Workforce planning

This is a massive failure of workforce planning. Despite the clear need, hundreds of doctors coming through UK medical schools and IMGs already practising in the NHS are being denied opportunities because of underfunding by successive governments, which have failed to increase the numbers of specialty training places. Dr Matt Kneale, DAUK committee member and former chair, said: “We recognise that there are real issues with specialty training places that need nuanced solutions that are both pragmatic and lawful. “It’s difficult to justify leaving UK-trained doctors unemployed while training numbers remain static. “These graduates could be contributing to the NHS workforce rather than being underutilised, especially given the public investment in their education. “It’s also worth questioning the fairness of continuing to recruit IMGs through costly PLAB exams when many face limited prospects of NHS employment.

International medical graduates

“This risks setting unrealistic expectations and could leave some IMGs feeling misled about their opportunities.” Dr Pushpo Hossain, DAUK’s IMG lead, said: “As an IMG myself, I had more than two-and-a-half years of NHS experience before applying for training jobs. “If an IMG has worked in the NHS for two years, they should be able to apply for training posts under the same criteria as a UK graduate. “This would strike a fair balance and recognise their experience within the NHS.” Tax payers’ money is increasingly being spent pushing non-doctor roles, such as physician associates, despite concerns over their training, scope of practice, and patient safety.

Non-doctor roles

The expansion of non-doctor roles is another factor impacting resident doctors and IMGs and limiting their opportunities. Patients want to see a doctor, and patient outcomes are significantly improved when they do. Dr Ellen Welch, DAUK vice-chair, added: “We need to look at why doctors are out of work, while rotas are understaffed and waiting lists still stretch into the millions. “We need our government to fund job opportunities for both UK and international graduate doctors instead of paying less qualified non-doctors to cover doctor roles.” Please support our work by contributing to our crowd funder or by becoming a member.

NHS Employers has published an FAQ in response to the changes to the immigration system announced by the Government.

A DAUK spokesperson said the changes caused “confusion, concern and heartache” among NHS staff and their families when they were announced by Home Secretary James Cleverly.

The spokesperson said the announcement was lacking in important detail and the language being used around the policy change has impacted international medical graduates (IMGs) already living and working in the UK, and those thinking of coming here.

In the announcement, the Government said it would “tighten the Health and Care Worker visa, which has seen a significant number of visas granted to care workers and their dependants, by preventing overseas care workers from bringing their dependants to the UK”.

NHS Employers said that these changes will only affect the care sector and not the NHS.

The Government also announced an increase in the minimum salary required for skilled workers from overseas – from £26,200 to £38,700 – and the more than doubling of income required for family visas – from £18,600 to £38,700.

These increases in salary thresholds do not apply to the Health and Care Visa route, NHS Employers said.

It also said that Health and Care Visa holders will continue to be exempt from paying the Immigrational Health Surcharge (IHS).

Read the NHS Employers changes to the UK immigration policy FAQs.

The DAUK spokesperson said: “We’re grateful for NHS Employers for clarifying many of the issues around the Government’s new immigration policy and what it will mean for people working in the NHS on a Health and Care Worker Visa.

“The Home Secretary’s announcement lacked important details about what it would mean for them and caused a lot of confusion, concern, and heartache.

“There’s no doubt that the language being used and that lack of information has had an impact on IMGs already living here and working in the NHS, and it’s bound to make people think twice about coming here in the future. 

“This at a time when there’s a staffing crisis in the NHS. There are thousands of vacant healthcare roles, and waiting lists continue to grow.

“We’re neither training enough staff nor retaining enough staff and our international colleagues are delivering vital care to people who need it.

“Without them things would be a lot worse.”

Home Secretary James Cleverly has announced:

• A ban on health and care workers bringing family dependants to the UK
• A hike in the minimum salary required for skilled workers from overseas from £26,200 to £38,700 from spring
• More than doubling the minimum income required for family visas from £18,600 to £38,700 from spring
• The scrapping of the shortage occupation list and employers being able to pay workers 20% below the going rate for jobs 
• A review of the graduate immigration route by the Migration Advisory Committee.

Dr Pushpo Hossain, DAUK’s international medical graduate (IMG) lead, said: “We have a huge number of vacancies in our National Health Service and immigration is delivering vital care to people who need it.

“The plans announced by the Government are cruel and inhumane and will only make the staffing crisis in the NHS even worse.

“We’re not training enough healthcare staff as it is, and we’re not retaining enough either with UK-trained staff already leaving in their droves because of pay and working conditions.

“This announcement will make it even harder for the migration of health workers to the UK, decimating recruitment and placing an even greater strain on the NHS.

“The current pay scale for many doctors and nurses wouldn’t meet the minimum salary threshold. Why would anyone work in a system that’s underpaid, understaffed and overstretched and accept they won’t be able to bring their families to be with them and to help them decompress at the end of a gruelling shift?

“It will also destroy family lives, causing misery for many people working in the NHS and could force them to leave.

“It will not only affect healthcare workers who were planning to come to the UK, but also the morale of IMGs, like myself, who feel targeted by inflammatory statements towards International healthcare professionals from this Government.”

“In short, the essence of the plan is a systematic destruction of the NHS.”