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The Covid-19 pandemic has put unprecedented pressures on the UK health and social care system. In response to the pandemic, the Government introduced measures to maximise the available workforce, which included increasing the number of staff from overseas. The Home Office have announced the extension of visas for some overseas health and social care staff. There have been calls for this to apply more widely to all overseas social care and non-medical NHS staff in recognition of their contribution during the pandemic. The pandemic, alongside the introduction of the new points-based immigration system from 1 January 2021 are likely to impact on longer term plans to tackle workforce shortages in health and social care.

Implications for overseas recruitment

The health and social care workforce increased by 446,000 between 2009/10 and 2018/19, and workers born overseas accounted for nearly 50% of the increase. However there continue to be well-documented workforce shortages in health and social care.

A key component of NHS workforce planning is to further increase international recruitment. In the longer term the Covid-19 pandemic and corresponding lockdown could have implications for the ability of the Government to meet its NHS pledges to boost the numbers of nurses and GPs.

Social care has increasingly relied on international recruitment to fill vacancies. The Nursing and Midwifery Council (NMC) have raised concerns that a likely impact of the Covid-19 pandemic will be to reduce opportunities for international recruitment, and “the reliance of social care on overseas nurses may place the sector in greater jeopardy”.

The introduction of the new points-based immigration system from 1 January 2021 also has implications for the health and social care sector. A ‘Health and Care visa’ has been introduced for healthcare workers, but there is no dedicated entry route for social care workers.

Ethical recruitment

The UK was the first country to implement a Code of Practice for the international recruitment of healthcare professionals. All healthcare organisations and agencies recruiting internationally are “strongly advised” to adhere to the code.

One of the key principles underpinning the code is that developing countries will not be actively targeted for recruitment. As the Covid-19 pandemic stretches healthcare services around the world, with especially acute pressures in low- and middle-income countries, it is likely this will have implications for considerations around future recruitment.

Measures to boost numbers of overseas staff during the pandemic

The Coronavirus Act 2020 included provisions for the emergency registration of health and care professionals across the UK, including overseas applicants. For example, nurses and midwives who had completed all parts of their Nursing and Midwifery Council (NMC) registration process aside from the final clinical examination were invited to join the Covid-19 temporary register.

A new medical support worker role was announced by NHS England, which was described by the British Medical Association as “suitable for those who do not yet have General Medical Council registration, for example, international medical graduates or refugee doctors currently living in the UK.”

Visa extensions and exemption from the Immigration Health Surcharge

The Government announced that visas of doctors, nurses and paramedics due to expire before 1 October 2020 would be automatically extended for one year. The Home Office announced that no fee would apply to the extension and there would also be an exemption from the Immigration Health Surcharge. The Government later announced the visa extensions would be granted to a wider range of health service staff and will apply to visas due to expire before 31 March 2021.The Home Affairs Select Committee have pushed for the visa extension to also be given to care workers and lower paid NHS staff.

Calls for all NHS workers to be exempt from paying the Immigration Health Surcharge intensified during the pandemic, and it was announced on 21 May 2020 that the charge would be abolished for all overseas health and care workers. It has since been announced that healthcare workers eligible for the new ‘Health and Care visa’ are exempt from the charge, whilst other healthcare workers are eligible for reimbursement on a 6-monthly basis.

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