The number of Welsh nurses and midwives leaving the NHS is on the rise, new figures have revealed. A total of 1,401 professionals living in Wales left the Nursing and Midwifery Council (NMC) register in 2021-2022 - 13% more than in the previous 12 months and the highest number since 2018-19.
While retirement was the biggest overall reason, more than a third (35%) of staff in Wales said the Covid pandemic had influenced their decision to leave, and 18% cited "too much pressure" as one of their top three reasons for leaving. Those in the 41-55 age bracket saw the biggest fall in registrations in Wales, down from 15,443 in 2020-21 to 15,160 in 2021-22.
Professor Geraldine Walters, NMC executive director of professional practice and lead director for Wales, said: "It's important to note the increase in people leaving the register compared to last year, which is something we're seeing in all four countries of the UK. Many people said the pandemic and pressure were factors, which need to be considered in workforce retention plans." You can get more health news and other story updates by subscribing to our newsletters here.
Read more: Wales faces a huge and growing shortage of nurses in the NHS
While the number of people leaving the register increased, thankfully so did the number of people joining for the first time. In total there were 1,600 joiners in Wales - a 10% rise from the 1,457 recorded in Wales the previous year. Despite the higher than average amount of leavers, the total number of nursing and midwifery professionals with registered addresses in Wales grew from 37,446 to 38,268 between April, 2021, and March, 2022.
Total number of people on the permanent register by registration type with an address in Wales
Meanwhile, the number of people on the register in Wales who trained in a European country has fallen by 4.2% to 571. Romania remains by far the most frequent EU/EEA country of training (239), followed by Poland (60), Spain (58), Italy (54) and Portugal (29).
The number of people on the register in Wales who trained outside of Europe has risen by 14.3% to 2,794. There are now 1,265 people who trained in the Philippines, by some way the most of any nation, and 946 people who trained in India. Nigeria (96), South Africa (87), and Zimbabwe (81) made up the rest of the top five. Read here about the Slimming World mum who's barely recognisable after dropping from 23 stone.
Commenting on the data, Helen Whyley, director of the Royal College of Nursing in Wales, said: "In 2021–2022, 1,401 people left the register in Wales. The 12.7% increase on the previous year is indicative of the overwhelming pressures on nurses, pushing many to leave the profession, and whilst we welcome the slight increase in those joining the register, this is not enough to cover the shortages of nursing staff.
"We need more nurses in Wales to ensure safe patient care. The Welsh Government must invest in student nurses, along with fair pay for nursing and continuing professional development, to ensure we retain the nurses we have, and to encourage more to choose nursing as a profession.
"In addition, the number of people on the register in Wales who trained outside the EU/EEA has risen by 14.3% to 2,794. We must ensure that we show our internationally trained nurses that they are valued and supported as part of our nursing workforce."
Across the whole of the UK it was a similar picture in terms of joiners and leavers. On, March 31, 2022, there were 758,303 professionals on the NMC register, which is 26,403 more than there were a year earlier and is the highest level it has ever been. However, 27,133 professionals came off the NMC register in 2021-2022.
Andrea Sutcliffe, NMC chief executive and registrar, said: "After four years of steady and welcome decline, the number of professionals leaving our register has now increased. As you might expect, retirement and a change in personal circumstances are always the most common reasons.
"But our latest report confirms the third most common reason was too much pressure, with stress and poor mental health being factors in many people's decision to stop practising. Midwives were the most likely to cite this reason, closely followed by mental health nurses.
"Then there were those who said their workplace culture was having a negative effect on them – again, enough of an effect that it was part of their decision to stop."
She added: "The headline news that there's more than three quarters of a million people on our register paints a positive picture. But there are warning signs beneath the rosier surface. We need to pay attention to the relatively slow pace of domestic growth, the increase in the total number of leavers and the reasons why they left. A focus on retention as well as attracting new recruits needs to be part of a sustainable workforce plan that supports the growth in the nursing and midwifery workforce we need to meet rising demands for health and care services."
The Welsh Government has used its Live Train Work campaign to attract overseas NHS workers. It has also committed to spending £262m each year to equip and train the next generation of health workers "with the skills that we need to develop the workforce of the future".
In the government's NHS recovery plan, it states: "We know that simply continuing to grow the existing workforce will not be enough to deliver our plans and we will need to find ways to release additional capacity and work in different ways to deliver for the people of Wales.
"Robust workforce planning will be used to ensure that we find ways to better match the capacity and skills of the workforce to the demand for services resulting not only from the pandemic but the underpinning changes in demographics, patterns of ill health, and the opportunities provided by new technology and new models of service delivery."
