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Immediate action on pay and working conditions needed to halt nursing exodus, warns RCN

9 Mar 2024

The government must urgently boost nursing salaries with a recruitment and retention payment alongside an above inflation pay rise for nursing staff this year.

Nurses in clinical setting The number of nurses actively planning to leave the UK 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.  

To stem the tide of departures, we’re urging the government to boost nursing salaries with a recruitment and retention payment, alongside an above inflation pay award, to recognise the chronic workforce shortages across the whole of the UK. 

Our findings are a result of a Freedom of Information (FOI) request to the Nursing and Midwifery Council (NMC). This revealed an alarming and sustained rise in nurses contacting the NMC about certificates of current professional status (CCPS), which nursing staff must submit before practising overseas. There’s been a total of over 35,000 CCPS issued in the last 5 and a half years.  

In 2021-22 around 5,000 were issued and applications more than doubled in 2022-23 to over 11,700. Between April and September 2023, the number of CCPS issued neared the total for the previous 12 months – meaning the total for 2023-24 is likely to see another huge rise.  

The rapid rise in certificate applications to leave the UK 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 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 CCPS, 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. 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.  

“Every day that the penny doesn’t drop, is another when more nurses choose to leave.”  

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

On pay, the UK ranks joint bottom alongside 3 others on the list of 35 countries, whereas New Zealand, the USA and Australia – the top 3 destinations that nurses have left or considered leaving England for – all rank significantly higher, indicating better pay is a key reason nursing staff are choosing to leave the UK for opportunities abroad.  

Page last updated - 08/03/2024