As of 30 September, the Nursing and Midwifery Council (NMC) Register includes 793,694 nurses (+0.7% since 1 April), 47,481 midwives (+1.9%) and 13,433 nursing associates (+5.1%). In addition, there are 6,193 dual registrants (-0.8%). There are a record 96,593 nursing and midwifery professionals who identify as men.

There has been 0.8% growth - 7,094 professionals -in the overall register between April and September. However, during the same period in 2024, the register grew by 1.8% or 14,940 professionals.

The past six months have seen a 25.7% drop in the number of professionals joining the register for the first time, and a 6.6% rise in those leaving, compared to the same period last year.

In particular, there has been a sharp fall in the number of internationally educated professionals joining the register for the first time.

In the six months to 30 September, 6,321 international professionals joined. That's a 49.6% drop compared to the 12,534 international joiners between April and September 2024. It is also the lowest six-monthly intake of new international professionals for five years.

This changes the overall balance of recruitment to the register. During the April to September periods from 2021 to 2024, there was an even or near-even split of UK and international recruitment to the register. However, from April to September this year, only 31.1% of joiners were from outside the UK.

Factors behind this may include changes for professionals on the Health and Care Worker visa. There has also been greater emphasis on domestic recruitment in England under the NHS Long Term Workforce Plan.

Additionally, analysis by the Health Foundation last year highlighted better earnings potential in countries such as Australia, New Zealand and the US.

Despite the slowdown in recruitment from countries such as India, the Philippines and Nigeria – major sources of recruitment to the UK workforce in recent years – the NMC Register has continued to become more ethnically diverse.

There are now 286,058 nurses, midwives and nursing associates who are Black, Asian or minority ethnic. That is a third of the Register at 33.2% – an increase of 0.7 percentage points since April (277,716 professionals) and 13.2 percentage points over the past five years (since September 2020).

Paul Rees, NMC chief executive and registrar, said: ‘The high-growth era of international recruitment appears to be ending. At the same time, domestic recruitment is steady. The resulting impact is that overall growth of the UK's nursing and midwifery workforce has slowed sharply.

‘Nonetheless, there are now more nurses, midwives and nursing associates on the Register than ever – and we regulate one in 50 working-age people in the UK. The Register has also continued to become more ethnically diverse. A third of nursing and midwifery professionals are now Black, Asian or minority ethnic.

‘However, these professionals are often held back by their experiences of racism and other forms of discrimination that sadly persist in society. Some of our registrants see the situation as being worse now than at any time in the last 30 years, suggesting we have reached a crisis point.

‘The whole health sector must do more to confront racism wherever it occurs, so that every nurse, midwife and nursing associate can feel safe, valued and able to deliver the high-quality care that we will all rely on at some point in our lives.'

Reaction

Caroline Waterfield, director of development and employment at NHS Employers, said: ‘Under the headlines there are numbers that act as an alarm call when it comes to developing the forthcoming 10-year workforce plan. Most notably in terms of the numbers of registered midwives and learning disability nurses.

‘The report shows a smaller number of midwives joining the register coupled with an increase in midwife registrants leaving, when compared to the same time last year, as well as a concerning further decline in learning disability nursing registrants. When it comes to learning disability nursing, decisive action must be taken to address the numbers being trained and retained in this critical and specialist area of nursing expertise.'

Unison national nursing officer Louie Horne said: ‘For decades, nurses and midwives from around the world have brought invaluable skills to the NHS. It would be a disaster to lose that contribution to vital services.

'This exposes the damage being inflicted by the government's unfair and ill-conceived immigration changes. It's clear an urgent rethink on these policies is needed.

'There are nowhere near enough nurses and midwives being trained in the UK, and far more must be done to retain those that are. That means having clear, attractive career pathways to keep staff in the sector.'

Suzie Bailey, director of leadership and organisational development at The King's Fund, said: ‘We need an honest debate about immigration's vital role in sustaining health and care, especially as the population ages and demand rises. The government and those contributing to the wider debate must confront the reality that restrictive immigration policies will have a significant impact on NHS staffing levels in the near term, and risk fuelling racism that could do significant damage to health and care services in the UK.

‘As the government develops its 10-year plan for workforce reform, it must ensure that workforce policy and immigration policy are aligned to support a sustainable and resilient health and care system that delivers better care for patients.'