Sharp drop in international recruitment slows overall growth of UK Register

The number of nurses, midwives and nursing associates eligible to practise in the UK has reached a record 860,801, but the overall growth of the workforce has slowed sharply. New data from the Nursing and Midwifery Council (NMC) shows that international recruitment has fallen to its lowest level in five years, marking a significant shift in the balance of new joiners to the Register.

As of 30 September, the Register includes 793,694 nurses, an increase of 0.7% since April, alongside 47,481 midwives, up 1.9%, and 13,433 nursing associates, up 5.1%. There are 6,193 dual registrants who are both a nurse and a midwife, a slight decline of 0.8%. The number of professionals identifying as men has reached a record 96,593. Overall, the Register grew by 0.8%—equivalent to 7,094 professionals—between April and September. This compares with 1.8% growth, or 14,940 professionals, during the same period in 2024.

The slowdown reflects 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 with last year. Most striking is the decline in internationally educated professionals. In the six months to September, 6,321 international joiners were recorded, down 49.6% from 12,534 in the same period of 2024. This marks the lowest six‑monthly intake of international professionals since 2020. Between 2021 and 2024, international recruitment consistently accounted for around half of new joiners. This year, however, only 31.1% of new registrants came from outside the UK.

Several factors may explain the decline. Changes to the Health and Care Worker visa have affected overseas professionals, while the NHS Long Term Workforce Plan has placed greater emphasis on domestic recruitment in England. Global competition is also a factor, with analysis by the Health Foundation highlighting stronger earnings potential in countries such as Australia, New Zealand and the United States. Despite reduced recruitment from traditional source countries including India, the Philippines and Nigeria, the Register has continued to diversify.

There are now 286,058 nurses, midwives and nursing associates who identify as Black, Asian or minority ethnic, representing 33.2% of the Register. This is up 0.7 percentage points since April and 13.2 points over the past five years. The NMC has pledged to confront racism and discrimination across the sector, signing the UNISON Anti‑Racism Charter, committing to de‑bias its regulatory processes, and increasing ethnic diversity among panel members who oversee Fitness to Practise hearings.

Paul Rees MBE, NMC Chief Executive and Registrar, said the high‑growth era of international recruitment appears to be ending, while domestic recruitment remains steady. “The resulting impact is that overall growth of the UK’s nursing and midwifery workforce has slowed sharply,” he said. “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.”

The NMC’s latest figures underline both the scale of the UK’s nursing and midwifery workforce and the challenges ahead. With international recruitment slowing and global competition intensifying, the sector faces mounting pressure to retain staff and ensure equality across the profession. 

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