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Exclusive: Increase in nurses 'quitting' register

An increasing number of nurses are allowing their registrations to lapse each year, at a time when the NHS is struggling with a shortage of qualified staff, an investigation by Nursing Times has found.

More must be done to support the current nursing workforce and also those that want to return to the profession, nursing leaders have said in response to the findings.

Latest figures supplied to Nursing Times reveal the number of people choosing to stop working as nurses. The number joining the register has increased by almost 10,000 since 2010. However, the number leaving it has reached a four-year high.

According to Nursing and Midwifery Council, more than 23,000 nurses allowed their registration to lapse during the 12 months prior to March – the highest number since 2010. This is equivalent to 3.4% of the total number of nurses on the register, which stood at 675,255 on 31 March.

In comparison, data for March 2010 shows 21,949 nurses allowed their registration to lapse. The number of lapses fell slightly in 2011 to 20,876, but increased again in 2012 to 21,851 before climbing to 23,088 this year.

Registration is recorded as lapsed when someone fails to pay their annual fee to the NMC, making it illegal for them to work as a qualified nurse.

Reasons for lapses include injury, career change, moving overseas or retirement – though some nurses remain on the register after 55 in order to do agency work.

The trend comes as evidence of a fresh crisis in nurse recruitment has emerged in recent weeks.

Nursing Times revealed last month that most acute trusts were increasing the number of nursing posts in their organisations, in order to maintain patient safety in the wake of the public inquiry on care failings at Mid Staffordshire Foundation Trust.

However, thousands of these posts remain vacant and at least a third of hospital trusts have actively recruit nurses from overseas to try and fill gaps in rotas.

Data from the NHS Information Centre reveals there were 347,444 qualified nurses working in the NHS in July 2013, a drop of 6,468 nurses since the coalition government was elected.

Howard Catton, policy director for the Royal College of Nursing, said: “Nurses do not take snap decisions to leave the profession.

“There is usually a lot of soul searching before quitting, which means that it’s likely to be a permanent decision and not one that’s readily reversed,” he said.

He called for the government and NHS to focus on encouraging current staff to remain in the profession.

“Given both the current shortage and the ageing of the profession, it is more important than it ever has been to retain the staff we have,” he said. “This means valuing and supporting nurses both as individuals and as a profession to do the job they aspired to on their first day of training.”

Return-to-practice courses have traditionally provided the most obvious route back into the nursing profession. A total of 35 universities are listed by the NMC as offering them.

However, courses can cost returners in the region of £1,500 each and individuals are required to find their own clinical placements.


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Readers' comments (41)

  • Most nurses I know would quit and do something else if they could.
    Add to the stress of the job, a truly awful employer, and you`re on a road to nowhere.
    Oh, and I've worked in ICU for 20 years, and yes I am completely burned out, but my employer doesn't care.

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  • I am a Band 7 of 20 + years experience looking to get out and will be another statistic for lapsed registration.
    We are being abused by politicians, chief executives, directors of nursing, matrons, auditors, newspapers, unions and patients for all the ills of the NHS. Doctors remain unaccountable and untouchable. If they do not want to engage with patients on the ward they simply do not come. We are weak and an easy target.

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  • If I could find another job with similar money to what I'm on now (band 5) I'd leave nursing tomorrow. Unfortunately, where I live the only thing on offer is minimum wage jobs and as my nursing qualification does not transfer to other roles I'm stuck.

    I've looked into getting a 'trade' of some sorts, but all the training programmes are geared-up for young apprentices.

    So, until the mortgage is paid I'm stuck - just not sure how long I can keep it up for.

