The number of nurses and midwives in the UK workforce has hit an all-time high thanks in part to an unprecedented surge in overseas registrants from outside Europe, new figures reveal.
However, the data released today by the Nursing and Midwifery Council also shows that workplace pressure and ongoing uncertainty over Brexit are continuing to drive thousands of people out of the profession.
“It’s a drop in the ocean compared to what’s needed”
As of March 2019, 698,237 nurses, midwives and nursing associates were on the NMC register – an increase of nearly 8,000 from the same time last year and the highest level since the current records began in 2015.
This rise was driven in part by a massive 126% leap in the number of professionals from outside of the European Economic Area (EEA) registering with the NMC for the first time, from 2,720 in the 2017-18 financial year to 6,157 in 2018-19.
In the latest count, there were 73,308 non-EEA nurses and midwives registered to practise in the UK.
Conversely, the number of registrants originating from countries in the EEA has fallen for the second consecutive year in the wake of the UK’s vote to leave the European Union.
sara gorton for index
As of March 2019, there were 33,035 nurses and midwives from the EEA on the NMC register – a 13% drop since the peak in 2017.
Over the past 12 months, just 968 EEA nurses and midwives have joined the UK workforce for the first time. While this was a slight rise from 805 in 2017-18, it compares with 6,382 in 2016-17 and 9,389 in 2015-16.
In addition, 3,333 EEA staff left the NMC register in 2018-19 – double the figure from 2014-15.
Meanwhile, the figures show an all-round boost in UK nurses and midwives, from 545,815 in March 2018 to 591,894 in March 2019.
However, in the past 12 months, 24,069 British nurses and midwives have quit the profession. While this is a 5% reduction from 2017-18, it is still up from 21,790 in 2014-15.
Alongside the new data, the NMC has released the results of a survey it carried out with more than 3,500 people who left its register between May 2018 and October 2018.
After retirement, the top reason for quitting given by respondents was “too much pressure”, with 998 (31%) of those polled saying stress had made them leave.
Of the EEA nurses and midwives questioned, 51% said Brexit had made them leave the UK.
“They have abused the goodwill of nurses for too long”
A quarter of those from outside EEA gave poor pay and conditions as a reason for leaving.
Health commentators across the board warned that the increase in staff was not enough to meet spiralling demand, with nurse vacancies in England’s NHS alone sitting at 40,000.
Dame Donna Kinnair, chief executive and general secretary of the Royal College of Nursing, said: “Any boost to the register is good news but looking behind the headlines raises further concerns.”
She said politicians “should be alarmed” by the finding that almost one in three had quit nursing because of intolerable pressure.
“They have abused the goodwill of nurses for too long and that dam is starting to burst,” Dame Donna warned.
Dame Donna Kinnair
She added that the “modest increases” in staff were not of the scale needed and cautioned that “the workforce crisis isn’t abating”.
“Every country of the UK needs a serious strategy for the domestic workforce to recruit, train and retain a new generation of nurses and have accountability set in law,” said Dame Donna.
Saffron Cordery, the deputy chief executive at NHS Providers, said the NMC figures “provide some optimism” but added that leaders needed to be realistic about the challenges.
Also highlighting the figures in the survey around workplace pressure, Ms Cordery said addressing the working culture in the NHS must be a “vital component” of the forthcoming workforce plan.
“Trusts are already working hard to make sure all staff feel valued and that the NHS is seen as a great place to work,” she said.
“But we will also need to see a mix of short-term and longer-term solutions including the expansion of international recruitment and greater investment in NHS education and training places,” she noted.
“Fundamentally while demand continues to rise frontline staff face substantial pressures which can make their roles particularly challenging,” said Ms Cordery.
Sara Gorton, head of health at the union Unison, said not enough had been done to reassure European nurses and midwives about their future after Brexit.
“The referendum result has made many EU nationals feel unwelcome,” she said. “It’s no surprise nurses and midwives think they’ll be better off elsewhere.”
“The pressures nurses and midwives face are real and must be taken seriously”
Ms Gorton said the government should be investing in expanding apprenticeship programmes for NHS staff who could not afford study fees following the removal of the bursary in England.
She added: “The small rise in the number of home-grown nurses is heading in the right direction, but it’s a drop in the ocean compared to what’s needed.
“Without proper funding and bold new ideas, experienced professionals from within the UK and across Europe will continue to leave, putting further pressure on the struggling health service,” said Ms Gorton.
Gill Walton, chief executive and general secretary of the Royal College of Midwives, said she was pleased to see the increase in registrants but raised concerns over the affect Brexit and heavy workloads were having on staff.
“The RCM has been shouting loudly about the impact of Brexit on our NHS staff from other EU countries and this is further proof of that,” she said.
“The government need to ensure that we keep the door open for EU midwives in the future who may want to work in our maternity services.”
Ms Walton added: “The pressures on maternity services and wider NHS remain high. It is a concern that a significant proportion of people cite job pressures and being unable to do their job well as they would like as reasons for leaving.”
Andrea Sutcliffe, chief executive and registrar at the NMC, said it was “encouraging” that the rise in numbers was being driven by both UK trained and overseas professionals.
She said it was clear changes introduced by the NMC to smooth out the overseas registrations process were making a difference.
“However, we only have to look at the well documented concerns around high vacancy and turnover rates that exist right across health and social care to know there’s a long way to go before we have all the people we need to ensure the best and safest care for everyone,” Ms Sutcliffe said.
“And while there has been a drop in the number of people leaving the register, our survey fires yet another warning shot – that the pressures nurses and midwives face are real and must be taken seriously if we are to properly attract, support and retain the workforce that we need now, and for the future,” she aded.