The Nursing and Midwifery Council (NMC) register of all nurses, midwives and nursing associates who can practise in the UK has reached a record 853,707 – around 2% of the total working age population.
The number includes more Black, Asian and ethnic minority professionals than ever - 277,716, which 32.5% of the NMC register.
However, there has been a significant slowdown in international recruitment to the register following years of growth. The NMC's latest data show that in 2024–2025, the number of international joiners fell by nearly a third to 20,671, compared to 29,628 in 2023–2024.
This slowdown in international recruitment was spread across countries, including the top three sources of international recruitment over recent years: India, the Philippines and Nigeria. The number of joiners who were educated in these three countries fell by 36.7%, 47.6% and 25.5%, respectively, over the past year.
Also, the number of international professionals leaving the register has increased by 33.3%, from 3,959 leavers in 2023–2024 to 5,276 last year. In the context of a growing register, this means that 2.7% of the international cohort left in 2024–2025, compared to 2.4% the previous year.
Meanwhile, a greater number of UK-educated professionals joined the register in 2024–2025: 32,163, which is 5.9% more than in the previous year (30,363). However, this was a smaller rate of growth than in 2023–2024, when the number of UK joiners grew by 11.9%.
Meanwhile, 28,789 people left the NMC register last year. That means 3.5% of the register left, compared to 3.4% in 2023–2024.
Retirement is the most common reason for people leaving the register, but in second place was physical or mental health. For the second year in a row, a total of 13% gave this as their main reason for leaving, with 70% of those saying their professional role had a negative impact on their physical health, and 85% saying it had worsened their mental health.
Only 19.9% of leavers said they would recommend a career in nursing or midwifery.
Paul Rees, interim chief executive and registrar, said: 'We've seen a slowdown in international nurses and midwives joining our register. That's a significant shift from recent years and there are likely a few reasons for it.
'Even with this change, our register is still growing – and it's becoming more diverse. That's a real strength. It also means we must make sure everyone can work in an environment that values diversity and tackles racism.'
In response, Caroline Waterfield, director of development and employment at NHS Employers, said: ‘In what are very challenging financial times for the sector, we know that to meet the existing demand, support waiting list reductions and improve patient experience we need to retain all of our existing talent, as well as continue to train the future generation of professionals via degree apprenticeships and university training.
‘Continued support for training and retaining a future workforce will be essential in the implementation of the forthcoming 10-year health plan.'
Unison national nursing officer Stuart Tuckwood said: ‘The continuing growth and diversity in registered professionals is good to see, but a sharp fall in the number of international joiners is a concern, particularly as the government is still far from training enough nurses and midwives within the UK.
‘Changes to immigration policy and inadequate NHS pay rises are making it harder to attract new recruits and keep hold of experienced overseas nurses. That threatens already-precarious staffing levels and adds even more pressure to the overstretched workforce.
‘The government has to make the NHS a place where health professionals want to stay and thrive.'