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  • I am a Band 6 Community nurse, and I love my job. However, I am sick to death of the continual erosion of terms of conditions; frozen salary, reduced pension, later retirement, vastly reduced mileage allowance, increased caseload. To top it all, my employer used to make a small contribution towards NMC registration but that was stopped without explanation or apology, and if I want to apply for another job I even have to pay my own CRB check. What a bloody cheek! I do not feel valued by my employer, my patients or the general public. I have willingly given hours of unpaid overtime to get the job done, sought appropriate training, got involved in mentoring student (with enthusiasm), "gone the extra mile" for patients, yet this counts for nothing and I feel I have been s*** on. The only thing keeping me here is my pension - and I really don't trust that promises will be kept regarding that. If it wasn't for the hope of a pension I would leave tomorrow and do almost anything else. The unions do nothing to support us, and the NMC is a disaster - it is a parasite feeding off apathetic nurses. No wonder sensible nurses are leaving in droves. If we were paid what we are worth, then maybe we would have a bit more pride and been keen to stay.

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  • It's no wonder registrations are decreasing. I agree with my colleagues above - the poor terms and conditions and the sheer disrespect nurses face makes it unattractive for newcomers. If you can get out and make a new career, it makes sense to do so.

    Those of us who've built a respectable career will remember when we were valued for our knowledge and skills, but now it's about cheapness and the only 'must have' qualification is a pulse. My hard earned degrees and specialist qualifications count for nothing now.

    I'm 63 and still on a couple of registers, but it's only because I can still make a difference for patients. If I lose that, there's no point any more.

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  • Band 5 and currently under threat of losing our enhancements and bank shifts as well as no pay rise ...wish id gone into another profession i thought NHS would look after employees well but its all about Audits and money as usual...

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  • I too am another statistic, having decided, after much soul searching, to prematurely retire from the the register. I was on it and consistently working over the past 30 years plus, and had become a highly skilled worker....but I could see what was coming, with the latest round of Government changes and finally decided enough was enough.
    I worked in acute mental health services and can honestly say that the patients/clients rarely made me feel that the job wasn't worth it: it was always the systems/structures/processes/poor resources/diminishing terms and conditions of service and the constant, ever increasing adverse interference from Government.

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  • I am quoting a comment written about another subject elsewhere in NT today.

    "I did not come into this job to work myself into a bitter state of slavish ineffectiveness."

    Unfortunately, it appears to happen regularly. However, given the fact that nurses unions and the nurses who are their members (and don't vote in ballots) have done absolutely nothing to prevent UK Nursing deteriorating to such a state, the bitterness and slavish ineffectiveness is very much their lot.

    We seem to do nothing more than endlessly list all our sacrifices (I work through all my breaks, stay behind for hours upon hours, never go the loo, never have time for a drink of water, donate a kidney and a lung, etc, etc!!) and losses and blame everyone else for our situation. Nurses have done nothing, really nothing, to help themselves. When nurses stop feeling sorry for themselves and actually start taking some meaningful measures against the onslaught, things may change. But I won't hold my breath. It is easier to leave or say nothing.

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  • I loved working as a nurse for 6 years. The NMC registration lapses in March 2014 and I will not be renewing it.
    Let me tell you why?
    I will not be held accountable for the failings of others; Doctors, managers & ad infinitum.
    I will be able to take my breaks, lunch and requested holidays.
    As a salesperson, I will be rewarded for my efforts.
    But, I'm going to miss many of the patients and colleagues who made it worthwhile for so long.
    Goodbye NHS, NMC & MP. Shame really. Nursing was for me. I'm leaving a profession in decline. Nurses are not looking after themselves or each other. How on earth can it be said that we 'advocate' for the most vulnerable?

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  • I know it isn't very much but I value and respect all of you


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  • I qualified and never practised. I have experience in other skills and employment. Nursing is brutal. Not patient care. The brutality is a tidal wave of inertia and perverse management by people who wouldn't know a patient from a clothes horse! The systemic blame culture is depressing. The skills, foresight and cpd which is the responsibility of nurses counts for little now. I don't know where it's all going :(

