The number of internationally educated nurses and midwives joining the UK register has dropped by a third in the last year, ending the upward trend of overseas recruitment.
The Nursing and Midwifery Council (NMC) has today published its annual registration data, showing how many nurses, midwives and nursing associates have joined and left the register in the last 12 months.
“The government has been as unethical in stopping international recruitment as its predecessor was in abusing it”
Lynn Woolsey
As well as the drop in international recruits, the report showed that many nurses had left the profession due to poor physical or mental health.
In total, the NMC register had a record 853,707 professionals as of 31 March 2025.
All fields of nursing saw an increase in numbers during 2024-25.
It was the first year since 2019-20 that there had been an increase in the number of learning disability nurses on the register.
Despite this, the regulator said its register’s growth had decelerated during 2024-25, arguing that this was mainly due to a significant slow down in international recruitment.
Since 2018, the number of internationally educated professionals joining the register had been rising steadily and, by 2023-24, almost half (49%) of all new joiners to the register were from overseas.
This trend has now reversed, with the latest data showing a 30% drop in international joiners – down to 20,671 compared to 29,623 the previous year.
As a result, the proportion of all new joiners educated outside the UK fell to 39%.
The slowd own happened across the top three source countries of international recruitment: India, the Philippines and Nigeria.
The NMC suggested that recent changes to visa rules may have played a part, and that there had been a rise in international professionals looking to move to other countries.
It comes as unions have been warning in recent months that there could be an “exodus” of overseas staff because of hostile immigration policies and poor salaries.
The NMC report found that the number of international professionals leaving the register increased by a third (33%) from 3,959 in 2023-24 to 5,276 in 2024-25.
The Royal College of Nursing chief (RCN) nursing officer, Lynn Woolsey, said the figures should “put pressure on Wes Streeting to come up with a 10-year workforce strategy to turn things around”.
She said: “The government has been as unethical in stopping international recruitment as its predecessor was in abusing it.
“This boom-and-bust approach must end and a strategy that boosts domestic supply and delivers fair treatment for international staff is what’s needed.
“We warned the government that hostile immigration policies and poor pay were driving international staff away and at a time when we couldn’t afford to lose a single nurse.”
For domestic recruitment, the NMC found that the number of UK-educated professionals joining the register had continued to grow but at a slower rate “and not by enough to offset the fall in international recruitment”.
Some 32,163 UK professionals joined the register in the 12 months to March 2025 – 6% more than the previous year but less than in 2023-24.
Meanwhile, the number of UK leavers rose by 1.3% to 23,513 last year but remains unchanged as a proportion of the growing UK cohort on the register.
In total, 28,789 people left the NMC register in the year to March 2025 – around 3.5% of the register.
The report noted that retirement remained the top reason why people left the register, however the second most common reason was physical health or mental health.
For the third year in a row, 13% said health was their main reason for leaving, with 70% of those saying their professional role had a negative impact on their physical health and 84% saying the same for their mental health.
Concerningly, only one in five (20%) of leavers said they would recommend a career in nursing or midwifery.
RCN chief nurse Ms Woolsey added: “It’s a damning indictment of life for a nurse in the UK that physical and mental health problems are among the biggest drivers of people quitting, whilst just one in five would recommend nursing as a career.
“Delivering better pay and improving working conditions must be urgent priorities for ministers.”
Separately, the NMC report showed that the profile of its register had changed, with more professionals from a Black, Asian and ethnic minority background.
These nurses and midwives now account for just under a third of everyone on the register (32.5%) – up from 20% in 2020.
Further, the regulator found that 2024-25 was the first year that more than 50% of new joiners were aged 31 and above.
It said this was predominantly due to large numbers of people aged 31-50 joining from outside the UK.
However, it also found an increase in the number of people from the UK joining the professions later.
In the last six months, 46.5% of UK joiners were aged 31 or above, compared to five years ago when the figure was 37%.
Paul Rees, interim chief executive and registrar, said: “We’ve seen a slow down in international nurses and midwives joining our register.
“That’s a significant shift from recent years and there are likely a few reasons for it.
“Even with this change, our register is still growing – and it’s becoming more diverse. That’s a real strength.
“It also means we must make sure everyone can work in an environment that values diversity and tackles racism.”
Mr Rees added that the NMC had “a responsibility to be fair to everyone” on its register, and that it would soon be setting “bold new targets” to eliminate bias from its regulatory processes.
