The number of nurses, midwives and nursing associates registered to practise in the UK has grown, but so has the number of people leaving the register, the NMC has revealed.
The NMC annual report for 2021-22, published today, showed the register of nurses, midwives and nursing associates grew by 26,403 to 758,303 – including almost 705,000 nurses, more than 40,000 midwives and nearly 7,000 nursing associates.
However, the number of people leaving the register also rose by 3,199 to 27,133, an increase of 13% on the year before and an end to four consecutive years of a decline in the number of leavers.
When asked why they left, the most common answer was retirement (43%) and personal circumstances changing (22%). However, these was followed by too much pressure (18%), poor workplace culture (13%) and the influence of the Covid-19 pandemic (12%).
The number of people joining the register for the first time also rose by 13,919 to 48,436, and almost half of first-time joiners trained outside of the UK.
The NMC said this sharp increase in the numbers joining the register partly reflected the impact of the Covid-19 pandemic on previous years, with travel restrictions meaning the number of internationally trained joiners fell sharply in 2020-21.
The number of overseas registrants has since risen following the lifting of restrictions, with 23,408 internationally trained professionals joining over the past year, 66% of whom trained in India or the Philippines, it added.
The number of UK-trained joiners increased only marginally, from 24,555 in 2020-21 to 25,028 last year. This led to a near even split between domestic and internationally trained new professionals over the past year.
Andrea Sutcliffe, chief executive and registrar at the NMC, said: ‘Our register is at the highest level ever. This is good news considering all the pressures of the last two years. But a closer look at our data reveals some warning signs.’
Ms Sutcliffe said a focus on retention as well as attracting new recruits needed to be part of a sustainable workforce plan to meet rising demands for health and care services. She also cautioned that growth of the workforce had become more reliant on internationally trained professionals.
She said: ‘These professionals make a welcome and vital contribution to our nation’s health and wellbeing. But we can’t take them for granted. Two years ago, we felt the pandemic’s impact on global travel; the number of international joiners to our register fell sharply. A future pandemic or other global disruption could see history repeat itself, but with an even bigger impact on the overall growth of the register. We also need to make sure that we are supporting, valuing and rewarding our internationally trained joiners so their careers can thrive in the UK.’
RCN chief executive Pat Cullen also questioned the sustainability of recruiting half of all new nurses from overseas. ‘The UK’s health and care workforce is proudly diverse, but it must be done ethically and come at the same time as increased investment in education and domestic workers,’ she said.
Ms Cullen said that the loss of more than 25,000 registered nurses last year was ‘being felt profoundly’ by both patients and nurse and, in the interests of safe patient care, government ministers ‘must act decisively’ to retain experienced nurses.
‘When we have tens of thousands of vacant nurse jobs, a sharp rise in leavers should not be overlooked while we welcome new recruits. Ministers should avoid overclaiming today – nursing staff tell us these shortages are biting more than ever,’ she said.
‘With an imminent government decision on NHS pay and the pay review body reports due this month, these figures are a reminder of the scale of the challenge and why radical action is needed to boost the nursing workforce.’
Health and care staff shortages are already ‘very clearly’ impacting care in the UK, an NHS leader has warned. The RCN has already warned that an overseas recruitment drive for nurses by NHS Scotland won’t solve the country’s staff shortage and called for a safe staffing law to be extended to community nursing and mental health inpatient wards in Wales.