The number of nurses and midwives registered to practise in the UK continues to be lower than the same point a year ago, largely due to a further decline in European staff, reveal new figures from the Nursing and Midwifery Council.
The size of the register shrank by nearly 500 nurses during the 2017-18 financial year, according to the NMC’s latest report on the number of registered nurses that it regulates.
“The number of people from the EU leaving our register remains a major concern”
It has also revealed for the first time that registrations in all fields of nursing have reduced in the past two years – apart from children’s nursing, which has seen a slight increase.
For those who were not retiring, problems with staffing levels was the main reason given by UK nurses exiting the register, while European registrants mostly said they came off the register because they were leaving the UK, according to a new survey by the NMC.
The data published today shows at the end of March 2018 there were 690,278 nurses and midwives on the register, which is 495 fewer than in March 2017.
However, the drop is not as great as it was during the year before, when the register shrunk by 1,782, from 692,556 in March 2016 to 690,773 in March 2017.
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This is largely because today’s data reveals an increase in the number of UK nurses and midwives joining the register – 21,931 in the past year, compared with 20,240 between March 2016 and March 2017.
In addition, the figures reveal fewer from this group departed, with 25,400 leaving in the past 12 months, compared with 29,434 between 2016 and 2017.
“Nurses returning home, or giving Britain a miss entirely, are doing so because their rights are not clear enough”
But this was alongside a drop in the number of people from the European Union joining the register -– 805 in the past 12 months compared with 6,382 between 2016 and 2017, according to the NMC report on the figures.
There was also a continuing rise in the number of European nurses and midwives leaving the register – 3,962, up from 3,081 the year previously.
Meanwhile, the overall number of nurses and midwives on the register from other parts of the world has continued to increase and is at its highest point in recent years.
The NMC’s report also highlighted for the first time how far the decline in the size of the register was affecting adult, children’s, learning disability and mental health nursing – though it points out staff do not always work in the role they are registered.
Between March 2017 and March 2018, the number of mental health nurses dropped by 320, learning disability nurses decreased by 329 and adult nurses reduced by 3,927 – and these were all on top of similar or larger decreases in the prior year.
Meanwhile, the number of children’s nurses increased by 1,051, following steady increases in recent years.
The NMC surveyed 3,496 people who left the register between June 2017 and November 2017 about why they departed.
Among the 3,137 UK nurses and midwives, around half said this was due to retirement, but 26% cited staffing levels as an issue, followed by 25% who said their personal circumstances changed.
In the group of 227 European nurses and midwives, the top reason – cited by 59% – was due to them leaving Britain, while 47% said Brexit had encouraged them to consider working outside the UK, and 22% said their personal circumstances had altered.
NMC chief executive and registrar Jackie Smith told Nursing Times: “It’s good to see the numbers from the UK stabilise, but if we look at the pattern over the last few years, it’s a decline. Because of the uncertainty, people are choosing to leave.
“The number of people from the EU leaving our register remains a major concern, despite reassuring comments from senior members of government and nurse leaders,” she added in a statement.
“We asked people why they were leaving and for the small number of EU nurses and midwives who responded it’s clear that Brexit is playing a part, while retirement and staffing levels are clear factors in the decision of UK nurses and midwives to leave the profession,” said Ms Smith.
“Starting to stem the loss of British nurses is welcome but the real battle is to inspire young people to join the profession”
She noted the government had announced an increase in undergraduate placements but said workforce planners should ”continue to look at what can be done to better support the nursing profession at this difficult time”.
Royal College of Nursing chief executive and general secretary Janet Davies said the NMC figures showed efforts to boost nurse staffing were being “dragged down by a botched Brexit”.
“Nurses returning home, or giving Britain a miss entirely, are doing so because their rights are not clear enough. Theresa May must use every opportunity to say they are welcome here and valued in health care,” she said.
“Starting to stem the loss of British nurses is welcome but the real battle is to inspire young people to join the profession,” she added.
She said higher starting salaries for newly qualified nurses, which is one of the key parts of the proposed NHS pay deal negotiated by the RCN and other unions, would “go some way” to attracting more people into nursing.
Status of EU NHS staff needs protection post-Brexit
But the government should go further by supporting students with grants and launching a national advertising and recruitment campaign, said Ms Davies.
“As the overall number of nursing staff falls again, it is patients who will worry the most,” she said. “The government knows patients can pay the highest price when staff shortages bite.
“Each country of the UK needs a funded and detailed plan to boost nurse numbers and ensure safe patient care,” she said.
Unison head of health Sara Gorton said: “Brexit has made many European nationals feel decidedly unwelcome. And with NHS staffing pressures showing no sign of easing, no-one could blame nurses and midwives for thinking they’ll be better off elsewhere.
“This European exodus continues apace, simply because the prime minister has yet to do enough to reassure EU nurses and midwives that they’ll have rights, jobs and a future once Brexit becomes a reality,” she said.
“The small rise in the number of home-grown nurses provides the faintest glimmer of hope, but it’s still way short of what’s needed to provide the care required. And with student numbers down, the future looks bleak,” said Ms Gorton.
She added: “Without more staff and proper funding, experienced professionals from within the UK and across Europe will simply keep leaving, and it’ll become ever harder for those that are left to meet the growing demands being placed on the NHS.”
Responding to NMC report, Liberal Democrat Brexit spokesman Tom Brake said: “These figures are deeply concerning. Our health service has been built and is maintained by the hard work of people from not just the UK but around the world.
“Many Brexit voters supported leaving the EU on the promise of more money for the health service,” he said. ”There cannot be a stronger reason for the public to have a final say on the deal, than the fact we can now see the harm Brexit does to our NHS.”
- Read the NMC’s full report: The NMC register 2018