Unprecedented Surge in UK Nursing Professionals Raises Retention Strategy Concerns

What does the data imply?

• The NMC register of nurses, midwives, and nursing associates has reached a record high of 788,638 (1.2 percent of the estimated population), with an increase of 30,351 in the past year.
• Almost half of the 52,148 new joiners last year came from other countries.
• The number of professionals who left the register slightly decreased, but more than half of them did so earlier than planned and most of them do not intend to come back.
• Five interrelated workforce challenges often influenced the decisions to leave, such as worries about the quality-of-care people receive.

The surge in Registered Nurses, Midwives, and Nursing Associates in the UK

The total count of registered nurses, midwives, and nursing associates practicing in the UK has reached an unprecedented figure of 788,638, marking a record high. This remarkable growth indicates that the NMC register now accounts for approximately 1.2 percent of the estimated UK population.

The year 2022-2023 saw the largest-ever influx of new joiners, with 52,148 individuals joining the NMC register. Notably, almost half of these joiners, totaling 25,006, received their education internationally. Concurrently, the number of joiners educated in the UK experienced an increase of 8.5 percent, surpassing 27,142.

Growing Ethnic Diversity and International Representation in the NMC Register

International recruitment is strong, with professionals from around the world comprising 20% of UK nurses. International joiners from non-European countries bring higher ethnic diversity to the register.
UK joiners are increasingly ethnically diverse, with nearly one-third from Black and minority ethnic backgrounds.

Ethnic diversity among new nurses, midwives, and nursing associates is reshaping the NMC register. In the past year, the proportion of registered professionals from Black and minority ethnic backgrounds has risen to 27.7 percent, accounting for over a quarter of the entire register.

Compounding Workplace Factors Affecting Departures

Last year, the number of healthcare professionals leaving their professions saw a slight decline, amounting to approximately 27,000 individuals. Nevertheless, the research conducted by the NMC highlights concerns for retention strategies in the UK Nursing workforce.

A significant finding reveals that over half (52.1%) left the register earlier than planned, with a quarter leaving much earlier. Moreover, a majority expressed their disinclination to return to the professions, including younger individuals.

The research identifies five key workplace factors that often influenced individuals’ decisions to leave their professions. These factors include burnout or exhaustion, lack of support from colleagues, concerns about the quality of care, excessive workload, and inadequate staffing levels. These factors together contribute to the challenges faced in retaining healthcare professionals.

Andrea Sutcliffe, Chief Executive and Registrar at the UK Nursing and Midwifery Council (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 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. 

“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.” 

Further important pointers

• The register maintained by NMC represents the count of professionals who are eligible to practice. However, it should be noted that not all listed on the register are currently actively working in their professions.
• The nursing associate role was introduced exclusively in England in 2019. This role serves as a bridge between registered nurses and health and care assistants, filling a crucial gap in the healthcare system.
• The 30,351 increase in the UK Nursing register may not perfectly match the total additional professionals. The discrepancy arises due to the inclusion of a separate registration category known as “dual registrants.” Dual registrants are registered as both nurses and midwives, but this category declined by 218.
• Please note that the exact sum of joiners, leavers, and the total number of registered professionals may not align perfectly. This discrepancy occurs because the data for joiners only includes individuals who are joining the register for the first time. It does not account for those who have re-joined after a period of practice interruption.
• NHS England, the NHS Confederation, and the NMC jointly published a novel resource in November 2022. The resource aims to combat racism among nursing and midwifery professionals working in the NHS.