Migration Advisory Committee (MAC) report on nursing shortage


On 15 October 2015, the government commissioned the MAC to review whether there is a shortage of nurses or specific nursing job titles which would be sensible to fill through non-EEA migration. Nurses were placed on the shortage occupation list on a temporary basis pending the MAC’s review of the evidence and subsequent advice.

See the full press release and report below

The Migration Advisory Committee (MAC) has reluctantly recommended that nurses remain on the Government’s shortage occupation list (SOL) – while criticising the health sector for failing to maintain a sufficient supply of UK nurses.

In its latest report, Partial Review of the Shortage Occupation List: Review of nursing, published today the Committee says the current shortage of nurses is mostly down to factors which could, and should, have been anticipated by the health, care and independent sectors. Many of these issues – including an ageing population, problems with staff training, pay and recruitment – have been compounded by the squeeze on NHS budgets, according to the MAC.


The Committee says it is sensible to allow health sector employers continued access to the SOL due to the lack of another short term solution. Department of Health evidence to the MAC suggested it will be another three years before there are enough UK-born nurses to meet demand. The MAC was commissioned by the Government to review whether there is a shortage of nurses or specific nursing job titles which it would be sensible to fill through non-EEA migration. Although the MAC were told there was no shortage of nurses a year ago, nurses were added to the shortage occupation list on an interim basis in October 2015 to ensure there were safe staffing levels across the NHS over the winter period.


Placing much of the blame for current nursing shortages on the sector itself, Professor Sir David Metcalf CBE, Chair of the MAC, said: “We have reluctantly made this recommendation. However, there is no good reason why the supply of nurses cannot be sourced domestically. There seems to be an automatic presumption that non-EEA skilled migration provides the health and care sector with a ‘Get out of Jail Free’ card. “The long term solution to addressing this shortage is recruiting and retaining staff by providing sufficient incentive and opportunity.”

The MAC had previously found that, on average, migrant nurses are being paid £6,000 less than equivalent UK workers. In its review, the Committee found evidence suggesting employers are using non-EEA nurses to save money rather than address the shortage through other means. The MAC also found:  The current shortage of nurses in England is closely linked to the decision to cut training places in England by almost a fifth between 2009 and 2013. 


Poor workforce planning remains a problem and until recently it did not take into account the demand for nurses in the care and independent sectors.  Continued financial pressures on NHS budgets, including ongoing pay restraint for nurses, have played a key role and may have incentivised healthcare employers to recruit migrant nurses at lower cost. The Committee is concerned that retaining nurses on the list could lead to nurses taking a significant amount of the certificates of sponsorship available under the Tier 2 limit, to the detriment of other employers who also require skilled non-EEA workers.

The Government has committed to an overall cap of 20,700 per year. The MAC therefore suggests a maximum annual cap of 5,000 places for nurses under Tier 2, with the limit reducing gradually over the next three years. The MAC also suggests an employer wishing to recruit a non-EEA nurse should be required to complete a resident labour market test – to ease concerns that employers are recruiting from outside the EEA to undercut the pay of UK nurses.

See Report here


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