International recruitment in the NHS workforce

This briefing is part of a series of briefings on the NHS workforce.

The NHS has many staffing vacancies that it struggles to fill. In December 2025, around 6.7% of roles in the workforce were vacant (100,000 full-time equivalent posts). Although the NHS workforce has been growing, demand for NHS services has been growing faster. People have increasingly complex health needs and the NHS has not been able recruit and retain sufficient staff to meet growing demand.

Over the years, the NHS has increasingly relied on international recruitment to fill vacancies. The benefits of international recruitment are that vacancies can be filled more quickly and cheaply than through training new medical staff in the UK. But some argue this has led to international recruitment being regarded as a “quick fix” to fill rising vacancies. In the past few years, there have been concerns about:

• the exploitation of international care staff and how international workers in the NHS are treated
• the sustainability of the international workforce
• recruitment from red list countries
• international recruits competing with UK medical graduates for a limited number of speciality training places

The government has responded by introducing immigration changes (to address exploitation), reinforcing its commitment to the code of practice (to address ethical questions about recruitment from red list countries) and introducing a bill to prioritise UK medical graduates when assigning training places. The government has also committed to reducing international recruitment in the longer term, from 34% today to less than 10% by 2035.

Who makes decisions about international NHS recruitment?

There are various different stakeholders involved in recruiting overseas healthcare professionals.

To work in the UK, healthcare professionals must register with the regulator for their profession (for example, doctors must register with the General Medical Council). Registering with a professional regulator involves taking a test of competence and demonstrating English language ability, although each regulator has its own process. Regulators decide on required processes and thresholds for registration.

At a local level, NHS employers are responsible for ensuring they have the workforce they need. This can include making decisions about the recruitment of internationally educated healthcare professionals.

Nationally, the government sets policies that can influence overseas recruitment, such as visa requirements, regulatory reforms or requirements for UK regulators to recognise certain qualifications. For example, the EU Exit Regulations ensure that UK regulators continue to automatically recognise relevant European Union, European Economic Area and Swiss healthcare qualifications as they did before the UK left the EU.

Numbers and trends

Most NHS staff in England are British, but around 21% are not (325,000 in June 2025). The Commons Library briefing on NHS staff from overseas: statistics examines trends in staff from overseas.

According to the General Medical Council’s state of medical education and practice in the UK workforce report 2025, there are approximately 138,400 licensed doctors who qualified abroad working in the UK, making up 42% of the total. Since 2015 (excluding the pandemic), there has been a year-on-year increase in international medical graduates joining the UK workforce. The 2024 increase was the smallest observed over the past decade: around 19,600 internationally trained doctors joined the register in 2023 (68% of joiners), and around 20,100 joined in 2024 (66% of joiners).

As of September 2025, around 209,800 (24% ) of nurses (PDF), midwives, nurses and nursing associates on the Nursing and Midwifery Council register trained overseas. In its latest recruitment data, the Nursing and Midwifery Council reported a slowdown in international recruitment, which it said slowed the overall growth of the UK register. Between April to September 2025, around 6,320 overseas trained nurses, midwives, nurses and nursing associates joined the register (31% of joiners). This is a 50% drop compared with the approximately 12,500 who joined between April and September 2024 (46% of joiners).

The number of people on the Nursing and Midwifery Council register or the General Medical Council register reflects the total number of staff who can work in the UK. However, it does not necessarily reflect the availability of staff for the NHS because registrants may not be practising or may be employed in the private sector.

Policy to address concerns with international recruitment in the NHS

The government introduced the Medical Training (Prioritisation) Bill on 13 January 2026. The bill was fast-tracked through Parliament and received Royal Assent on 5 March 2026 to become the Medical Training (Prioritisation) Act 2026. The act introduces a system that prioritises medical training places (for foundation and specialty training) for graduates of UK medical schools in the UK and certain other groups. The government has said the act implements its commitment to prioritise UK medical graduates for training in the 10 Year Health Plan for England.

In July 2025, the government removed care workers and senior care workers from the Health and Care Worker visa route for new overseas recruits. The government said these changes were to reduce abuse and exploitation of overseas care workers.