The UK’s largest nursing union warned of a workforce “exodus” with tens of thousands of young staff leaving the profession, as NHS bosses backed calls for ministers to meet unions to agree on a pay deal and avoid further strike action.
Nearly 43,000 nurses across the UK in the early stages of their careers have quit over the past five years, figures from the Royal College of Nursing (RCN) show – almost equal to the record 47,000 nursing posts now vacant in NHS England.
The RCN said the loss of nurses aged 21 to 50 and midwives was “extremely concerning”. Many of those leaving between 2018 and 2022 variously said stress, burnout, inability to deliver adequate care, poor workplace culture, the pandemic and being underpaid were behind their decisions to leave.
The RCN’s report, Valuing Nursing in the UK, comes as the union plans to escalate its pay dispute by withdrawing staff from emergency departments, intensive care and cancer wards in the next round of industrial action.
Dates for the next strikes by nurses in England are expected to be announced within days, with the action expected to take place within a couple of weeks. The RCN is understood to be considering action across three separate days and throughout the night.
The strikes, which would probably have the biggest impact on patients so far, could be compounded if junior doctors also vote to strike from next month, said NHS Providers, which represents NHS bosses.
“Plans to escalate strikes even further is alarming given the significant impact they’ve already had on patients,” said Saffron Cordery, the deputy chief executive of NHS Providers. “The walkouts have led to 137,000 appointments being postponed so far, with nearly 50,000 of those being from Monday and Tuesday last week alone.”
The RCN has demanded a 19% pay rise for this year, but its general secretary, Pat Cullen, has said she will call off action if ministers prove willing to discuss matching the 7% offer made by the Welsh government.
Nurses in England have so far been given 4%, as recommended by the NHS pay review body, and ministers have refused to offer more.
“Neither trust leaders nor their staff want patients to be impacted, but frontline workers feel they’ve been pushed to take action due to their challenging working conditions and pay levels,” Cordery said. “The only way to avert more disruption is to bring the strikes to an end, which means the government must talk to the unions now about pay for this financial year.”
The RCN’s report, which draws on data from the Nursing and Midwifery Council, shows that many early-stage nurses who have quit since 2018 have left health and social care work completely. The findings build on analysis from the King’s Fund thinktank last year which found that two-thirds of nurses leaving the NHS were under the age of 45.
One student nurse quoted in the RCN report spoke of no longer wanting the career. “The reality feels as though I must sacrifice my own health and wellbeing, for a less than satisfactory wage, in order to do half the job I would like to. I see nurses crying, extremely stressed but wanting to do good and yet are not given the opportunity to,” they said.
The report says better pay, improved opportunities to reach leadership roles, and career progression are all important for retaining young nurses. But keeping staff from leaving might not be enough. Figures from Ucas last week pointed to an 18% fall in the number of students applying for nursing courses in England in the past year.
Cullen said: “That nurses aren’t just choosing to retire early but are quitting, and not just the NHS but the profession entirely, when they’re only a few years into their career, is deeply worrying. It speaks volumes about the dire state that ministers have allowed nursing to fall into through years of underfunding and neglect. The prime minister needs to get round the negotiating table and offer a fair pay rise to stop the exodus.”
