Record number of nurses but concerns raised that ‘pressure’ could lead to drop

A record number of nurses and midwives are working in the UK, but the nursing regulator has warned that “pressure” on frontline staff could have a significant impact on numbers who leave the profession.

The Nursing and Midwifery Council (NMC) said more must be done to address pressure on staff and “negative workplace culture”.

It comes just after a nurse who looked after Boris Johnson when he was seriously ill with Covid-19 resigned, citing the Government’s 1% pay offer and its lack of respect for the profession.

Jenny McGee, who cared for the Prime Minister in intensive care at St Thomas’ Hospital in central London, told a Channel 4 documentary: “I don’t know how much more I’ve got to give to the NHS. We’re not getting the respect and now pay that we deserve.”

The NMC also raised concerns that there could be an exodus of retirees after the pandemic is over, after its figures suggested a significant number may have put off retirement to help colleagues battle Covid-19 on the front line.

The annual report of the NMC’s register – which holds details of all practising nurses and midwives in the UK – shows that in the year to March 31 there was a record number of nurses and midwives on the register, almost 732,000.

The NMC report states that the data “paints a positive, encouraging picture, and speaks to the crucial role that nursing and midwifery professionals have played on the front line of the pandemic.”

But it said that when the data is examined in depth there are some notes of caution.

A poll of 5,639 nurses who left the register between July 2019 and June 2020 found that retirement was the most common reason for leaving, but more than a fifth (22.7%) said they left the workforce due to “too much pressure”, which led to stress and poor mental health, and 18% cited workplace culture issues.

The authors cautioned: “Many people also told us that too much pressure and negative workplace culture were factors.

“These issues existed before the pandemic, and may well outlast it, further disrupting an already fatigued nursing and midwifery workforce. If not addressed, this could have a significant impact on the number of people we report leaving our register over the next year and beyond.”

Meanwhile, there has been a rise in older nurses and midwives on the register and the number of people considered to be in the retirement age brackets – those aged 56 and over – rose by 6.2% compared to the previous year.

There are now more than 154,000 nurses and midwives over the age of 56 on the register – including almost 60,000 aged 61 to 70 and 3,380 aged over 71.

“This suggests that people may have stayed on to help tackle the pandemic, which is testament to their commitment to their profession and public health,” the report states. “But if they have delayed their decision to retire, we may see them leave our register, and therefore the workforce, when the pandemic is over.”

The rate of growth in the register is slower than previous years and despite rises in the number of people applying to study nursing and midwifery at university, there has been a drop in the number of international nurses coming to work in the UK as a result of the coronavirus pandemic and Brexit, it added.

Andrea Sutcliffe, NMC chief executive and registrar, said: “There’s no doubt this has been a year unlike any other. It’s been difficult and, at times, traumatic for our incredible nursing and midwifery professionals, who’ve worked tirelessly to continue to care for people in the most challenging of circumstances.

“Given the impact of the pandemic, it’s great our register has continued to grow and, overall, today’s report paints a picture of cautious optimism.

“However, while our register shows welcome and much needed positive UK growth overall, the pace of that growth has slowed. We’ve also seen the continued reliance on international recruitment, which makes us vulnerable to the impact of world events, as the early months of the pandemic showed.

“It’s also great to see fewer people have left our register, but we know from our leavers’ survey that workplace pressures and stress are among the key reasons for leaving. As we begin to address the longer term effects of Covid-19 on our health and care services, it’s clear we must do all we can to support the physical and mental wellbeing of our professionals so they feel able to stay.

“The pandemic has driven a surge of interest in our wonderful professions. It’s now the responsibility for all of us as leaders across the health and care system to heed the underlying pressures and work together to develop, support and sustain the nursing and midwifery workforce we need to cope with the future challenges ahead.”

Commenting on the report, Pat Cullen, from the Royal College of Nursing, added: “This report confirms there is trouble on the horizon for people needing health and care services.

“Fewer nurses registered with the NMC this year than last. The register is growing nowhere near enough to meet patient demand. The situation will get worse when one fifth of the register retires in the next few years.

“This doesn’t include those nursing staff planning to leave due to high stress, poor pay and benefits and a negative workplace culture. This is clearly a major risk for the quality and safety of patient care, which is only set to increase in demand.”

Sean O’Sullivan, from the Royal College of Midwives (RCM), added: “The significant pressures on maternity services and the wider NHS, serious and longstanding midwife shortages, coupled with a paltry and insulting pay offer for NHS staff in England could see midwives and other staff exiting the NHS, particularly those close to or at retirement age.

“An RCM survey last year showed that a majority of midwives have considered leaving the profession, with a third seriously thinking about it. These are worrying statistics that need to be taken seriously.

“Staff have worked to the point of mental and physical exhaustion and it is no wonder that many simply do not want to take it anymore.

“The solution is to give NHS staff time and support to recover from the toll taken by the pandemic and continue and speed up investment in more midwives. The Government must also give NHS staff an early and significant pay award to make up for a decade or more of pay stagnation, which is something that the public support, and that they deserve.”

Care minister Helen Whately said: “I am incredibly grateful to all our remarkable NHS staff, and it’s tremendous to see the record numbers of nurses on the register.

“It’s been a year like no other and thousands of nurses and midwives have worked flat out to tackle this virus, providing exceptional care for society’s most vulnerable people and safely bringing new life into the world. We are committed to growing their numbers as we build back better, including delivering 50,000 more nurses by the end of this parliament.

“There is no better time to join the profession, and the number of applicants to study nursing is growing hugely– rising by 34% this year alone. On our part, we will continue to improve the support for nurses and midwives who have been through so much over the last year, including dedicated mental health support in our 40 NHS staff wellbeing hubs across the country.”