Top nurses have said that planned government reforms for the health service “stand no chance” if issues with recruitment and retention in the profession are not addressed.
They made the warning as new figures show the number of nurses and midwives registered in the UK has grown to a record high.
However, experts say the workforce is “increasingly inexperienced”, faces worrying shortages and still relies heavily on candidates from overseas.
Policymakers have been urged to consider measures such as student loan forgiveness schemes to ensure there are enough homegrown staff.
The latest mid-year report from the Nursing and Midwifery Council shows there were a record 841,367 professionals on the register as of the end of September, an increase of 14,949 compared with the previous six months and 22% higher than March 2017.
The NMC said growth has been upheld by “two pillars” in the past seven years: a “steady pattern” of domestic recruitment and a “significant rise” in overseas joiners.
The figures show 14,780 UK-educated professionals joined the register between April and September, a fall of 1.8% compared with the previous six months, while 11,569 UK-educated staff left the register, 1.6% higher than the figure reported in the six months to September 2023.
Meanwhile, the NMC said international recruitment “could be starting to slow”.
Its data shows there were 12,534 internationally educated joiners on the register in the six months to September, which is 16.6% fewer than the same period last year. Some 2,573 international staff also left the register, an increase of 33%.
Kuljit Dhillon, the interim executive director of strategy and insight at the NMC, said: “Nursing and midwifery are among the UK’s most trusted professions, so as we head into another tough winter, we hope there is small comfort in the growth of our register to a record 841,000.
“At the same time, there are notes of caution in our data around international recruitment, which has been a pillar of workforce growth in recent years.
“We’ve seen a fall in internationally educated joiners and an even higher proportional rise in leavers, although it’s important to view leavers’ data through the lens of a growing register.”
Nevertheless, Prof Nicola Ranger, the general secretary and chief executive of the Royal College of Nursing (RCN), called the figures “bad news for patients”.
She said: “Nurse recruitment is slowing, the numbers of new starters is falling and we are witnessing a devastating increase in people leaving within five years of joining. At a time of widespread vacancies, these trends are incredibly worrying for our NHS and the people that rely on its care. Across health and care services, international recruitment was utilised to plug rota gaps, but we are now watching as thousands of overseas staff choose to go elsewhere.
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“This comes as the number of student nurses in the UK dropped considerably again this year, showing worse years seem be ahead. As demand for care soars, ministers across the UK need to recognise this as a perfect storm for patient safety and take action to improve recruitment and retention.
“Working for low pay, in understaffed, under-resourced services takes its toll with burnout pushing highly trained nursing staff out the door.
“Across England, we desperately need a loan-forgiveness scheme to boost domestic recruitment into the profession. The government’s NHS reforms stand no chance of being delivered without addressing these fundamentals.”
Dr Billy Palmer, a senior fellow at the Nuffield Trust thinktank, welcomed the growth in the register but said the workforce was facing shortages. He also described the figures as “a chronic symptom of a domestic clinical education system that is not fit for purpose”.
Palmer said: “The UK’s nursing and midwifery workforce is increasingly inexperienced and facing deeply worrying shortages in important areas, with learning disability nursing numbers still lower than five years ago.”
A Department of Health spokesperson said: “Nurses have been overworked for years, leaving them burnt out and demoralised. That’s why we accepted the recommendations of the independent pay review bodies to award them and other 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.”