The UK’s nursing and midwifery workforce has become larger and more diverse, but new figures show a marked slowdown in the number of people joining the professions.
Data from the Nursing and Midwifery Council, the regulator for nurses, midwives and nursing associates, shows there are now 867,935 people on its register. For the first time, more than a third are from Black, Asian or minority ethnic backgrounds.
The NMC’s latest report records 293,778 registrants from those backgrounds, equivalent to 33.8% of the total. Health leaders said the figures reflect the important contribution of staff from many communities and countries to NHS and care services across the UK.
However, the same report points to weaker workforce growth. The register increased by 14,228 professionals in 2025 to 2026, a rise of 1.7%. That is around half the previous year’s growth rate, when the register expanded by 27,289 professionals, or 3.3%.
The regulator said the change was linked to fewer new nurses, midwives and nursing associates joining the register, alongside a smaller rise in the number leaving. In total, 41,542 professionals joined for the first time in 2025 to 2026, down 21.4% from 52,833 the year before.
At the same time, 30,323 people left the register, up from 28,789 in 2024 to 2025. The NMC said burnout and exhaustion were among the main reasons given by those leaving. For patients and families, workforce numbers matter because they affect the ability of health and care services to fill rotas, maintain safe staffing levels and reduce pressure on existing teams.
The largest change was in internationally educated nurses and midwives. The NMC said 10,961 overseas trained professionals joined the register in 2025 to 2026, which was 9,708 fewer than in the previous year. That represents a fall of 47%.
India, Nigeria and Ghana were the three largest source countries for internationally educated nurses and midwives joining the UK register. Nigeria and Ghana are on the international recruitment “red list”, which means UK employers should not actively recruit from those countries because of concerns about weakening health systems that already face serious workforce shortages.
The rules do not prevent individuals from red list countries applying for UK roles on their own initiative. The NMC said employers should follow the government’s ethical recruitment code and avoid targeted recruitment from countries with the greatest workforce challenges.
The Philippines, which has long been one of the biggest sources of internationally trained nurses for the UK, was not among the top three for the first time in a decade, according to the report.
The domestic training pipeline has also weakened, though less sharply. The number of UK educated professionals joining the register fell to 30,581 in 2025 to 2026, down 4.9% from 32,164 the previous year.
Professor Lynn Woolsey, chief nursing officer at the Royal College of Nursing, described the figures as “deeply worrying”. She said previous warnings about reducing investment in the domestic nursing workforce while restricting international recruitment had not been heeded.
She said the government’s forthcoming workforce plan should include new investment to increase the number of nurses trained in the UK and action to improve retention. Retention means keeping existing staff in the workforce, particularly experienced nurses and midwives whose skills are important for supervision, training and continuity of care.
Unison head of health Helga Pile welcomed the increased diversity of the workforce but said equal opportunities remained a concern. She also pointed to job cuts and recruitment freezes as factors behind the slower growth in the register, and said keeping experienced staff should be treated as seriously as recruitment.
Ms Pile said burnout was preventable and added that racism and discrimination faced by some workers required “sustained, focused action”. NHS Employers, the King’s Fund and the Nuffield Trust also highlighted the need for employers to address racism in the workplace after the publication of the NMC figures.
The NMC has called on employers and education providers across the UK to embed its anti-racism principles for nursing and midwifery education and practice. These principles are intended to support fairer learning and working environments and to reduce discrimination that can affect staff wellbeing, progression and retention.
Emma Westcott, the NMC’s executive director of strategy and insight, said it was “more important than ever” that nursing and midwifery professionals can work without racism or discrimination. She also said overseas professionals make a valued contribution to UK health and care, but recruitment should not undermine health systems in countries facing the greatest staffing pressures.
The latest figures show a workforce that remains at record size and is more representative than in previous years, but with slower growth and fewer new entrants from both the UK and overseas. The immediate policy question for health services is how to strengthen training, recruitment and retention while maintaining ethical international hiring and improving working conditions for staff already in post.
