On 25 June 2026 the Health Foundation published a briefing called "Immigration and the NHS: the evidence." Its conclusion is blunt: the average person who moves to the UK is more likely to work in the NHS than to use it, and pays more into the system than they take out. If you hire from overseas, that finding matters, because recruitment policy is moving in the opposite direction to the evidence.
Here's what the briefing says, and what it means for employers who sponsor workers.
What the evidence shows
Three findings stand out.
On the money: available estimates suggest people who migrate to the UK pay more in taxes and visa charges than the cost of the NHS and other public services they use, at least over the short to medium term. They help fund the health service well before they ever lean on it.
On the workforce: non-British nationals make up around 1 in 5 NHS staff in England. They are also far more likely to work in health and care than UK-born workers. In 2024, 19% of jobs held by people with non-UK nationalities were in health and care, against 14% of jobs held by UK nationals.
On perception: the public consistently overestimates both how much migrants use the NHS and how much of the workforce they make up. Around a third of people think non-British nationals are more than half of NHS staff. The real figure is closer to 20%. Asked what is actually driving the pressure on the health service, most people point to funding (37%), management (36%) and staff shortages (29%) long before they point to immigration (22%).
Put together, the picture is close to the opposite of the one we're often handed. The group described as a strain on the health service is, in large part, the group keeping it running.
Policy is heading the other way
While the evidence points one way, recruitment policy is moving the other.
The government has committed to reducing international recruitment into health and care. The nursing international recruitment programme ended in 2024. Between 2023 and 2025, the number of nursing visas granted fell by 92%. Plans set out in 2025 go further for social care, closing the overseas route to new applicants and lengthening the path to settlement for care roles.
The Health Foundation's verdict on that direction is direct: the latest target to reduce international recruitment "is not realistic and risks worsening workforce shortages." It calls instead for "a longer term, fairer approach to NHS recruitment."
The logic is hard to argue with. You cannot keep cutting the supply of a workforce that is already short and expect the shortage to ease. It moves onto the people already covering the gaps: the nurse picking up another shift, the carer working short, the manager who cannot fill a rota.
For employers, the takeaway isn't the politics. It's the planning. If you rely on overseas hiring, the routes and the rules are tightening, and it pays to map the impact before it reaches you rather than after. See where your sponsorship stands.
What it means if you hire from overseas
Two things matter more than ever.
The first is getting ahead of the changes instead of reacting to them. Rule changes that affect sponsorship rarely arrive with much notice, and the cost of being caught out, a delayed start date, a missed reporting deadline, a hire you can no longer make, lands on the employer, not the Home Office.
The second is keeping the workers you already sponsor compliant. When a government tightens a route, scrutiny on existing sponsors tends to rise, not fall. A sponsor licence is far easier to keep than it is to win back.
The bottom line
The Health Foundation briefing isn't a campaign document. It's a careful read of the evidence, and it's honest about the gaps: there's no national study comparing how migrants and UK-born residents use the NHS using data from 2021 onwards. What it does show clearly is that the simplest version of the immigration story, that migrants are a drain, doesn't survive contact with the numbers.
For the businesses and care providers who depend on overseas hiring to stay staffed, that's worth holding on to. The evidence is on your side. The policy, for now, isn't. The job is to plan around both.
Borderless Immigration helps UK employers sponsor overseas workers without the spreadsheets, the solicitor bills, or the compliance risk. If immigration changes are about to reshape your hiring, book a demo and we'll show you where you stand.
Source: Health Foundation, "Immigration and the NHS: the evidence", 25 June 2026.
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