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  • I often feel the same about lapsing my registration but like an earlier contributer until I can get a job that pays the same wage (top band 5) I am stuck where I am. I am the main wage earner since my husband (60 this year) had to take a lower paid (min wage) job after being made redundant twice in a year (2008/9) followed by a year unemployment on no benefits. We fell behind with our mortgage and in a depressed housing market it was catch 22 as we couldn't even sell for what we owed on the mortgage. It has taken several years but we are starting to make headway into clearing our debts.
    So its not surprising that I ended up on anti depressants with all the stress at home and working in a stressful job with an un-supportive bitch of a boss who thankfully has now left so things have gradually improved at work as well.
    I love the patient contact element of my job but the paper/computer work and politics get me down most days.
    I have even thought of doing the same job as my daughter who works for an energy company in a call centre and for a 30hr week can take home around £1100mth which is a bit less than I earn at present but at least the stress would stay at work at the end of my shift.

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  • I myself after much soul searching have decided to retire after 37 years next year but I'm hoping to do some bank shifts as my pension won't cover the bills! But at least I will be able to have my holidays when I want them, no more weekends and I will take all of Christmas and New Year off. Fabulous! Retirement is too short and there are loads of things I want to do before I get too old as well as spend more time with my family so I have finally made my mind up but it is a difficult decision because there is no going back.

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  • Roll on 55! I will have knotched up 36 years of nursing by then, which I have mostly enjoyed, but will be glad to retire and do other things while still young enough.

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  • I know about a dozen, if not more, nurses who are coming up to 55 in the next couple of years and not one plans to stay on - they're all going to take their reduced lumper and go and I don't blame any of them.

    The NHS should be bending over backwards to try and retain these really highly skilled staff, but I honestly don't think they're bothered. As long as there's enough names on the off-duty, that's all that counts.

    Nursing isn't what it used to be, actually the whole NHS has changed. I find that there's no banter or daft carry-on like there once was. People are too concerned with backbiting and bitching now, I hate it.

    I just think it's really sad that so many people (me included) are unhappy in their jobs. Roll on retirement.

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  • Anonymous | 22-Nov-2013 5:50 pm

    And what do you think nurses should be doing, may I enquire, politely?

    Everything one does to object to the abuses committed against Nurses by their employers, in Health Organizations in the UK puts one at risk of being branded as a trouble maker or a whistle blower. And as everyone else knows, this is a risky place to be. This has resulted in more than one person I know, having a "case manufactured against them" and have then found themselves reported to the NMC. An Action which might be described as Management getting the NMC to shut the Nurse up for a good long time.( The NMC have difficulty working out truth from fiction , you know , so the Nurse sits in a queue for 2 years or more waiting for a hearing, with no certainty of a truthful hearing when it comes to the crunch). Well hey, not every nurse can afford for that to happen to them, you know.

    I think the 23,000 nurses who have allowed their registration to lapse have done the most sensible thing they could have. No one thanks a dead nurse, so get out while you are still alive! They have shown how they feel by walking out.

    For those who feel stuck in Nursing, my heart goes out to you, I am one of the people who have let my registration lapse this year. I am fortunate, I have 3 different qualifications, one I got before I nursed and then I did Life Long learning, while I was nursing. So my choice would be to teach, if push came to shove. Although it would probably mean I would have to take on "hard to teach students "( plenty of these around)which are even more challenging than those Health Service Managers, who are as deaf as posts and as insensitive as a block of stone... take my word for it!

    Consider teaching English as a foreign language, or basic Skills, if you can't find anything else to get you off the rat run. And good luck!

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  • To any nurses who live in a rural area like me and felt they had no choice but to stick it out because they're too old to retrain.... Have a look at this I felt the same as you a few years ago and I was so depressed I didn't know what to do with myself. But if you like teaching and clinical work and don't mind travel, have a look at pharma. I don't mean sales, I mean as a nurse advisor. You get a decent car, a phone, a laptop, you work from home so they put another line in and pay for your broadband. You get good training and incentives (which aren't sales related) and your NMC subs paid plus time off for clinical practice. As well as going to conferences and generally being treated like a hard working human being not a doormat. Yes I lost my NHS pension and I only get 25 days holiday a year but I feel 25 years younger. I was a band 6 and I now earn about 60K if you include bonus. I teach new people in my company about our products and run inductions, and give lectures to other nurses at CPD events. There are lots of agencies and it can feel like a cattle market but I just chose a therapy area I loved and researched all the companies. I went straight onto their websites and applied direct. It took me 3 interviews to get in. I didn't have to relocate and take the kids to another school or end up in some crappy dead end job on rubbish money. I wish I'd done it years ago. It isn't all sleazy reps or dodgy companies, if you do your research and find the right place. I've never looked back and I've helped 2 friends get similar jobs, one's a midwife, the other a DN. Even if you decide not to, it's worth a look.

