782Kent, Surrey and Sussex 67,473 6,524 4,602 1,492 719North Central and East London 54,666 8,294 4,224 3,603 1,502North West London 33,779 5,460 3,600 1,986 1,374South London 44,057 6,560 3,798 3,125 1,433North East 67,856 1,285 1,558 418 146North West 168,895 5,579 5,286 1,618 618South West 76,716 4,522 2,233 810 513Thames Valley 23,677 3,071 1,426 776 361Wessex 47,911 3,734 2,173 602 338West Midlands 112,595 3,455 4,522 1,582 770Yorkshire and the Humber 110,272 3,045 3,067 1,378 418England 969,371 61,938 45,483 20,562 9,401
NHS STAFF BY REGION AND NATIONALITY GROUP, JUNE 2017
12 NHS staff from overseas
2. Doctors 74% of doctors in hospital and community health services (HCHS) are British. This is lower than other NHS staff categories.
12% (13,265) doctors report an Asian nationality, of which two-thirds are Indian or Pakistani.
10% (10,599) of doctors report an EU nationality other than British, with Irish people making up one-fifth of this number. Most are from countries that joined the EU before 2004.
There are 3,238 doctors with an African nationality. The highest ‘Other’ nationality is Australian, with 345.
These figures vary by English region, as the chart below shows (data for June 2017). However, the percentage of non-British doctors has the most uniform regional distribution of any staff category – there is relatively little difference between regions compared with the figures for nurses, which are presented in the next section.
Unlike in other categories, London does not have an above-average percentage of non-UK doctors. In the South West, 83% of doctors are British. In the East of England, 67% are British. North Central & East London has the highest percentage of EU doctors, at 14.4%. Irish and Greek doctors together account for two-fifths of that region’s EU doctors.
HOSPITAL DOCTORS BY NATIONALITY GROUP, JUNE 2017
70%
67%
74%
72%
74%
73%
76%
73%
83%
72%
80%
73%
75%
8%
11%
10%
14%
14%
14%
7%
8%
8%
11%
9%
8%
7%
16%
16%
11%
9%
8%
9%
12%
14%
6%
13%
8%
15%
13%
4%
4%
4%
East Midlands
East of England
Kent, Surrey and Sussex
North Central and East London
North West London
South London
North East
North West
South West
Thames Valley
Wessex
West Midlands
Yorkshire and the Humber
UK EU Asia Africa Other
British 81,376
Indian 6,413
Pakistani 2,330
Irish 2,143
Greek 1,678
Malaysian 1,548
Italian 1,007
Egyptian 1,005
German 919
Nigerian 829
Sri Lankan 755
Romanian 649
NATIONALITY OF DOCTORS, SEP 2017
74%
12%
10%
0%
50%
100%
UK AsiaEU AfricaOther
13 Commons Library Briefing, 7 February 2018
Data is also available on the country in which doctors gained their primary medical qualification. A summary breakdown is shown in the chart to the right. The percentage of doctors who gained their primary qualification in the UK (64%) is lower than the percentage who report British nationality (74%). This may be because people who qualified in another country have since become British citizens.
20% of doctors qualified in Asia. In total, almost 17,000 doctors qualified in India or Pakistan, while just under 9,000 now report either India or Pakistani nationality. 6% of doctors qualified in Africa, compared with 3% who now report an African nationality. Meanwhile, 9% of doctors qualified in another EU country, compared with 10% who now report an EU nationality.
The table below shows variation in country of qualification between region. There are three regions were over 40% of HCHS doctors qualified outside the UK: East of England (45%), West Midlands (43%) and East Midlands (42%). In these three regions, over a quarter of doctors qualified in Asia. In every region, at least one in five doctors qualified outside the UK.
HOSPITAL DOCTORS BY COUNTRY OF QUALIFICATION, JUNE 2017
58%
55%
62%
63%
66%
65%
67%
64%
79%
67%
75%
57%
65%
7%
10%
9%
12%
12%
12%
7%
7%
7%
9%
8%
7%
6%
26%
26%
20%
16%
13%
14%
19%
22%
9%
17%
11%
27%
22%
7%
7%
7%
5%
5%
5%
6%
6%
4%
4%
4%
7%
5%
East Midlands
East of England
Kent, Surrey and Sussex
North Central and East London
North West London
South London
North East
North West
South West
Thames Valley
Wessex
West Midlands
Yorkshire and the Humber
UK EU Asia Africa Other
Great Britain 72,074
India 12,390
Pakistan 4,443
Egypt 1,843
Nigeria 1,686
Greece 1,349
Ireland 1,273
Italy 1,042
South Africa 1,016
Iraq 992
Sri Lanka 952
Romania 947
DOCTORS: COUNTRY OF QUALIFICATION, SEP 2017
64%
20%
9%6%
0%
50%
100%
UK AsiaEU AfricaOther
14 NHS staff from overseas
Changes since 2009 There are now substantially fewer Indian doctors in England’s NHS than in 2009. In 2009, Indian doctors made up almost 12% of those with a known nationality – this has now fallen to 6%. There have also been reductions in doctors from other non-EU countries such as Zambia, Syria, Iran, Zimbabwe and South Africa.
