England’s NHS is facing a workforce crisis amid a plummeting rate of UK doctors joining the service, medical experts have warned.

The findings come after analysis of NHS Digital workforce data by BBC Shared Data Unit show that the share of UK homegrown doctors and nurses joining the service reached a record low over the past seven years, meaning recruiters were increasingly eyeing up overseas candidates.  

While the government said doctor numbers were at record high with 34 percent rise since 2010, critics said the level of domestic recruitment was unsustainable to match demand.  

British Medical Association’s Dr Amit Kochhar said: “The NHS is facing a workforce crisis and since well before the pandemic has struggled to recruit and retain staff. As of December 2021, more than 110,000 posts in secondary care are vacant, almost 8,200 of which are medical posts.

“High vacancies create a vicious cycle: shortages produce environments of chronic stress, which increases pressure on existing staff, and in turn encourages higher turnover and absence.”

The NHS has always been reliant on the expertise of international medical graduates, and has become more so during the past few years, he said.

Patricia Marquis, Royal College of Nursing (RCN) Director for England, said: “The number of unfilled nursing posts in the NHS is unsustainable. Every vacant role makes safe patient care harder to maintain.

“We are seeing a sharp increase in people leaving nursing, with 25,000 leaving the UK register in the last year.

"After a decade of real terms pay cuts, a growing over reliance on international recruitment and limits on education funding, our members are saying enough is enough.

"Those working in the NHS in England and Wales will have their say in a ballot on industrial action over pay. Ministers must begin to listen.”

Figures show 58 percent of doctors joining the health service in 2021 were UK nationals, down from 69 percent in 2015.

The share of UK nurses joining NHS England dropped from 74 percent in 2015 to 61 percent in 2021.  

In terms of overseas recruitment, the share of doctors joining from the Rest of the Word grew from 18 percent in 2015 to 34 percent last year. For nurses, the share grew from 7 percent in 2015 to 34 percent in 2021 from overseas.

The Department of Health and Social Care responded to the findings: “The workforce varies based on many factors on both local, national, and international basis.

"Changes between 2015 and 2021 that may have impacted this include more rigorous language tests introduced by the Nursing and Midwifery Council (NMC) around the time of the referendum, which DHSC supports as an important patient safety measure, and the economic recovery of southern European countries.

“Many nurses from these countries had come to the UK to work when there was limited work available at home.

“Following the [EU Exit] referendum, the Prime Minister made it clear that EU staff in the health and care sector were welcome and encouraged them to stay.

"Steps were taken to ensure existing EU staff were able to remain in the UK post-EU Exit. For example, the government launched the EU Settlement Scheme and enabled NHS Employers to provide support for EU staff throughout the transition period.”

What’s the trend like in Buckinghamshire?

At Buckinghamshire Healthcare Trust, the share of UK staff joining the trust dropped by 12.9 percent between 2015 and 2021.

For share of staff joining from the EU, the trust saw 7.2 percent drop over the same period.

Meanwhile, the share of staff recruited from the Rest of the World grew by 20.1 percent between 2015 and 2021.

The local figures signal a similar trend as across NHS England as a whole. 

View the year on year percentage change in share of staff by nationality joining Buckinghamshire Healthcare Trust using the tool: 


Click on the chart to recap on the changes in the share of doctors and nurses working for the NHS England as a whole: