Liverpool, 14 May — The Royal College of Nursing (RCN) has warned that the UK government’s new immigration policies could worsen an already critical staffing crisis in the NHS and social care, as tens of thousands of internationally educated nursing professionals consider leaving the country.
Speaking on the third day of the RCN’s annual conference in Liverpool, the union described the government’s immigration approach as a “hostile environment on steroids” that threatens to inflict significant damage on essential public services.
The warning follows the release of a new RCN report, Unreciprocated Care: Why Internationally Educated Nursing Staff Are Leaving the UK, based on a survey of more than 3,000 migrant nursing staff, including care workers, nursing support staff, and registered nurses. The findings reveal that 42% of respondents are already planning to leave the UK, with two-thirds of those intending to migrate to countries other than their home nations. When asked what might influence their decision to stay, 70% cited salary and 40% pointed to immigration policy.
The report comes amid government plans to shut down the care worker visa route and implement more restrictive immigration measures. Currently, migrant workers in social care and the NHS cannot access public funds until they achieve indefinite leave to remain — a process that takes at least five years under existing rules. The government has proposed doubling this qualifying period to 10 years, further limiting access to essential support. The policy has reportedly left some migrant workers reliant on food banks and charity assistance, with one nurse revealing they were forced to send their infant child back to their home country due to financial hardship.
In contrast, countries such as Canada and New Zealand offer permanent residency upon arrival for healthcare workers, along with more competitive pay and quicker pathways to settlement.
At the conference, RCN General Secretary and Chief Executive Professor Nicola Ranger criticized the proposed visa changes, warning of a mass departure of migrant staff without a viable plan to strengthen the domestic workforce. She urged the government to abolish the “no recourse to public funds” (NRPF) rule and grant immediate indefinite leave to remain for internationally educated nursing staff.
“The government’s cruel measures could accelerate an exodus, doing great damage to key services,” Ranger said. “Rather than pandering and scapegoating, ministers should focus on what patients and vulnerable people need – safely staffed services.”
According to the RCN, up to 55,000 migrant nursing staff may be considering leaving the UK. That figure excludes care workers, meaning the actual number could be significantly higher as others cancel plans to migrate or reconsider their futures.
Workforce shortages remain acute across the sector. NHS services currently face more than 34,000 unfilled registered nurse posts across the UK, while England’s care sector alone is grappling with approximately 131,000 vacancies.
The report also highlights widespread experiences of discrimination. Sixty-four percent of respondents reported facing some form of discrimination since moving to the UK.
Nurses shared deeply personal accounts in the report, shedding light on the toll of financial pressures, systemic racism, and a lack of support:
A nurse from India said: “My salary has not increased as quickly as my house rent and council tax… sometimes, I struggle to pay the bills and couldn’t afford even the basic food items by the end of each month.”
A nurse from Trinidad and Tobago described “systemic racism and bullying in the workplace,” noting that migrant staff were often expected to endure abuse.
A Kenyan nurse recounted having to rely on charities for food and clothing and sending their baby back home due to unaffordable childcare.
A nurse from the Philippines, despite expressing love for the UK and their job, said: “It’s too tiring to defend this country when it’s not reciprocating the care and support that we as immigrants deserve.”
The RCN is calling for immediate action to retain and support internationally educated nursing staff, warning that without meaningful change, essential health and care services will continue to deteriorate.
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