Government plans to make it harder for migrant workers to settle in the UK, along with mounting visa fees and restrictions, risk worsening the NHS staffing crisis, according to new data released today (Tuesday) by UNISON.
A survey of almost 1,900 international health staff who came to work in the UK found more than two fifths (43%) are now considering leaving the country. Almost a quarter (23%) don’t feel welcome and nearly a fifth (19%) feel unsafe as a result of anti-immigrant rhetoric.
It comes as the government faces criticism over plans to change the rules for how migrant workers can make the UK their home.
Ministers want to at least double the period required for individuals to gain settled status, with low-paid social care and NHS workers having to wait 15 years. This is on top of existing visa restrictions and thousands of pounds in fees, which workers must find to come to the UK and stay here.
The NHS and social care sectors rely heavily on staff from places such as the Philippines, India and Nigeria, says UNISON. Around one in five NHS staff working in England have a non-UK nationality.
However, respondents to the UNISON survey talk about the difficulty of trying to plan for the future if the rules change and the unsettling impact on their families. Others say it’s not fair to move the goalposts when staff came to the UK in good faith to work in health and care jobs.
The findings of the survey have been released to coincide with UNISON’s annual health conference, which began yesterday in Edinburgh. Almost three fifths (58%) of international workers who took part say the government’s plans are adding to their stress at work.
UNISON says a mass exodus of overseas workers would be a disaster for the NHS. Figures released in December showed a 50% drop in the number of international nurses, midwives and nursing associates coming to the UK.
Health ministers have admitted they don’t know what effect the changes to settlement rules will have on the NHS.
The union says ministers must rethink the plans and change how they talk about migrant workers.
UNISON head of health Helga Pile said: “The UK’s health and care services would collapse without the skilled workers who’ve come here from overseas. How we treat them matters – they should be respected, not taken advantage of and abused.
“It’s shocking so many NHS staff say they don’t feel safe or welcome in this country. No wonder so many are thinking of leaving.
“These findings make it clear ministers must think again about trebling the settlement period for crucial migrant health and care staff. Otherwise, the workforce crisis will get worse.
“Politicians of all stripes need to stop demonising people who are doing crucial work, often for very low pay. They’re the ones shoring up the UK’s crumbling health and care sectors. We simply cannot do without them.”
Notes to editors:
– UNISON surveyed 19,356 NHS staff between 27 January and 27 February 2026. A total of 1,894 said they were part of the international workforce, which refers to people who have travelled to the UK to work, or to study ahead of working in the UK.
– Staff experiences recorded by the survey include:
“Extending the period of sponsored visas to 15 years traps workers in a system where their right to stay is tied to a single employer. This significantly increases the risk of exploitation as workers may fear that raising concerns about pay or conditions will lead to them losing their sponsorship and being kicked out of the UK.” Care assistant, Yorkshire and Humberside.
“Increasing the time period for indefinite leave to remain is giving me and my family sleepless nights. The job is stressful enough without this on top.” Healthcare support worker, East of England.
– UNISON’s annual health conference began yesterday (Monday 13 April) and continues until tomorrow (Wednesday) at the Edinburgh International Conference Centre, Edinburgh EH3 8EE. The union’s general secretary Andrea Egan gave the keynote speech on Monday.
– This morning (Tuesday) Baroness Doreen Lawrence will be in conversation at the conference discussing race issues within the NHS and the pressures on migrant healthcare workers.
– Health workers from across the UK have been in attendance to debate a variety of motions including NHS pay, support for migrant workers, mental health, a greener NHS, sexual safety, problems with NHS salary scales, and safe staffing.
– UNISON is the UK’s largest union with more than 1.3 million members providing public services in education, local government, the NHS, police service and energy. They are employed in the public, voluntary and private sectors.
Media contacts:
Dan Ashley M: 07508 080349 E: d.ashley@unison.co.uk
Anthony Barnes M: 07834 864794 E: a.barnes@unison.co.uk
