WESolutions
Recruitment is at the heart of WEsolutions’ approach to healthcare staffing. With the ongoing nurse shortages in the UK, understanding the true cost and benefit of recruiting nurses globally vs locally is vital, not just in financial terms, but in delivering quality care, shaping workforce stability, and ultimately ensuring a robust health service.
In this blog, we explore:
- The costs of recruiting nurses locally
- The benefits of recruiting nurses locally
- The costs of recruiting nurses globally
- The benefits of recruiting nurses globally
- Cost comparison insights from current healthcare reports
The Costs of Recruiting Nurses Locally feedback
When employers try to fill nursing positions domestically, several factors contribute to the overall expense:
- Training and Education Investment
Training a nurse via a university can cost the NHS approximately £37,000, including seat fees and support. Apprenticeships may demand far more, in the region of £140,000 per nurse, especially when considering the full training pipeline (Nuffield Trust). While once committed, UK-trained nurses may stay longer, the initial outlay is substantial. - Recruitment and Onboarding Expenses
Hiring locally still incurs costs, job adverts, interviews, induction programmes, and support during the early months. While they do not match overseas recruitment in complexity, these still add up, especially in high-turnover roles. - Agency Reliance in the Short Term
When local recruitment cannot keep pace with demand, NHS trusts resort to agency staff. Between 2020 and 2022, the NHS spent approximately £3.2 billion on agency nurses, funds that could have paid the salaries of nearly 31,000 permanent Band 5 nurses (The Royal College of Nursing).
To put numbers on it, trusts spent:
- £800 million in 2020 on agency nursing
- That rose to £1.3 billion in 2022, a 63% increase (The Royal College of Nursing).
- Overall, temporary staffing costs in England reached well over £10 billion, factoring in both agency and bank staff (The Guardian).
- Attrition and Replacement Costs
Losing a fully trained nurse can cost around £12,000 in recruitment and training expenses (Nurses). High turnover can therefore quickly increase cost pressure for employers.
The Benefits of Recruiting Nurses Locally
Despite these costs, recruiting locally offers significant benefits that make it a vital part of workforce planning:
- Familiarity with NHS Standards and Culture
Domestic recruits already understand UK healthcare systems, documentation, and clinical expectations. This speeds up onboarding and reduces supervision time. - Higher Retention in Some Cases
Nurses trained in the UK are often more likely to stay in the NHS long term, especially if career development pathways and conditions are attractive. - Ethical and Sustainable Practice
Training locally avoids ethical concerns associated with pulling staff from healthcare systems in countries with workforce shortages. It aligns with long-term strategic goals like the NHS Workforce Plan (The Guardian). - Support for the UK Economy
Investing in domestic nursing education supports universities, local healthcare employers, and the broader economy.
The Costs of Recruiting Nurses Globally
International nurse recruitment brings its own set of costs, both tangible and hidden:
- Direct Financial Costs: An NHS trust can spend between £2,000 and £12,000 per nurse to recruit from overseas, covering agency fees, visas, flights, language training, OSCE preparation, accommodation, and sometimes surcharges (Nuffield Trust, PMC).
- Administrative and Cultural Burden: Trust staff often need to assist with language training, cultural integration, and training to familiarise recruits with NHS systems. Sometimes that might require trips abroad or extra local mentoring (Nuffield Trust).
- Ethical Complexity: The UK follows the WHO Global Code of Practice and a ‘red list’ of countries from which active recruitment is discouraged unless part of bilateral agreements, factors that restrict where recruits may legally come from (Nuffield Trust, The Guardian).
- Visa and Immigration Uncertainty: Changes to immigration rules can disrupt supply. Recent policy shifts suggest limits on overseas recruitment in care may soon come into force, potentially leading to staffing crises (Financial Times).
Economic modelling indicates that restrictions on workers bringing dependants and increased visa costs could cost businesses tens of billions over ten years (Financial Times).
The Benefits of Recruiting Nurses Globally
For many healthcare providers, these costs are a price worth paying, especially when local hiring fails to fill gaps. Benefits include:
- Rapid Response to Vacancies: International recruits often arrive within 8 to 12 weeks from hiring to deployment, much faster than training new UK staff (My Healthcare Recruit).
- Cost Savings over Time: While upfront spending is significant, the break-even point is typically around 24 weeks, after which overseas recruits can save money by replacing expensive agency staff (My Healthcare Recruit).
- Specialised and Experienced Personnel: Many recruits bring valuable experience in critical care, neonatal units, mental health, or other areas where UK training pathways struggle to keep up (Nursing Jobs UK, Nursing Jobs UK).
- Agency Cost Reduction: Hiring internationally bypasses the need for expensive agency cover. Permanent staff provide consistent care and reduce turnover costs (Nursing Jobs UK, My Healthcare Recruit).
- Cultural Diversity and Broader Perspectives: International nurses bring cultural awareness and can enhance care for a diverse patient base. They often stay longer; Our data at WeSolutions shows that non-EU nurses are 28% less likely to leave than UK nurses (We Solutions).
- Long-Term Retention and Integration: Overseas nurses under sponsorship are likely to remain with their trust throughout the sponsorship duration, and many eventually settle permanently (Nursing Jobs UK).
Cost Comparison Insights from Healthcare Reports
| Aspect | Local Recruitment | Global Recruitment |
|---|---|---|
| Upfront Cost | High (£37,000+ per trained nurse) | Moderate (£2,000–£12,000 per recruited nurse) |
| Time to Deploy | Weeks to a few months, depending on notice periods and local availability | 2-3 months for international |
| Agency Spend | Very high when using temp staff (£3.2 bn+) | Reduced reliance on the agency vastly lowers costs |
| Retention | Good for long-term UK-trained staff | International nurses show strong retention if supported well |
| Ethical Considerations | Fully ethical and domestically sustainable | Risks of depleting the source country if not done via ethical frameworks |
| Cultural Value | Familiar with NHS systems | Adds diversity and new perspectives to the workforce |
A Human Perspective
Imagine the head of a small hospital trust staring at a rota with a dozen vacancies. They can either wait months for newly trained UK nurses or bring skilled international nurses who can start within weeks. Each day without full staffing risks patient safety and staff burnout.
That decision hinges on more than spreadsheets. It touches on mission, equity, and the future of healthcare. At WEsolutions, we believe in crafting balanced strategies, where global recruitment relieves immediate strain and local investment builds long-term resilience.
Conclusion
There is no one-size-fits-all answer. Recruiting nurses locally nurtures sustainability and supports domestic systems, but takes time and money. Recruiting nurses globally offers rapid relief, specialised skills, and long-term personnel benefits, yet requires rigorous policy compliance and cultural support.
For WEsolutions and clients alike, the optimal approach blends both methods. Use global recruitment to address urgent gaps thoughtfully and ethically; simultaneously, invest in training, retention, and making UK nursing roles appealing for local talent, especially through better support, progression, and stability.
