NMC register sees 50% drop in nurses joining from overseas

There has been an almost 50% collapse in the number of international professionals joining the Nursing and Midwifery Council (NMC) register compared to the same six-month period last year, new data shows.

A new ‘mid-year update’ published today by the nursing regulator revealed the number of nurses, midwives and nursing associates who can practise in the UK has risen to a record high of 860,801.

However, it warns of a ‘slower growth’ of the NMC register overall – with a 25.7% decline in the number of new professionals joining the register in the six months to 30 September and a 6.6% rise in those leaving, compared to the same period last year.

The main reason behind the slowdown was a ‘sharp fall’ in the number of internationally educated nurses and midwives joining the register for the first time.In the latest six-month registration window (1 April–30 September 2025), a total of 6,321 international nurses and midwives joined the NMC register – representing a 49.6% fall compared with the 12,534 international joiners recorded between April and September last year.

This is the lowest six-monthly intake of international professionals for five years.

Reliance on ‘red list’ countries

The data shows a particular decline in nurses joining from the Philippines (-68.1%) and from India (-57.8%).

The changing landscape means the Philippines has fallen out of the top three largest sources of international recruitment.

After India, the second and third largest sources of international recruitment are now ‘red list’ countries Nigeria and Ghana. Being on the World Health Organization’s red list means they cannot be actively targeted for nurse recruitment.

According to the NMC’s data, the number of joiners from Nigeria still fell by 27.8%, and from Ghana by 9%, compared to the same period last year.

Stability in UK joiners

By contrast, new joiners educated in the UK remained more ‘steady’, with 13,973 UK-educated professionals joining the register for the first time between April to September.

This is a 5.4% drop on last year, however the NMC has said that this figure should be interpreted cautiously as the data snapshot is taken on 30 September, which is mid-way through the peak season for domestic graduates.

That means the number may fluctuate significantly depending on when cohorts are added to the register, the NMC said.

In the past six months, 12,361 people trained in the UK left the register, equivalent to 1.9% of UK-educated professionals on the register – a marginal increase from 1.8% in the same period last year.

‘The world of all worlds’

The Royal College of Nursing (RCN) warned that the ‘stall’ in domestic joiners and decline in international recruitment meant the nursing profession was ‘potentially entering the worst of all worlds’.

RCN chief nursing officer Lynn Woolsey, said: ‘International recruitment is collapsing, even before further hostile immigration policies come in, while the number of domestic joiners continues to stall.

‘At a time of already widespread nursing staff shortages, with tens of thousands of nursing jobs remaining unfilled, the dashboard is flashing red for the future of services and patient care.’

Ms Woolsey warned that the current numbers of domestic nurses ‘will nowhere near make up’ for the overall decline in nursing staff arriving into the UK.

She called on ministers to ‘wake up’ and to grow and invest in the domestic nursing workforce.

‘We now need to see a serious, detailed and fully funded plan to grow the domestic workforce and an end to the pursuit of hostile immigration policies,’ she added.

‘This lack of joined up thinking in the heart of government cannot continue if we are to solve the many crises facing the NHS and social care and assure its future.’

The need to confront racism

Paul Rees, NMC chief executive and registrar, said: ‘The high-growth era of international recruitment appears to be ending. At the same time, domestic recruitment is steady. Overall growth of the UK’s nursing and midwifery workforce has slowed sharply.’

Mr Rees noted that there are also more nurses, nursing associates and midwives on the NMC register than ever before, with a third of nursing and midwifery professionals now also being Black, Asian or minority ethnic.

‘However, these professionals are often held back by their experiences of racism and other forms of discrimination that sadly appear to be growing again in our society,’ he said.

‘Some of our registrants see the situation as being worse now than at any time in the last 30 years, suggesting we have reached a crisis point.

‘The whole health sector must do more to confront racism wherever it occurs, so that every nurse, midwife and nursing associate can feel safe, valued and able to deliver the high-quality care that we will all rely on at some point in our lives.’

Addressing career progression

Rohit Sagoo, chair of the British Sikh Nurses Association, said the findings show a ‘failure to nurture and retain’ international nursing and midwifery professionals.

‘As international inflows reduce, it becomes even more urgent to address progression, inclusion, and leadership equity for those already in the workforce,’ he said.

‘Ethical recruitment must be matched with fair career trajectories, otherwise the NHS risks losing highly skilled professionals and weakening long-term workforce resilience.

‘Without addressing retention, progression, and belonging, the NHS risks losing experienced global talent from a global workforce.’

Coumarassamy Marimouttou, founder and chairman of the British Indian Nurses Association (BINA), echoed these concerns, adding: ‘International nurses have been the backbone of the NHS for decades, and their contribution is invaluable.

‘We witnessed this during the pandemic period. We must address the barriers they face, from discrimination to cost-of-living pressures, and work together to create a welcoming, fair, and supportive environment. Our commitment is to ensure every nurse, whether trained in the UK or overseas, feels respected and valued.’

In June, annual data revealed the number of professionals on the NMC register reached a record high but that international recruitment between April 2024 and March 2025 had fallen by almost a third (30.2%) – ending the upward trend in international recruitment seen over the past six years.

This year the government introduced plans to ban the recruitment of care workers from overseas, with nurses warning at the RCN Congress in May of the ‘incredibly miserable’ consequences.

In October, tougher new English language requirements were unveiled under a law introduced in Parliament. Though at the time, the NMC said it ‘does not foresee’ government changes to English language requirements impacting overseas professionals on its register.

Last December, figures showed a 65% annual drop in Health and Care Worker visa grants when compared with data from 2023. This came after the government last year banned direct care workers arriving from overseas from bringing dependents on their visa.