There is a record nursing and midwifery workforce with greater ethnic diversity but also a significant fall in international recruitment, according to new data from the Nursing and Midwifery Council (NMC).
The NMC register of all nurses, midwives and nursing associates who can practise in the UK has reached a record 853,707 – around two percent of the total working age population.
The number includes more Black, Asian and ethnic minority professionals than ever: 277,716. That is just under a third of everybody on the NMC register (32.5 percent, compared to 30.6 percent on 31 March 2024).
However, there has been a significant slowdown in international recruitment to the register following years of growth. The number of internationally educated professionals joining the NMC register had been rising steadily since 2018–2019 (except for 2020–2021 when the pandemic impacted global travel). By 2023–2024, almost half (49.4 percent) of all new joiners to the NMC register were internationally educated.
The NMC’s latest data show that last year, 2024–2025, the number of international joiners fell by nearly a third to 20,671 (compared to 29,628 in 2023–2024). That means the proportion of all new joiners who were educated outside the UK fell to 39.1 percent (the total number of joiners in 2024–2025 was 52,834).
This slowdown in international recruitment was spread across countries, including the top three sources of international recruitment over recent years: India, the Philippines and Nigeria. The number of joiners who were educated in these three countries fell by 36.7 percent, 47.6 percent and 25.5 percent, respectively, over the past year.
Changes to visa rules may have played a part, and in England there is now a stronger focus on recruiting people locally through the NHS Long Term Workforce Plan. We are also seeing a rise in international professionals looking to move to other countries, possibly because they can earn more.
Also, the number of international professionals leaving the register has increased by a third (33.3 percent), from 3,959 leavers in 2023–2024 to 5,276 last year. In the context of a growing register, this means that 2.7 percent of the international cohort left in 2024–2025, compared to 2.4 percent the previous year.
Meanwhile, a greater number of UK-educated professionals joined the register in 2024–2025: 32,163, which is 5.9 percent more than in the previous year (30,363). However, this was a smaller rate of growth than in 2023–2024, when the number of UK joiners grew by 11.9 percent.
A grand total of 28,789 people left the NMC register last year. That means 3.5 percent of the register left, compared to 3.4 percent in 2023–2024. Retirement is always the top reason why people leave the register, according to respondents to our annual leavers’ survey.
However, concerningly, the second-most common reason for leaving last year was people’s physical or mental health. For the second year in a row, a total of 13 percent gave this as their main reason – with 70 percent of those saying their professional role had a negative impact on their physical health, and 85 percent saying it had worsened their mental health.
Only 19.9 percent of leavers said they would recommend a career in nursing or midwifery.
Paul Rees MBE, Interim Chief Executive and Registrar, said:
“We’ve seen a slowdown in international nurses and midwives joining our register. That’s a significant shift from recent years and there are likely a few reasons for it.”
“Even with this change, our register is still growing – and it’s becoming more diverse. That’s a real strength. It also means we must make sure everyone can work in an environment that values diversity and tackles racism.
“The Nursing and Midwifery Council has a responsibility to be fair to everyone on our register, whatever their background. That’s why we’ll soon be setting bold new targets to eliminate bias from our regulatory processes.”
Responding to the latest data from the Nursing and Midwifery Council (NMC), Caroline Waterfield, director of development and employment at NHS Employers, said:
“The new report from the NMC provides valuable data to strengthen our understanding of what is happening within the nursing and midwifery professions and inform current and future workforce supply and retention activity.
“There is a welcome rise in the numbers of nurses, midwives and nursing associates on the register, up 3.3 per cent to a record 853,707 in 2024/25. This growth - from a combination of both UK training and international recruitment - is critical to ensuring employers have access to vital nursing and midwifery expertise to help meet the current demand being experienced in all parts of the system.
“Critically, the data draws out that Black, Asian and ethnic minority professionals now account for just under a third of everyone on the register. We know from other reports and survey feedback that colleagues can have a worse staff experience than others. Alongside the NMC's commitment to addressing bias in their regulatory processes, which we see as essential, employers also have work to do to continue to improve the experience for all of our people.
“In what are very challenging financial times for the sector, we know that to meet the existing demand, support waiting list reductions and improve patient experience we need to retain all of our existing talent, as well as continue to train the future generation of professionals via degree apprenticeships and university training. Continued support for training and retaining a future workforce will be essential in the implementation of the forthcoming ten-year health plan.”
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