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Poor working conditions drives huge increase in number of nurses leaving NMC register


Poor working conditions, including inadequate staffing levels affecting the quality of care, are motivating more nurses and midwives to leave the register than join it for the first time in recent history, according to figures released by the Nursing and Midwifery Council today.

Although recent media coverage has focused on the impact of Brexit and the falling numbers of European Union nurses joining the register, the regulator has today published figures that show it is mainly UK nurses and midwives leaving the register.

“We hope our data will provide evidence to support government and employers to look in detail at how they can reverse this trend”

Jackie Smith

Between 2016 and 2017, 20% more people left the register than joined it. This is the first time this has happened in recent history and has caused the register to shrink.

Since 2013, the size of the NMC’s register has been growing steadily every year. But as of March 2017 there were 690,773 nurses and midwives on the register – a drop from the 692,556 in March 2016.

In a survey conducted by the NMC last month about the reasons for leaving, which had over 4,500 responses from nurses and midwives who had left the register during the previous 12 months, 44% said it was due to working conditions (including issues such as staffing levels).

Meanwhile, 28% said it was down to a change in personal circumstances (such as ill health or caring responsibilities), and 27% said they had left due to disillusionment with the quality of care provided to patients.

Other reasons given included poor pay – 16% of respondents stated this was in their top three reasons – and 26% said it was due to difficulty in meeting the revalidation requirements, often because they were not able to practise for the required number of hours.

The difference between joiners and leavers is most pronounced for UK nurses and midwives. This group makes up around 85% of the NMC’s register. Between 2016 and 2017, 45% more UK registrants left the register than joined it.

“These figures are the starkest warning yet that nurses have put up with too much for too long”

Janet Davies

Jackie Smith, NMC chief executive and registrar, said: “At a time of increased pressure on the healthcare workforce to deliver quality patient care, we hope our data will provide evidence to support government and employers to look in detail at how they can reverse this trend.”

The data also shows that the numbers of nurses and midwives leaving the register before retirement age is increasing. Excluding those who retire, the average age of the rest of those leaving the register has reduced steadily over time from an average of 55 years old in 2013 to 51 years old in 2017.

The data shows that rates of leaving are increasing across all age groups below 60 years of age. This is particularly noticeable for those aged under 40.

One reason for those leaving the UK register could be to practise overseas because the regulator says it has seen an increase in the number of verification requests – by licensing authorities, which are often the equivalent of the NMC in different countries – made about UK registrants.

Verification requests are an important indicator of the numbers of nurses and midwives who have left or may intend to leave the UK to work in a different country.

“The government need a sustainable, long term approach to NHS staffing, starting with the long overdue pay rise for NHS workers”

Jonathan Ashworth

Responding to the latest NMC figures, Janet Davies, chief executive and general secretary of the Royal College of Nursing, said: “These figures are the starkest warning yet that nurses have put up with too much for too long. Our members have had enough, and as a result the profession is shrinking.

“Patients are paying the price for the government’s failure to plan for the future and it looks set to get worse. With more people leaving than joining, the NHS will be further than ever from filling the 40,000 vacant nurse jobs in England alone.”

“The average nurse is £3,000 worse off in real-terms compared to 2010. The 1% cap means nursing staff can no longer afford to stay in the profession and scrapping student funding means people can no longer afford to join it,” she said.

“Just as worrying is the fact that these latest figures show more British nurses are moving to work abroad,” she added.

Figures released by the NMC earlier this year showed a small but significant increase in the numbers of EU nurses opting to leave the register.

A survey of 247 EU nurses who left the register over the past 12 months shows that 58% said they were leaving or had already left the UK, 32% said Brexit had encouraged them to consider working outside the UK, while a further 32% said unhappiness with working conditions had encouraged them to depart.

The overall reduction in nursing numbers is most noticeable in England as most registrants are based there but there is some evidence that the other UK countries are showing similar patterns.

The overall number of initial joiners – which includes UK, overseas and EU registrants – increased from 25,208 in the year 2012/13 to 30,638 in 2015/16. This then dropped to 29,025 in the year 2016/17.

The numbers of UK registrants leaving has increased from 19,819 in 2012-13 to 29,434 in 2016-17.

The data released today covers the period between April 2012 and March 2017. Data for the first quarter of 2017 (April to June) will be released next month, although the regulator says it expects this to show a continued decline in overall numbers on the register.

“The Conservative government’s approach to workforce management in the NHS has been catastrophic”

Jonathan Ashworth

Labour’s shadow health secretary, Jonathan Ashworth, said the reduction in the number of nurses on the NMC’s register should be a “badge of shame” for the government.

”The Conservative government’s approach to workforce management in the NHS has been catastrophic,” he said. “Their neglect of the NHS workforce, combined with the endless pay restraint, is driving people out of health professions.

“The government need a sustainable, long term approach to NHS staffing, starting with the long overdue pay rise for NHS workers which Labour argued for at the election,” he added. 

A spokeswoman for the Department of Health said: “We are making sure we have the nurses we need to continue delivering world-class patient care – that’s why there are almost 13,100 more on our wards since May 2010 and 52,000 in training.

“We also know we need to retain our excellent nurses and last week we launched a national programme to ensure nurses have the support they need to continue their vital work,” she added.


