NHS Saves £14 Billion Through Overseas Staff Recruitment, But MPs Warn of Training Shortfall

The NHS has saved an estimated £13.8 billion in training costs by recruiting doctors, nurses and midwives from overseas, according to a report from the All Party Parliamentary Group on global health and security. But the same report warns the government isn’t training enough homegrown staff — and hasn’t properly compensated the countries these workers came from.

The Numbers Behind the Savings

The APPG calculated that as of June 2025, around 218,727 non-British doctors, nurses and midwives — roughly 35% of those three staff groups — had been recruited from abroad. Hospital doctors accounted for the biggest chunk: £9.9 billion in avoided training costs across 81,127 posts, based on an average of £122,012 to train each doctor domestically. GPs added another £1 billion from 9,070 overseas-trained positions, and nurses and midwives made up the remaining £2.9 billion across 128,530 roles.

That’s a lot of money the NHS didn’t have to spend.

The Plan to Cut Back

The NHS Long Term Workforce Plan, published in 2023, aims to shift the balance. The target: reduce the proportion of overseas-recruited staff from about 24% of new joiners to between 9% and 10.5% by 2036–37. To get there, the government has pledged £2.4 billion over five years to expand domestic training — doubling medical school places, increasing GP training positions by 50%, and nearly doubling adult nursing places by 2031–32.

MPs aren’t convinced it’ll work. Training a doctor takes ten years or more, and the published plan itself projects a shortfall of 260,000 to 360,000 staff by 2036 even with intervention. Dr Beccy Cooper, Chair of the APPG, put it bluntly: international workers are “part of the NHS’s DNA” and bring global experience that benefits patients.

The Ethical Problem

There’s a catch. More than a third of NHS doctors were born and trained overseas, according to 2024 data. They’ve been essential in keeping services running, especially during periods of high demand and burnout.

But the APPG report makes clear the UK hasn’t adequately compensated the countries it recruits from. The “brain drain” effect — skilled workers leaving for wealthier nations — weakens healthcare systems in lower and middle-income countries. The Department of Health says overseas staff remain important while it builds domestic capacity, but balancing those two priorities is proving difficult.

Agency Costs and Staff Leaving

The NHS also has a temporary staffing problem. In 2022, it spent over £3 billion on agency staff alone — money that could have gone to permanent positions. Research suggests one internationally recruited permanent doctor saves around £100,000 over nine years compared to filling the same role with locums.

Staff retention has improved — the leaver rate fell from its 2022 peak to about 10% by late 2024 — but it’s still above the workforce plan’s target of 7.4% to 8.2%. Every doctor or nurse who leaves creates another gap that needs filling, often at agency rates.

Key Takeaways

• The NHS has saved £13.8 billion by recruiting 218,727 overseas-trained healthcare professionals, with hospital doctors representing the largest saving at £9.9 billion
• The government wants to cut overseas recruitment to 10% of new joiners by 2036–37, but MPs say the plan is unrealistic given projected staffing shortfalls
• More than a third of NHS doctors qualified abroad — they’re essential to keeping services running, but the UK hasn’t compensated source countries
• Agency spending of over £3 billion a year diverts funds from permanent posts; better retention and recruitment would reduce this

What This Means for Kent Residents

For patients in Kent, this is about who treats you and how long you wait. NHS Kent and Medway ICB and local trusts including Maidstone and Tunbridge Wells and East Kent Hospitals rely heavily on internationally recruited staff to fill rotas and keep clinics open. If the government cuts overseas recruitment without training enough replacements, Kent could see longer waiting times and reduced service availability.

The workforce plan’s training expansion won’t produce new doctors for another decade. In the meantime, international recruitment remains the main tool for filling gaps. If you’re struggling to get an appointment, contact your GP practice or call NHS 111 for guidance on accessing care.