Brexit challenges faced by migrant nurses in the NHS

03 September 2019


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A new report has found that since the EU referendum in 2016 overseas nurses are experiencing higher levels of discrimination and are more likely to consider leaving the NHS.

This is one of the main findings of a report written by University of Nottingham academics, Dr Georgia Spiliopoulos and Professor Stephen Timmons, who conducted in-depth interviews with both EU and non-EU nursing staff. Their report focuses on the problems confronting migrant nurses during the ongoing Brexit negotiations and makes policy recommendations. 

One of the most frequent complaints was the increase in racist incidents, since Brexit, from colleagues in the NHS and their local communities. The nurses said they felt supported by hospital senior staff with appropriate regulations in place. However, there were differences in practice between NHS Trusts and hospital wards.

"The referendum result has been interpreted, by the EU and non-EU NHS nurses interviewed, as a signal that migrants are not welcome in the UK and they were considering migrating elsewhere," said Dr Georgia Spiliopoulos from the University’s Centre for Health Innovation, Leadership and Learning. "Our findings have serious implications for patient care. There is already a shortage of nurses with an estimated 36,000 nursing vacancies."

Theodora*, is a Greek nurse who works in a hospital in the south-west of England. She told the researchers: “After the referendum the situation has changed. I don’t quite feel settled. I had racist attitudes from a patient’s husband. When I was giving his wife her medication he told me to go back to the country I came from. I said to him: 'I can’t go because I have to take care of patients in the NHS'. He calmed down. The hospital has written to us to say if anything happens we must report it. We feel protected in theory but there is still an attitude. You can still feel something wrong in the air.”

Limited career opportunities and bias, from senior staff and management towards promotion, was another obstacle faced by non-British nurses. Delays in recognising their overseas qualifications or experience and inconsistencies between NHS Trusts, in the length of contracts and benefits offered to non-British nurses, were also cited as reasons not to stay.

The departure of EU nurses has had a impact on the daily lives of the migrant nurses who felt they had less emotional support. Theresa*, a Spanish nurse working in the NHS, said she was considering migrating again: “If I am not happy with the job, with no supportive circle of friends, I have no reason to stay here. At this point I am also thinking of migrating to other countries.”

Nurses also reported having to work harder and taking on additional responsibilities with no extra pay.  Low staffing levels have been linked to poorer outcomes for patient care and a higher risk of hospital deaths.  

Drawing upon their findings, the report has made a number of recommendations to support the NHS in keeping migrant nurses and recruiting more to make up for the shortfall. They include:

  • NHS needs to continue to protect staff from discrimination not only from their co-workers and the public but from management
  • NHS Trusts need to increase their collaboration to support newly hired staff and improve consistency between trusts in offering visas for more than two years
  • Hospital management needs to value previous nursing experience of nursing staff

Dr Spiliopoulus added: “Pastoral care and support for career development are important. If these measures are not implemented we will see even fewer nurses in our hospitals. NHS Trusts need to do more to tackle these issues by working more closely and sharing best practice."

The findings were discussed by Dr Spiliopoulos at the European Sociological Association conference on 21 August.

The full report can be found here

*Names have been changed