Nurse talking to doctor.

The already short staffed nursing workforce in UK National Health Service is set to experience further pressure if the trends in a recent Nursing and Midwifery Council (NMC) report continue – for the first time in history the number of nurses on the register had dropped year on year.

Statistics clearly showed that the decrease was the result of nurses leaving the register rather than a reduction in the number of new registrations. Contributing factors were the numbers of European Union (EU) nurses leaving the register as well as a dramatic fall in the number of EU nurses joining the register in the wake of the June 2016 UK vote to leave the European Union.

“the decrease was the result of nurses leaving the register rather than a reduction in the number of new registrations.”

The number of EU nurses leaving the register increased by 67% compared to the year before, while new registrations by EU nurses dropped by a massive 89% – from 10,178 to 1,107. EU nurses, who make up about 5% of the nursing workforce in the UK, are part of the highly skilled workers from Europe who feel discriminated against and uncertain of their immigration status after Brexit. Around 56% of all skilled workers and 86% of health sector staff from the EU stated that they were planning to leave the UK, according to a recent study.

The NMC figures further show that over the past year the number of UK graduate nurses leaving the register also increased by 9%. The number of nurses joining the register from countries outside Europe has, however remained steady over the last five years.

“It’s worrying that we are seeing a continuing rise in nurses and midwives leaving the register and our data is clear that this is being driven by both UK and EU registrants,” said Jackie Smith, Chief Executive and Registrar of the Nursing and Midwifery Council. “These figures continue to highlight the major challenges faced by the UK’s health and care sectors around the recruitment and retention of staff. Nurses and midwives work incredibly hard in very difficult circumstances.” Smith expressed the hope that those responsible for dealing with issues in the health workforce would respond to what the trends are showing.

“Just a small drop off in NHS nurses from the EU will make a bad situation worse. And when trusts can’t cover gaps in rotas it affects the quality of care,” wrote Saffron Cordery, director of policy at an NHS trade organization. “NHS nurses and midwives cannot give the quality of care they want to if they are run ragged. We cannot keep on expecting them to go the extra mile, time and again.” He stressed the need for steps to ease the severe workplace pressures, clarity around the pay cap, and confirmation by the government that EU staff would have the right to remain working for the NHS.

Janet Davies, Chief Executive of the Royal College of Nursing, was of the opinion that the figures released the NMC represented a double whammy for the NHS and the patients. “These dramatic figures should set alarm bells ringing in Whitehall and every UK health department,” she said.

Conversely, the UK government did not appear to be perturbed by the statistics. “These figures represent a mere 0.2 percent decrease in the 689,738 nurses and midwives currently registered with the NMC and there are in fact more nurses on our wards since last year,” was the response of a Department of Health spokesman. “We are also ensuring the NHS has the staff it needs for the future through our 25 per cent increase in nurse training places.”

All of this is happening against a backdrop of an estimated 40,000 vacant nursing positions in the UK. Although the government has committed to increasing the number of places for nurse training this will not provide a solution in the short-term, especially if the trend shown in the recent NMC figures continues together with the population’s growing demand for healthcare services.