Comparative analysis on international nurse recruitment: how the UK compares

In 2025/2026, MigrationWork was commissioned by the Royal College of Nursing to undertake comparative analysis of how different countries sought to recruit internationally educated nurses (IENs) to fill shortages in their domestic labour markets.

The analysis focused on how countries were using immigration policies, alongside other incentives, as a lever by which to attract internationally educated nurses.

The findings are striking.

They reveal that the UK is fast becoming an international outlier when it comes to valuing, attracting, and retaining international nurses, and that the proposed move to “earned settlement” risks making that worse.

On almost every measure, pay, the cost of permanent settlement, the path to permanent residence, and access to public benefits, the UK is less attractive than its competitors. Our Comparative Overview shows how the UK compares to all six countries in relation to key criteria.

While other countries are proactively trying to attract more international nurses to meet their growing healthcare demands and ageing populations, the UK stands out as one high-income country whose immigration policy is driven purely by a desire to reduce net migration and actively discourage settlement, despite facing the same challenges.

Since publishing the “earned settlement” proposals, the government have conceded that key public sector workers, such as nurses, would still be allowed to settle after five years. However, this still leaves an estimated 35,000 nurses in the independent and social care settings who could wait up to 15 years for settlement, as well as nursing assistants and nursing support workers.

This matters not only for the people affected, but also for the sustainability of the UK’s health and social care workforce.

Making settlement harder risks wasting significant public and employer investment in overseas recruitment, while deepening staffing instability in the NHS. And it could further reduce the UK’s ability to attract and retain internationally educated nurses at a time when the UK has yet to secure a robust domestic pipeline.

You can download and review the research by clicking on the link. The report involved four in-depth case studies, focused on countries that are most actively seeking to recruit more internationally educated nurses: Canada, Germany, Australia, and New Zealand, and a rapid review of two other countries (US and Ireland).