The number of recorded Greek doctors has more than doubled. The number of Romanian doctors has increased from 174 to 649; Italians from 416 to 1,007; and Irish from 1,389 to 2,143.
In 2009, British doctors made up 70% of all those with a known nationality. That has risen to 74%.
3. Nurses 84% of nurses & health visitors in hospital and community health services (HCHS) are British.
7% (21,237) of nurses report an EU nationality other than British. Of these, 57% are either Irish, Spanish or Portuguese.
6% (17,448) of nurses report an Asian nationality. Of these, 91% are either Philippine or Indian.
There are 6,899 nurses with an African nationality. The highest ‘Other’ nationality is Jamaican, with 448.
These figures vary more between English regions than those for doctors, as the chart below shows (data for June 2017). In the North East, British nurses make up 96% of the total. In North West London, the figure is 66%. The proportion of nurses from other EU countries varies from 1.2% (North East) to 15.3% (South London). One-third of nurses from other EU countries work in London.
Note on changes over time: the number of staff with an ‘unknown’ nationality has fallen substantially, so some increases in individual nationalities may be due to improved information rather than new staff.
British 250,788
Philippine 9,544
Indian 6,313
Irish 4,580
Spanish 4,107
Portuguese 3,385
Italian 2,611
Zimbabwean 2,390
Romanian 1,708
Polish 1,372
Nigerian 1,250
Ghanaian 810
NATIONALITY OF NURSES & HEALTH VISITORS, SEP 2017
84%
7%6%
0%
50%
100%
UK EUAsia AfricaOther
15 Commons Library Briefing, 7 February 2018
Changes since 2009 There are now substantially fewer nurses from some nationalities than in 2009. There has been a reduction of over 1,400 Zimbabwean nurses (36% of the total). There have also been large reductions of nurses of Philippine, Indian and Nigerian nationality. There are estimated to be 53% fewer South African nurses, 46% fewer Malaysian nurses and 39% fewer Australian nurses than there were in 2009.
For several European nationalities there have been very large increases since 2009. The number of Portuguese nurses has risen from 210 to 3,388; the number of Italian nurses from 192 to 2,611, and the number of Spanish nurses from 406 to 4,107. However, all three of these nationalities saw a reduction in numbers between December 2016 and September 2017.
NURSES & HEALTH VISITORS BY NATIONALITY GROUP, JUNE 2017
90%
75%
77%
70%
66%
67%
96%
92%
88%
71%
83%
89%
92%
5%
11%
11%
15%
15%
15%
4%
7%
18%
10%
11%
8%
7%
11%
10%
4%
6%
6%
5%
6%
6%
6%
4%
East Midlands
East of England
Kent, Surrey and Sussex
North Central and East London
North West London
South London
North East
North West
South West
Thames Valley
Wessex
West Midlands
Yorkshire and the Humber
UK EU Asia Africa Other
16 NHS staff from overseas
4. Clinical support staff This category includes staff who are not professionally qualified – e.g. support to doctors and nurses, support staff for ambulances, support staff for scientific and therapeutic services, trainees, and healthcare assistants.
91% of support to clinical staff report a British nationality. 3.9% (13,336) are from other EU countries. Half of these are either Polish, Irish, Spanish or Portuguese.
2.8% (9,561) report an Asian nationality. 79% of these are either Philippine or Indian.
2.0% (6,67) report an African nationality.
As with the figures for nurses, there is substantial variation between regions. In London, around three-quarters of clinical support staff are British, while in the North East, 98% are British. In London North West, 8% of support staff are Asian and 10% are from other EU countries – the highest proportion of all regions in both categories. The highest proportion of African clinical support staff is found in South London, at 8%.
