How many NHS staff are foreign nationals?

Most NHS staff in England are British, but around 19% are not. Around 265,000 out of 1.5 million staff reported a non-British nationality in June 2023, up from 220,000 a year earlier This amounts to nearly one in five of NHS staff with a known nationality.

Between them, these staff hold over 200 different nationalities. 122,000 are Asian nationals (8.6%), while Over 70,000 are EU nationals (5.2%).

Of every 1,000 NHS staff in England…	 	…813 are British 	…86 are Asian 	…52 are from the EU 	…38 are African 	…10 are from somewhere else

Most common nationalities of NHS staff, June 2023						 						 	British/UK	1,151,394			Pakistani	7,082 	Indian	60,533			Ghanaian	6,134 	Filipino	34,652			Romanian	6,018 	Nigerian	22,851			Zimbabwean	5,917 	Irish	13,711			Spanish	5,114 	Polish	11,606			Egyptian	4,148 	Portuguese	8,339			Nepalese	3,562 	Italian	7,302			Greek	3,469

Source: NHS Digital, NHS Workforce Statistics June 2023, HCHS staff in post summary tables

The NHS records self-reported nationality, which may sometimes reflect a person’s cultural heritage rather than their citizenship or country of birth, and isn’t necessarily a measure of immigration. For 2% of NHS workers, nationality is unknown. The percentages here exclude staff whose nationality is unknown. This data doesn’t cover those working in social care or in the independent sector, or staff not directly employed by the NHS.

The proportion of NHS staff with Asian and African nationalities has risen in recent years

The proportion of NHS staff reporting an Asian nationality has risen from 4.0% in 2016 to 8.6% in June 2023. Reported African nationality has risen from 1.8% to 3.8% since 2016.

Reported EU nationality rose from 2.9% in 2009 to a high of 5.6% in 2017. Since then it has gradually fallen and was 5.2% in June 2023.

Line chart showing trends in the percentage of NHS staff in different nationality groups since 2009

Source: NHS Digital, NHS Workforce Statistics June 2023, HCHS staff in post summary tables

London has the highest proportion of NHS staff with non-UK nationality

30% of NHS staff in London report a nationality other than British – higher than any other NHS region. The lowest percentage of non-British staff is in the North East and Yorkshire, at 11%.

The proportion of non-UK staff is higher for doctors (35%) and nurses (28%) than for staff overall (19%).

Bar chart showing the percentage of NHS staff by nationality group and region

Source: NHS Digital, Supplementary information on NHS staff by nationality and region (see downloadable files for data)

Has the number of EU staff in the NHS changed since the 2016 referendum?

Because coverage of NHS nationality data has improved over time, comparisons of nationality in the NHS over time should be made only with caution. In June 2016 there were 89,548 with an unknown nationality. As of June 2023 this had fallen to 29,659 – a fall of two thirds – while the total number of staff employed by the NHS has increased.

This means that some apparent increases in staff numbers for nationalities and nationality groups are likely to be due to improved data coverage rather than genuine increases. In other words: because a higher proportion of NHS staff now have a recorded nationality, increases in the recorded number of staff with a given nationality would be expected even if there were no genuine changes in the actual number of staff with that nationality.

In June 2016 there were 58,702 NHS staff with a recorded EU nationality, and in June 2023 there were 74,142 – an apparent rise. But to present this as the full story would be misleading, because there are around 60,000 more staff for whom nationality is known now than in 2016. It is very likely that there has been an overall increase in the number of NHS staff with EU nationality since 2016, but we can’t be sure about the scale of the change, and it would be misleading to calculate an increase based solely on the two numbers above.

Claims about changes in the number of EU staff (or other nationality groups) which don’t mention the importance of staff with unknown nationality should be regarded with due scepticism.

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