The number of nurses and midwives leaving the profession has increased substantially, with many citing poor workplace cultures and too much pressure as factors that influenced their decision.
Although the number of people on the Nursing and Midwifery Council (NMC) register rose by 26,403 to a record 758,303 in the year to 31 March 2022, some 27,133 left the register. This was an increase of 13%, reversing a downward trend in leavers over recent years.
Nurses and midwives have to be registered with the NMC before they can work in the NHS. Not everybody on the register will currently be working.
When a sample of leavers were asked about their top three reasons for doing so, retirement (42.9%) was the most frequently cited. However, 18.3% put too much pressure on their mental health in their top three, and 13% said the workplace culture was having a negative effect on them.
In response to a question about whether the Covid-19 pandemic had affected their decision to leave, 36.5% of respondents said it had had either ‘some’ or a ‘strong’ influence. Some 11.8% put the pandemic in their top three reasons for leaving.
Culture in the NHS
One respondent said: “It was not the virus itself, it was the working conditions it led to. Regularly caring for 2, 3 ,4 women who should have been 1-2-1 was terrifying and exhausting. Wearing the same mask all day because there were no others,
begging for sterile gowns for crash sections, holding pee in all day because you are so short staffed, the list goes on.”
The NHS staff survey in March found that the organisation’s morale score had fallen to its lowest since 2017, with increases in the proportion of staff thinking about changing jobs, feeling unable to meet all their demands at work, and feeling unwell because of work-related stressors.
Andrea Sutcliffe, chief executive and registrar at the NMC, said: “Our register is at the highest level ever. This is good news considering all the pressures of the last two years. But a closer look at our data reveals some warning signs.
“Those who left shared troubling stories about the pressure they’ve had to bear during the pandemic. A focus on retention as well as attracting new recruits needs to be part of a sustainable workforce plan to meet rising demands for health and care services.”
Sutcliffe said it was concerning that the sector had become more reliant on internationally-trained professionals. Of 48,436 who joined the NMC register for the first time last year, 23,408 (48%) had trained overseas. Sixty-six per cent of these had trained in India or the Philippines.
The NMC register report for 2021-22 says that the number of new joiners who had trained in the UK had risen only marginally from 24,555 in 2020–2021 to 25,028 last year.
In 2020 a Health and Care Visa was launched for overseas health workers who wanted to work for the NHS. The visa lasts for up to five years, but can be extended.
Sutcliffe said: “These professionals make a welcome and vital contribution to our nation’s health and wellbeing. But we can’t take them for granted.
“Two years ago, we felt the pandemic’s impact on global travel; the number of international joiners to our register fell sharply. A future pandemic or other global disruption could see history repeat itself, but with an even bigger impact on the overall growth of the register. We also need to make sure that we are supporting, valuing and rewarding our internationally trained joiners so their careers can thrive in the UK.
“I very much hope our data will help support long-term sustainable workforce planning in health and care services across the UK, for the benefit of our professionals and the public we all serve.”