More early-career nurses quitting and ‘vowing to never return’

The Nursing and Midwifery Council (NMC) has today published its annual registration data, which shows how many nurses, midwives and nursing associates have joined and left the register in the last 12 months.

“New ministers have to grasp the nettle and make nursing an attractive career”

Nicola Ranger

While the report noted many positive trends around recruitment, it also exposed ongoing retention issues, which continue to cast a cloud over nursing and midwifery workforce ambitions.

On a positive note, the report showed that, between April 2023 and March 2024, the number of registered professionals grew by 37,723 to a record 826,418.

In line with the past few years, the number of adult, children’s and mental health nurses rose again this year, while the number of learning disability nurses dropped.

The growth in the register was mostly due to the continuous rise in first-time joiners, with 59,991 in the last 12 months alone.

However, the report said that, while the proportion of people leaving the register was declining, some registrants were leaving earlier than planned.

In the last year, 27,168 people left the NMC register – down 3% in the last year. Around half of these people left earlier than planned – typically five years sooner – in line with last year’s survey findings.

Concerningly, one in five (20%) nursing and midwifery professionals who left the register in the last year did so within the first 10 years of their career.

This means that over 5,500 early-career nurses have walked away from the profession in the last 12 months.

In the NMC’s annual leavers survey, retirement, poor health and burnout were the top three reasons cited for why professionals left the register.

Poor health was reported as being both physical and mental (75% and 62%, respectively).

Four in five (81%) of those citing poor mental health specifically said their role negatively contributed to this.

The top reasons for leaving were consistent between nurses and midwives, but staffing issues and concerns about quality of care were more common among midwives.

Most leavers said they would not recommend nursing or midwifery as a career.

The general secretary and chief executive of the RCN, Professor Nicola Ranger, said it was “deeply alarming” that over 5,000 early-career nurses has chosen to quit the profession.

“When the vacancy rate is high and care standards often poor due to staffing levels, the NHS cannot afford to lose a single individual,” she said.

Professor Ranger added: “New ministers have to grasp the nettle and make nursing an attractive career.”

She warned that working in understaffed and under resourced services was “taking its toll”, and that poor health and burnout was pushing nursing staff “out the door”.

“This is a tragedy for patient care,” she added.

Composition of the register

The NMC report found that the profile of its register has continued to change, particularly around the ethnic profile of registrants.

It comes as the number of first-time joiners were almost equally split between UK educated joiners (30,363) and those educated internationally (29,628).

In the last 12 months, 49% of new joiners were educated outside of the UK, meaning internationally educated staff now make up nearly a quarter (23%) of the register.

Almost half (14,615) of this year’s new joiners were educated in India, followed by the Philippines and Nigeria.

However, the NMC warned that it continued to see rises in first time joiners from the World Health Organization’s (WHO) ‘red list’, which should not be targeted for recruitment due to their own shortages.

On this trend, Professor Ranger said: “The reality for the government is that international recruitment is masking the failure to recruit enough domestic nursing staff, with equal numbers joining services from overseas.

Nicola Ranger

“Our migrant nursing staff are incredible and vital to the delivery of our health and care services, but this overreliance is unsustainable and unethical.”

Separately, the report showed that, of the latest cohort of UK educated joiners, 29% were from Black and minority ethnic backgrounds.

This means that professionals from Black and minority ethnic backgrounds now make up nearly a third (31%) of the register, compared to 20% in 2019.

Meanwhile, the report showed that the overall number of male professionals on the NMC register had also shown a steady increase, rising to 91,678 this year.

Notably, the number of male professionals who trained in the UK was declining, from 7% in March 2019 to 5% in March 2024.

In contrast, the number of internationally educated male professionals joining had risen over the same period, from 5% to 8%.

Responding to the data, the chief executive of NHS Providers, Sir Julian Hartley, said: “It’s great to see more NHS nurses, midwives and nursing associates than ever before but the hard part now is holding on to them.

“It’s a big worry that a survey of leavers found almost half quit the profession earlier than planned, many blaming burnout and poor physical and mental health,” he said.

Sir Julian noted that the aim of the NHS Long Term Workforce Plan was to establish “a more sustainable supply of trained home-grown staff”, but that NMC figures showed many were still coming from overseas.

He added: “With almost one in three people on the register from Black and ethnic minority backgrounds it’s vital that we keep working hard to ensure that the NHS is a great place to work – inclusive, promoting equality and combatting discrimination.”

Matthew McClelland

Matthew McClelland, executive director of strategy and insight at the NMC, said: “We welcome the record number of nurses, midwives and nursing associates across the UK.

“This is positive news as professionals face a rising demand for health and social care services, caring for peoples’ increasingly complex and changing needs, and daily workforce pressures.”

Mr McClelland said the NMC was committed to working with partners across the sector “to provide professionals with the support they need to carry out their essential roles”.

“I hope our data can provide the insight we need to support all those on our register, and the wider sector, so they can provide the safe, effective, and kind care the public has the right to expect,” he added.