Numbers of nurses, midwives and nursing associates that are registered to practise in the UK have seen a major uptick in numbers, reaching record heights of 788,638, a staggering stat that means the Nursing and Midwifery Council (NMC) register is now equivalent to 1.2% of the estimated UK population.
This level of growth has come following a strong 12-month period from 2022-2023, which represents the highest number of new joiners to the NMC’s register in a single year, coming in at a total of 52,148. A total of 25,006 of these joiners have been internationally educated, whilst the number of UK educated joiners saw a rise of 8.5%, reaching 27,142.
As international recruitment is consistently rising at significant rates, workers who are globally educated now account for up to one in five nurses, midwives and nursing associates who can practise across Britain.
Andrea Sutcliffe, Chief Executive and Registrar at the NMC, said:
“At a time of rising demand for health and care services, it’s welcome news that our register has grown to a record level, due to an increase in domestically educated joiners together with the ongoing surge in international recruitment.
“These joiners are more ethnically diverse than ever. This matters because NHS research in England shows that Black and minority ethnic staff are more likely to experience harassment, bullying or abuse. There’s also clear evidence that discrimination impacts on the quality-of-care professionals give, leading to worse health outcomes for people. Therefore, it’s more important than ever for employers to foster inclusive cultures, free of the racism and discrimination that profoundly affect people from minority ethnic communities.”
With the majority of international joiners coming from outside of Europe, the ethnic diversity in these fields of work is growing exponentially, accompanied by the increased diversity within UK-based joiners, seeing almost a third within the last year coming from black and minority ethnic backgrounds.
Caroline Waterfield, director of development and employment at NHS Employers, part of the NHS Confederation, said:
“It is good to see an increase in the numbers of nurses, midwives, and nursing associates on the NMC register, and we welcome the growth in international and UK trained new joiners last year. The NHS hugely benefits from the talented staff attracted from around the world and we know employers have been increasing efforts to offer more training placements and provide training for new nursing associates and those undertaking the nurse degree apprenticeship.”
Whilst this rise in international recruitment is great for expanding knowledge and experience within the sector, whilst also providing a workforce that represents and reflects the various minority backgrounds of patients, there is cause for concern due to the reliance on international recruitment.
In response to this news, Saffron Cordery, deputy chief executive of NHS Providers, said:
"The contribution of staff from overseas is invaluable but the NHS can't keep on relying on international recruitment. We must invest massively to train the number of home-grown staff the NHS needs alongside colleagues from abroad.”
Conversely to this recruitment progression, more than half of the people who have left the register (52.1%) have done so earlier than originally planned, seeing up to a quarter leaving significantly earlier than expectations, including most reporting that they would be unlikely to return.
People’s decisions to leave come from being influenced by burnout or exhaustion, minimal colleague support, concerns over the quality of care, the workload, and staffing levels.
Responding to these findings, James Buchan, Senior Fellow at the Health Foundation said:
“The NMC’s survey of people leaving the register also paints a concerning picture, with over half of respondents saying they are leaving the profession earlier than planned, pointing to burnout, lack of support and high workload as contributing factors.
“In order to retain existing nurses, and train and recruit the skilled professionals we need, a fully funded long term workforce plan for the NHS and social care is urgently needed and long overdue.”
Andrea Sutcliffe, also addressed the flaws in retention, saying:
“While recruitment remains strong, there are clear warnings about the workplace pressures driving people away from the professions. Many are leaving the register earlier than planned because of burnout or exhaustion, lack of support from colleagues, concerns about the quality of people’s care, workload, and staffing levels.
“Our insight can support nursing and midwifery leaders across health and social care to focus on the right issues in their retention strategies. Addressing those issues must be a collaborative effort aimed at improving staff wellbeing and retention, for the benefit of everyone using services.”
