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Nursing Exodus: Nurses fleeing England for better pay

Press Release 09/03/2024

The number of nurses actively planning to leave England for better pay and conditions abroad has skyrocketed in recent years – with the number rising more than four-fold between 2018/19 and 2022/23, new official figures disclosed to the Royal College of Nursing reveal.

To stem the tide of departures, the College says the government must urgently boost nursing salaries with an emergency top-up payment worth several thousand pounds, alongside an above inflation pay rise for nursing staff this year. The RCN is also urging the Chancellor to bring forward a series of measures to increase domestic student nurse recruitment.

Following a Freedom of Information request to the Nursing and Midwifery Council (NMC), official data highlights an alarming and sustained rise in nurses applying for certificates of current professional status (CCPS), which nursing staff must obtain before practising overseas. Every year since 2018/19 has seen an increase in the number of CCPS’ issued - with a total of over 30,000 (30,901) issued in the last five and a half years.

But the RCN is now able to point to a dramatic increase in CCPS applications between 2021/22 and 2022/23, with numbers applying for a certificate more than doubling from around 4,400 to over 10,000. Between the six months from April to September of last year alone, the number of CCPS’ issued neared the total for the previous 12 months – meaning the total for 2023/24 is on course to see another huge rise.

The RCN says the rapid rise in certificate applications to leave England came during the most intense period of the UK’s cost of living crisis, in which inflation peaked at 11.1% in October 2022. After over a decade of real-terms pay cuts, nursing staff were left financially exposed, forcing thousands to consider better paid jobs in health and care overseas.

The official figures come after the Westminster government submitted its latest evidence to the Pay Review Body, which is tasked with making recommendations to the government on wage rises for this year. The RCN said ministers will soon need to name a number for pay rises this year, reminding the government that pay is a key lever in dealing with the recruitment and retention crisis gripping services.

A recent report published by the Organisation for Economic Co-operation and Development (OECD) showed nursing, on average, is a far more highly paid career in most other OECD countries - where full-time nurses working in the hospital sector can expect to earn 20% more than the full-time average wage. In the UK, nurses working in hospitals earn approximately 10% less than the full-time national average. The RCN says nurses are voting with their feet because pay, terms and working conditions are better overseas.

On pay, the UK ranks joint bottom alongside three others on the list of 35 countries, whereas New Zealand, the USA and Australia – the top three destinations that nurses have left or considered leaving England for – all rank significantly higher. This indicates better pay is a key reason nursing staff are choosing to leave for opportunities abroad.

With tens of thousands of vacancies in the NHS, the RCN is reminding government that one of the key levers to boost recruitment and retention – and ultimately keep patients safe – is to pay staff fairly and improve working conditions.

The data also highlights that many internationally educated nurses have left or considered leaving the UK. Since 2018, over 14,000 UK nursing staff trained in India requested certificates of current professional status – as did around 7,000 trained in the Philippines and 3,000 trained in Nigeria. Applications to practise in India, the Philippines and Nigeria are very low – indicating nurses are not simply returning to their country of origin. The RCN says this highlights that the government’s overreliance on recruiting internationally educated nursing staff is not a long-term solution, with many eventually leaving the UK.

RCN General Secretary and Chief Executive Professor Pat Cullen said:

“Low pay and poor working conditions are driving chronic workforce shortages. With the prospect of better pay and working conditions abroad, it should be little wonder why nurses are opting to use their skills elsewhere.

“The NHS has been a pioneer in health and care but today struggles to compete on the world stage – and it is patients who feel the impact.

“Solutions to the nursing workforce crisis are often described as being overly complex. But the reality is that those working in health and care services want to be rewarded fairly and to deliver the level of care they were trained to.

“The government’s submission to the pay review body indicates that it hasn’t yet grasped the urgency of the workforce crisis in nursing. Every day that the penny doesn’t drop, is another when more nurses choose to leave.”


Notes to Editors

The below data details the year-on-year increase in the number of certificates of current professional status (CCPS) issued by the NMC to nurses between 2018/19 and 2023/24.















*Note the 2023/24 figures show six months of the year only (from April to September 2023), with the full year’s figures anticipated to be higher.

CCPS’ are issued by the NMC when a current or ex-practising UK registered nurse is applying (or considering applying) to an overseas regulatory body to work as a nurse. Also, CCPS’ expire after 3 months, which may mean some nurses will request more than one CCPS’ as part of their application process. Lastly, applying to work in certain countries will mean requesting a certificate for the national regulatory board, as well as a local state board. This means that the numbers of CCPS’ issued do not necessarily correspond with the numbers of actual nurses who have left to work outside the UK, but can be used as an indicator of movement.

The data also highlights that many internationally educated nurses have left or considered leaving the UK. Since 2018, 14,756 UK nursing staff trained in India applied for certificates of current professional status. 7,270 trained in the Philippines and 3,237 trained in Nigeria have also applied.

In February, university admissions service UCAS announced a 26% drop in applications to study nursing in England across the most recent two-year period. The RCN has called on the government to introduce emergency support for nurse students.

The Organisation for Economic Co-operation and Development (OECD) Health Division report, published in November 2023, is available here.

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