The Health and Care Professions Council (HCPC) has voiced concern over the relatively high rates of physiotherapists and other allied health professionals (AHPs) from overseas who de-register within four years of practising in the UK.

In a foreword to a report published last week (25 September), Bernie O’Reilly (pictured above), the HCPC’s chief executive and registrar, said: ‘The retention of staff has been a long-term issue for the health and care workforce in the UK and in particular the NHS.

‘While retaining staff in all health and care professions and settings is critical to safe and effective care, the levels of retention in AHPs …  are becoming increasingly important.’

Of the 15 professions regulated by the HCPC, physiotherapy has one of the highest rates of new registrants who join via the international route. This applies to nearly one physiotherapist in three (32 per cent) joining the register, compared to dietitians, for example, where the rate is nearer one in four (28 per cent).

Both these professions have relatively low retention rates – with 30 per cent of physios and dietitians from overseas going on to leave the register within four years. This compares to 17 per cent of radiographers, for example, the HCPC’s new analysis summarised in the report shows.

‘While retaining staff in all health and care professions and settings is critical to safe and effective care, the levels of retention in AHPs …  are becoming increasingly important’ [Bernie O’Reilly]

With all registration routes combined, the rates of leaving the HCPC register varied between professions – from 3 per cent (one in 30) operating department practitioners to 15 per cent (one in seven) physiotherapists.

NHS 10-year plan for England brings new focus

In his foreword to the report, Mr O’Reilly notes that the publication of The NHS 10-year plan for England in July 2025 put a fresh focus on the importance of workforce retention and the need for action. ‘As these plans start to be implemented, retention continues to be a top priority for the health and care sector,’ he notes.

While the finding that there is a lower level of retention among international registrants was not a surprise, the HCPC is concerned that this can affect overall retention levels in professions with higher proportions of registrants who have joined via the international route.

‘Many young international-route registrants work in the UK on two-year visas, which in part explains their lower retention rate,’ Mr O’Reilly points out. Our analysis can provide useful insights to help inform workforce planning, particularly in those professions that rely on the international supply to meet UK workforce demands.

Professions with relatively large proportions of new registrants joining via the international route include

• dietitians (28 per cent of new registrants joining)

• physiotherapists (32 per cent)

• radiographers (35 per cent)

These three professions (above) also have relatively low retention rates – approximately 30 per cent of dietitians and physiotherapists left the HCPC register within four years, compared to 17 per cent of radiographers.

The HCPC report also found lower levels of retention among overseas students who had qualified in the UK. ‘For parts of the UK with higher proportions of overseas students, such as Scotland, this then leads to lower overall retention rates in those areas,’ Mr O’Reilly states.

‘Everyone in the sector, including regulators, has a role in supporting retention and addressing issues where they exist in support of safe, effective and high-quality care.’

Balance needed in recruitment routes

The HCPC welcomes action to address retention issues that workforce planners, education providers and employers have taken in recent years. Despite this, questions remain on how best to balance recruitment of domestically and internationally trained professionals to meet workforce demands, Mr O’Reilly notes.

‘By sharing these insights and making our analyses widely available as part of our interactive online data hub, we aim to support the healthcare sector to retain the right skills and experience in the critical professions delivering care to the public,’ he adds.

Accessing the HCPC data hub

The HCPC’s data hub provides insight relating to all 15 health and care professions. Launched earlier this year, it is already playing a key role in informing workforce planning decisions, the HCPC said.

The dashboard on the hub shows that retention for international-route registrants, within four years of initial registration, was highest among arts therapists (86 per cent) and practitioner psychologists (85 per cent). The lowest rates were recorded by chiropodists/podiatrists (48 per cent), speech and language therapists (51 per cent), and occupational therapists (53 per cent).

Fact file

• one internationally trained registrant in three leaves the HCPC within four years

• this compares one in 20 registrants who had taken a ‘UK-route’

• the difference could be due, in part, to the fact that many young international-route registrants de-register after their two-year working visas end

• the HCPC is the professional regulator for more than 360,000 health and care professionals 

To access copies of the report – titled How long do new HCPC registrants stay registered for? An analysis of first-time HCPC registrations: 2013 to 2020 – click