NHS CLINICAL SUPPORT STAFF BY NATIONALITY GROUP, JUNE 2017
95%
89%
87%
76%
74%
76%
98%
96%
93%
85%
91%
95%
97%
5%
6%
8%
10%
8%
4%
8%
5%
4%
5%
6%
8%
5%
4%
7%
6%
8%
East Midlands
East of England
Kent, Surrey and Sussex
North Central and East London
North West London
South London
North East
North West
South West
Thames Valley
Wessex
West Midlands
Yorkshire and the Humber
UK EU Asia Africa Other
British 309,307
Philippine 4,345
Polish 3,463
Indian 3,192
Nigerian 2,380
Irish 2,093
Portuguese 1,240
Italian 1,065
Spanish 1,026
Ghanaian 983
Romanian 935
Jamaican 861
NATIONALITY OF SUPPORT STAFF, SEP 2017
91%
0%
50%
100%
UK EUAsia AfricaOther
17 Commons Library Briefing, 7 February 2018
Changes since 2009 The number of Romanian clinical support staff rose from 108 to 935; Portuguese from 321 to 1,240; Nepalese from 177 to 590; and Polish from 1,232 to 3,463. The number of Indian and Philippine staff in this category also doubled, which is in contrast with the reductions in non-EU staff in the doctor and nurse categories.
5. Infrastructure support staff This category includes those working central functions, hotel, property & estates, managers, and senior managers. Note that these figures include only directly employed staff, not contracted-out posts.
92% of infrastructure support staff report a British nationality. 7,162 (4%) report another EU nationality. 44% of all EU infrastructure support staff are from Poland or Ireland.
1.9% (3,342) of infrastructure support staff report an Asian nationality. 62% of these are either Indian or Philippine. 1.3% (2,271) report an African nationality. 42% of these are either Nigerian or Ghanaian.
In each region of England, over four-fifths of infrastructure support staff are British. As in other categories, the North East has the highest proportion of British staff, at 98%. In North West London, 8% of infrastructure support staff are from other EU countries.
British 161,609
Polish 2,001
Indian 1,290
Irish 1,154
Portuguese 853
Philippine 758
Nigerian 619
Italian 498
Spanish 382
Ghanaian 331
Romanian 299
Jamaican 298
NATIONALITY OF INFRASTRUCTURE STAFF, SEP 2017
92%
0%
50%
100%
UK EUAsia AfricaOther
18 NHS staff from overseas
Changes since 2009 The number of Chinese infrastructure support staff has almost halved to 107. The number of Polish staff in this category increased from 1,113 to 2,002. Portuguese infrastructure support staff levels rose from 445 to 844.
6. GPs No data is collected on the nationality of GPs. However, NHS Digital publishes data on the country where GPs in England gained their primary medical qualification. Country of qualification is recorded for around 90% of GPs. This data is only recorded by broad country groups, so we do not know how many GPs qualified in specific countries.
As of September 2017, 78% of GPs with a known nationality qualified in the UK. This is higher than the equivalent for hospital doctors (section 2).
1,483 GPs (4.4%) qualified in EU or EEA countries. 4,560 GPs, 13.5% of the total, qualified in Asia. 1,116 GPs (3.3%) qualified in Africa, and 427 (1.3%) gained their primary qualification elsewhere.
In three regions (East of England, North West London and West Midlands), over a quarter of GPs qualified outside the UK. In Wessex and the South West, nine in ten GPs qualified in the UK.
NHS INFRASTRUCTURE SUPPORT STAFF BY NATIONALITY GROUP, JUNE 2017
95%
90%
86%
85%
83%
83%
98%
96%
91%
86%
90%
96%
95%
6%
8%
7%
8%
7%
5%
7%
5%
5%
5%
East Midlands
East of England
Kent, Surrey and Sussex
North Central and East London
North West London
South London
North East
North West
South West
Thames Valley
Wessex
West Midlands
Yorkshire and the Humber
UK EU Asia Africa Other
GPS: COUNTRY OF QUALIFICATION, SEP 2017
78%
4%13%
0%
50%
100%
UK EEA Asia
Africa Other
19 Commons Library Briefing, 7 February 2018
GPs BY COUNTRY OF QUALIFICATION, JUNE 2017
78%
71%
76%
77%
69%
78%
78%
75%
92%
81%
90%
73%
80%
3%
6%
5%
4%
6%
4%
4%
4%
4%
4%
4%
15%
15%
11%
13%
18%
10%
13%
15%
9%
4%
19%
13%
5%
5%
5%
3%
5%
East Midlands
East of England
Kent, Surrey and Sussex
North Central and East London
North West London
South London
North East
North West
South West
Thames Valley
Wessex
West Midlands
Yorkshire and the Humber
UK EU & EEA Asia Africa Other
BRIEFING PAPER Number 7783 7 February 2018
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