Joan Pons Laplana is a senior digital charge nurse working on the frontline in an intensive care unit treating coronavirus patients at Sheffield Teaching Hospital in the north of England. Like many of his colleagues in the state-run National Health Service (NHS), the 45-year-old medic is not British. The Spanish national works alongside people from Germany, Italy, Portugal, Philippines and India, as well as those from the UK. “Sometimes the most difficult accents to understand are the British ones,” Laplana, who has lived in the UK for 20 years, told AFP. The international mix of staff at Sheffield is far from untypical in British hospitals. Parliamentary figures published last July show that some 153,000 workers out of 1.2 million NHS staff are non-British. “This is 13.1 percent of all staff for whom a nationality is known, or just over one in eight,” it reported. “Between them, these staff hold 200 different non-British nationalities. Around 65,000 are nationals of other European Union countries — 5.5 percent of NHS staff in England. Around 52,000 staff are Asian nationals, according tot the parliamentary figures. Among the most common 16 nationalities of people working for the NHS were Indian (21,207), Nigerians (6,770) and Zimbabweans (4,049). In addition, the health service think tank the King’s Fund, calculates that beyond the NHS, around one in six of the 1.5 million people working in adult social care, in the private sector, are from overseas. “The NHS depends on the important contribution that they (overseas workers) make,” said Alex Baylis, assistant director of policy at King’s. “This has come into sharp focus in recent weeks, as all NHS staff have gone above and beyond the call of duty to look after patients who are ill with coronavirus.” Foreign staff The contribution of the NHS, like health workers globally elsewhere, has been lauded during the coronavirus pandemic. However, in the UK the role of non-British workers, and particularly those from the European Union, has been brought into sharp focus because of Brexit, where immigration was a key issue. Britain is reliant on such workers at a time when the future of many of those people to remain in the country is uncertain after the country left the EU in January. “Nobody has asked me where I come from in the last few weeks,” said Laplana who spoke out publicly against Brexit following the 2016 referendum. The government said on Wednesday that 69 NHS workers have died during the outbreak, including those from overseas. They include Alice Sarupinda, a nurse from Zimbabwe, and Jenelyn Carter a healthcare assistant from the Philippines. Since the 2016 referendum set Britain on a turbulent path to leaving the EU, there have been doubts about how the NHS will cope with any potential exodus of staff as a result. Freedom of Information figures published in November revealed that in three years since the referendum, more than 11,600 NHS staff from the EU had left the UK, including 4,783 nurses. Coupled with an election pledge by Boris Johnson’s government to spend an extra almost £34 billion (38 billion euros, $42 billion) a year on the NHS, questions have been raised about how workforce gaps could be plugged. “Regardless of Brexit, the NHS will continue to need staff from overseas,” adds Baylis. “With almost 100,000 vacancies, ethical international recruitment is the only realistic option for addressing the NHS’s staffing shortfall for at least the next five years.” Policy shift Already the urgency of coronavirus has seen a shift in government policy. Last month, the Home Office announced that 2,800 frontline NHS workers, whose visas are due to expire this year, would be extended for 12 months free of charge so they could “focus on fighting coronavirus”. But political opponents say that is not enough. The Liberal Democrats this week called on ministers “to give all foreign nationals working in the NHS and social care indefinite leave to remain in the UK”. The King’s Fund has also called on the government to waive an annual surcharge, set to increase to £625 this year, payable by overseas NHS workers so they can access the healthcare services they help deliver. Post coronavirus, it is clear that the treatment of international NHS workers will become a major political topic in the UK. In a country where a weekly round of applause is held for NHS and other frontline workers, it would take a brave government to deny healthcare staff improved living and working rights and conditions. But Laplana is unconvinced. He said that for his two decades in the UK he did not consider himself a foreigner but “Brexit put an end to that”. “I am a sceptic,” he says. “It will last for a while but then we will go back to blaming migrants for anything.”