As I have shared before, there are many things I didn't know about the Nursing and Midwifery Council (NMC) before I started working there. One such interesting area is why, what and how the NMC maintains a register of professionals. This month, I am particularly interested in the NMC mid-year Registration Data Report (NMC, 2024) detailing information from 1 April 2024 to 30 September 2024, which has just been published.
The Nursing and Midwifery Order (2001) (https://www.legislation.gov.uk/uksi/2002/253/part/III/made) is the legislation that sets out the articles or ‘rules’ that enable the NMC to deliver its primary purpose, which is to protect the public. Regarding the NMC register, there are detailed rules cited in the Nursing and Midwifery Order, laying out the expectations of the NMC role of maintaining a register, what the entry requirements are, what is recorded, and the handling of concerns about registrants.
Register leavers and joiners
The NMC publishes regular reports detailing leavers and joiners, alongside key individual and professional demographics, which give us insight into the shape of the UK nursing, midwifery and nursing associate workforce.
The latest NMC Registration Data Report recorded a total of 841367 professionals who are currently on the NMC register. This is an increase of 1.8% or 14949 recorded 6 months ago, and 151629 (22%) more than in March 2017.
However, although the register had shown growth in recent years, the total number of professionals – whether UK or internationally educated – who joined the register for the first time between April and September fell by 9.2% to 27313 (compared to 30085 in the 6 months to September 2023).
The register has seen total leavers this year of 14142; however, the number of leavers as a proportion of the growing register is reported to be unchanged at 1.7% (NMC, 2024).
Key headlines and issues
Although there are several areas for the NMC to consider regarding the current shape of the register, I also think that there are some key headlines that nursing and midwifery leaders need to consider, both strategically and locally, to understand the shape of their workforce and what employer planning and support is required (NMC, 2024):
There are more detailed data available at country level and field-specific level. However, the high-level headlines stated above, among other considerations do call upon us to question if we are creating the right culture and environment in which nurses, midwives and nursing associates wish to both join the workforce and stay in the workforce.
The Nuffield Trust (Rolewicz et al, 2024) has reviewed how we have got into this situation and has stated that, in the face of both insufficient domestic recruitment and a ‘leaky’ training pipeline, the NHS is relying increasingly on recruitment from abroad to fill nursing roles.
A key factor that is contributing to the shortfalls has been a failure to train sufficient numbers of staff, recognising that this has been particularly pronounced for nurses, where there was a large decline in the number starting nursing after the early 2000s. Johnson (2024) reported that there are 21% fewer nursing students starting courses at universities across the UK than 3 years ago.
Supportive actions
There are several areas in which the NMC is actively seeking to support the workforce, such as its review of the quality of practice learning. This has been encouraged by the government, which has reiterated calls as the work progresses and more is understood, to reduce student nurses' practice learning hours from 2300 to 1800, as part of its submission to the NHS Pay Review Body (Department of Health and Social Care, 2024).
The Nuffield Trust has cited an example of a recent NHS programme to improve the retention of nurses that appears to have made a positive impact with, in turn, improvements in patient care (Rolewicz et al, 2024). However there is clearly much more that needs to be done, and current actions are having to redress a situation that has arisen because the workforce has all too often been neglected or not prioritised in previous NHS policies and plans.