• 02 July 2019
  • 5 min read

Will the MAC's changes to the Shortage Occupation List be enough to save the NHS?

  • Nurses news
    Nurses.co.uk editorial team

MAC, the Migration Advisory Committee, released a report on the UK Shortage Occupation List. Find out what it means for you and for nursing.

In May 2019, the Migration Advisory Committee (MAC) conducted a full review of the UK Shortage Occupation List (SOL).

The SOL contains skilled and specialist occupations that are difficult to fill with UK-based professionals alone, allowing employers to recruit overseas candidates from outside of the European Economic Area (EEA).

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They, in turn, are not subjected to the stringent level of visa restrictions and costs that they would be faced with if applying for a role that does not appear on the SOL.

If the report’s recommendations are implemented by the government, this could be the first step towards easing staff shortages across the health sector because it strongly advises the extension of roles currently listed on the SOL that come under the ‘medical practitioner’ and ‘nursing’ categories.

But how will this affect the recruitment and retention of non-British nurses, and would this be sufficient in a post-Brexit Britain if the free movement of EU citizens ends?

Visa Implications for non-EEA citizens

As it stands, non-EU citizens who wish to work in the UK must fulfil Tier 2 visa requirements, meet a minimum salary threshold of £30,000 and have a confirmed job offer from a UK employer who has a Sponsor Licence.

If more nursing occupations were added to the SOL, however, they would have more realistic salary thresholds based on UK averages.

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Given the fact that an average UK nurse’s salary in £23,000, relaxing this boundary would be hugely advantageous for the NHS and healthcare sector’s recruitment needs.

If the government was to adopt the recommendations put forward by the MAC, it would mean that non-EU nurses would no longer be restricted by many of the Tier 2 Visa requirements.

They would still have to apply for a Work Visa, but this would be a much less costly and complex process than usual.

A Tier 2 Visa usually costs £610 per application, plus an additional £610 for each Dependent Visa (a visa for a child or spouse).

Whereas, if an occupation is listed on the SOL, the cost of applying under the Tier 2 category is only £464, with the same amount payable for children and spouses.

Last year, the Tier 2 visa cap, which came under fire because it cut the UK off from thousands of necessary, highly-skilled migrant doctors, was removed for both medical practitioners and nurses.

This means that migrant doctors and nurses have unlimited access to the UK job market, if they apply through the accepted Tier 2 Work Visa route.

Removing the Tier 2 visa cap for overseas doctors and nurses is undoubtedly beneficial for the UK’s understaffed NHS and healthcare sector, and according to Home Secretary Sajid Javid, this was a necessary step because, “doctors and nurses play a vital role in society and at this time we need more in the UK. That is why I have reviewed our skilled worker visa route.”

The impact on medical professionals from EU countries

According to a House of Commons Briefing Paper dated 10th October 2018, the NHS has 63,000 members staff who are EU nationals (5.6% of the total workforce), a third of which work in the London area, and 7% of all NHS nurses are EU citizens.

The Briefing Paper notes that in 2015-16, the percentage of EU nurses joining the NHS was 19%, which dropped to 12.4% in the year following the 2016 EU referendum and fell further still in 2017-18 to 7.9%.

The drop in EU nurses gaining employment in the NHS is mirrored by a rise in those leaving, which has increased from 9% in 2015-16 to 13% in 2017-18.

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This worrying trend is examined further in research conducted by the National Institute of Economic and Social Research (NIESR), which predicted the potential loss of another 5,000-10,000 EU nurses from the NHS by the end of the Brexit transition period in 2021.

Whilst the MAC’s recommendations are good news for non-EEA healthcare practitioners who wish to work in the UK, what does this mean for European medical professionals?

If an end to free movement is implemented post-Brexit, EU citizens who wish to work in the UK would be subjected to the same visa requirements as non-EEA professionals.

Changes to the SOL would make it easier for EU nurses to apply for a UK work visa after Brexit, but relaxing the eligibility criteria and salary threshold is unlikely to attract EU nurses to the UK or encourage those currently working in the NHS to stay, when they could work within the healthcare sector of another EU country without the cost or inconvenience of having to apply for a visa at all.   

It is clear that increasing the amount of nursing occupations on the SOL is a step in the right direction in terms of ensuring more overseas medical professionals would be eligible to work in the UK and provide the UK healthcare sector with much-needed staff.

Much more needs to be done, however, to counteract the loss of EU nurses and other healthcare practitioners due to the uncertainty of Brexit, in order to prevent the further depletion of an already overstretched NHS.

  • Nurses news
    Nurses.co.uk editorial team

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  • Nurses news
    Nurses.co.uk editorial team

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