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  • I have worked for the NHS for 28 years and hoped to be able to hang on for another 10 years to find out they want me to work for another 12 years to get the same pension. I feel I have been enslaved since I was 18 years old to a dictatorship of unsocial hours, ungrateful managers and a load of bitchy colleagues. I am looking for another job. I don't care about the pension, I want my sanity.

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  • "Everything one does to object..."

    Like what? What is this "everything"? How many nurses do anything to object? And what is it that they do to demonstrate objections? Some might complete an incidence form every now and again, but give up very easily. The fact is that very few do anything to object to anything. There are some who will be quite brave and vociferous. Those who do, usually end up suffering quite badly because their colleagues stand by feafully and don't support them. Do you know of a group of nurses who, in recent times, have stood together in a united manner and demanded change? I don't either.

    A few years ago two academics, Elizabeth Morrison and Frances Milliken, were left shocked at what they later termed "employee silence". This was following the proposed introduction of a new initiative which everyone in their department felt was awful and caused a lot of anxiety. At a big department meeting about the inititaive, attended by all staff, no one said anything when the subject came up!! Sound familiar? Morrison and Milliken couldn't believe it and designed a study to try to understand employee silence in organisations. 85% of those in executive posts felt unable to raise concerns. Even when there is a moral imperative to act, people remain silent and do nothing because they do not want to be labelled as troublemakers. So they become detatched and bury their heads in the sand.

    Stanley Milgram, who carried out social science experiments in the 1960s spoke about blind obedience in groups. He concluded that people change focus when they are in groups. What is clear and moral when working alone, where conscience is brought into play, disappears when working within a hierarchy, where authority replaces conscience.

    In Ohio, a group of Psychiatrists wanted to test whether or not nurses would obey doctors even when they endangered the lives of patients. In the study, 22 nurses were ordered to administer an unauthorised drug in an excessive dose. The prescribing doctor would do so over the phone and would be unknown to the nurse. Sounds ridiculous, doesn't it? Who would agree to that? Indeed, the researchers canvassed 33 graduate and student nurses and 31 stated that they would refuse to carry out the order. However, in the experiment 21 of the 22 participating nurses were prepared to carry out the order.

    That is one of the reasons why so many did nothing for years at Mid Staffs and it was only the actions of relatives which finally brought it to an end.

    What do I think we should be doing?

    We should be uniting together and drawing up a list of demands (not requests or points for discussion) which should be presented to the government with the threat that non-compliance will result in real, united and sustained industrial action. We should demand that the leadership of our unions organise and facilitate that action and we, the members, must act and be prepared to support action.

    A lot is written about 'culture change' without looking at basic psychology. Nurses need to look at themselves individually and as a group and take responsibility. The amount of text mileage on these threads spent blaming everyone and everything else is testament to how neccessary it is for nurses reflect on their own inaction. There are approx. half a million nurses in the NHS alone. We are the single biggest workforce in Europe. I believe that we have the potential to completely transform the NHS. However, I do know that, with few exceptions, nurses are apathetic and cowardly. 33 years in and the only time I remember nationwide united action (with the inevitable exception of the RCN) was in 1982 when we took on Thatcher, went out on strike and won our pay rise.

    So I will ask in return, what do you think we should do?

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  • Apologies, the above comment is addressed to :
    Anonymous | 22-Nov-2013 11:03 pm in reply to his/her question.

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