Readers' comments (9)

  • More encouraging proof that the Tories plan to privatise the NHS by first destroying it is working well. Well done Mr. Hunt. Keep up the good work.

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  • Destination Norway!

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  • Just read the 'Strategy For Keeping Staff ' on Line, which the government are using to defend themselves today and it brings me no hope that they fully understand the stress it causes nurses and patients when there are not enough nurses on shift to deal with the patients needs. I stayed two and half hours after my shift last night ( paid) because yet again the night shift were short. I am working one extra shift this week , while on leave, to bring the ward to minimum numbers of nursing staff. We never now reach our high level of staff but bump along on minimum level or below. Our pay review is now linked to achieving our mandatory training, but time to do this at work is sadly lacking. Yet the increments were suppose to reflect that as you spend longer in the role your usefulness increases. I agree Mandatory training should be met, but please give us all a few shifts where we have the staffing to sit at a computer and not be interrupted in order to carry this out.
    I returned to Practice after Francais and love this work. I am in my mid 50's so know that there has been a huge increase in the amount of work done at the coal face as the general health of those I care for is much more frail and expectations hugely higher than the past. Just pay the rate that the job deserves and return to supporting Student Nurses go through training without debt. Rely on nurses from overseas if you must but is this really fair to expect other countries to train your nurses. I hear that Spain no longer has an excess to send us .

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  • I have just finished a return to nursing course in Northern Ireland. Now just turned 50, I originally trained as a nurse but ended up going into business with my partner and leaving nursing behind. After 15 successful years, getting married, having three children, our business suddenly declined and I quickly decided to do a return to nursing course to go back into nursing. I was so surprised at how quickly the nursing came back to me and how much I enjoyed it, apart from the attitude of the nurses towards me. It was as if they were suspicious of me. The junior staff were fantastically helpful, and friendly but some of the most senior staff nurses deliberately tried to make things difficult for me, and as for having a mentor.....well, she could not have been more unhelpful. She made it clear from the word go that she didn't want me anywhere near her. I was appalled by the whole experience, and the lack of teamwork and support for fellow nurses was sadly too obvious to me. It seemed to be "every nurse for themselves." I was enthusiastic, I loved the work, and was determined to finish the course. I worked 250 hours with no pay, received no feedback from my mentor and felt totally excluded from the team. I am now wondering if I should bother re-registering at all. I just wonder why would I want to work for 20,000 pounds a year in a place like that. Feeling undervalued, trying to slot into that shitty hierarchical nursing structure on the ward. The doctors respect and support each other so much more, never would they be heard saying a bad word about each other. The nurses on the other hand.........! Nurses simply need to be paid a lot more for so many reasons, if not only because they deserve it! How the government have managed to get away with paying such shocking wages to nurses is truly beyond me!!!

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  • My advice to anyone thinking of taking up nursing. DONT
    1. you want to be persecuted by the NMC
    2 bullied and harassed by anyone as nurses have no power to fight back
    3 overworked
    4 underpaid
    this country does not deserve a nursing profession

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  • Since qualifying four years ago I am already looking to re train all together. I entered nursing to help others and provide excellent care and job satisfaction, regardless of pay. I have worked in intensive care and across medical and surgical wards. I have found distinct lack of leadership, career development pathways or even a simple thank you from my seniors and other team members. After struggling to make 7am starts and working a mix of days and nights I had enough. I had a young son at home with a disability and was constantly refused flexible working. My rate of pay was £11.40 per hour. Now I work for a nursing agency and can earn £35 per hour for a night shift. I get a thank you and always made to feel part of the team and can pick and choose my own hours. However, working across private sectors and the NHS there are two themes that are constant, the lack of permanent staff and basic care. The compassion and will can be seen but the resources and staff levels are not. I very often witness scenes and acts of care not much dissimilar from the Mid staffordshire scandal. When the Francis report was published safe staffing levels were issued and managers and chiefs stood and listened. With the impending nurse shortage and no support from our current government i really do fear we are going to lose our NHS and most of all the amazing caring nurses that go that extra mile. Yes.... Even on agency in work past my contracted hours and do not get paid extra. The accountability and compassion never leaves you. I pray things will turn around soon....

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  • Good choice on Norway! You won't regret that one I love that country, lived there as a child. I moved overseas to Canada, at least we get paid what we are worth here and I can have a life not lose my money each month working full time to taxes etc. Try paying more, being more supportive, stop placing blame NMC who are now worse than ever in many ways, and try being far more supportive for a start. You're revalidation process now is a joke, especially as it's obvious they are also discriminating.

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  • I too am one of the increasing number of over 50's that have had a pension settlement given to me and have applied to retire. After 35 years of working in what was a great profession I am now disillusioned how we have been treated and even more demoralised and saddened as how as a profession have we allowed our selves to be walked over by governments, often unacknowledged by employers and persecuted by a nursing regulator that isn't not fit for purpose.
    I cant wait till the end of the year......................

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  • Sadly this is simply a sign of change and how nurses are no longer thought of as important people in society rather than just hospitals. The NMC register fell by 2500 this year and I know nurses who have moved onto greener pastures working in coffee shops and setting up their own health businesses with their transferable skills. What a loss!!

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