The NHS is set to implement an above-inflation pay rise in 2025, aimed at addressing long-standing grievances among healthcare staff. However, top nursing figures warn that the government’s reforms to the health service could falter unless critical issues around workforce recruitment and retention are urgently addressed.
Despite a record high in registered nurses and midwives, concerns are growing over an increasingly inexperienced workforce and persistent reliance on international recruitment. Experts argue these trends could jeopardize the delivery of safe and effective care.
A Record High, but with Caution
The latest mid-year report from the Nursing and Midwifery Council (NMC) shows a record 841,367 nurses and midwives were registered in the UK as of September 2024—an increase of 14,949 in six months and 22% higher than March 2017. This growth has been supported by domestic recruitment and a significant rise in internationally educated joiners.
However, cracks are beginning to show. UK-trained healthcare professionals joining the register fell by 1.8% in the past six months, while the number leaving rose by 1.6%. The NMC also highlighted a sharp decline of 16.6% in NHS international recruitment by joiners compared to the same period last year, coupled with a 33% rise in leavers from overseas.
The Perfect Storm for Patient Safety
Professor Nicola Ranger stated that “nurse recruitment is slowing, the numbers of new starters are falling, and we are witnessing a devastating increase in people leaving within five years of joining,” she said. “Burnout from working in under-resourced and understaffed conditions is pushing highly trained nursing staff out the door.”
Professor Ranger called for immediate action, including a student loan forgiveness scheme, to incentivize domestic recruitment. Without such measures, she warned, the government’s NHS reforms stand no chance of success.
An Inexperienced Workforce Under Pressure
Dr. Billy Palmer of the Nuffield Trust described the workforce as “increasingly inexperienced,” with 28% of nurses and midwives having five years’ experience or less. He pointed to troubling shortages in areas such as learning disability nursing, where numbers remain lower than five years ago.
Dr. Palmer criticized the reliance on international recruitment, noting that nearly half of all new registrants were educated outside the UK. “This is a chronic symptom of a domestic clinical education system that is not fit for purpose,” he said, urging policymakers to adopt bold measures like student loan forgiveness schemes to ensure a sustainable workforce.
Government Response
A Department of Health spokesperson defended the government’s efforts, emphasizing the importance of the 2025 pay rise in tackling issues of burnout and demoralization among nurses. “We accepted the recommendations of the independent pay review bodies to award NHS staff an above-inflation pay rise. We will work with staff to rebuild our health services and give the NHS the stability and certainty it needs,” the spokesperson said.
While this commitment is a step forward, the pressures facing the nursing profession suggest that systemic changes are essential. Without addressing the root causes of workforce instability, the NHS risks failing to meet the growing demand for care.
The Workers Union Says…
“The 2025 NHS pay rise offers hope for improved conditions, but experts caution that pay alone will not resolve the deeper issues of recruitment, retention, and workforce experience. Urgent action, including innovative policies like student loan forgiveness schemes, is needed to safeguard the future of nursing and midwifery in the UK.”
