Young, Ruth; Noble , Jenny; Mahon, Ann; Maxted, Mairead; Grant , Janet and Sibbald, Bonnie
Evaluation of international recruitment of health professionals in England.
Journal of Health Services Research & Policy, 15(4) pp. 195–203.
Objectives: To explore whether a period of intensive international recruitment by the English National Health
Service (NHS) achieved its objectives of boosting workforce numbers and to set this against the wider costs,
longer-term challenges and questions arising.
Methods: A postal survey of all pre-2006 NHS providers, Strategic Health Authorities and Deans of
Postgraduate Medical Education obtained information on 284 (45%) organizations (142 completed questionnaires). Eight subsequent case studies (74 interviews) covered medical consultant, general practitioner, nurse, midwife and allied health professional recruitment.
Results: Most respondents had undertaken or facilitated international recruitment between 2001 and 2006 and believed that it had enabled them to address immediate staff shortages. Views on longer-term implications, such
as recruit retention, were more equivocal. Most organizations had made only a limited value-for-money
assessment, balancing direct expenditure on overseas recruitment against savings on temporary staff. Other short and long-term transaction and opportunity costs arose from pressures on existing staff, time spent on induction/pastoral support, and human resource management and workforce planning challenges. Though recognized, these extensive ‘hidden costs’ for NHS organizations were harder to assess as were the implications for source countries and migrant staff.
Conclusions: The main achievement of the intensive international recruitment period from a UK viewpoint
was that such a major undertaking was seen through without major disruption to NHS services. The wider
costs and challenges meant, however, that large-scale international recruitment was not sustainable as a
solution to workforce shortages. Should such approaches
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