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Record numbers of nurses are quitting the NHS in England, according to a new analysis.
More than 40,000 have left the health service in the past year – one in nine of the workforce, data examined by the Nuffield Trust for the BBC has shown.
The think tank said many of these were highly skilled and knowledgeable nurses with years more work left.
The Nuffield Trust said there is increasing evidence that stress and the need for a better work-life balance is driving nurses to leave.
Unless something is done, the Government will struggle to hit its target to recruit an extra 50,000 nurses in England during this Parliament, it said.
The Department of Health said it will publish a workforce strategy and is halfway towards its recruitment target.
But data shows there were just 4,000 more joiners than leavers, meaning the high number of leavers is almost cancelling out the rise in new joiners.
Dr Billy Palmer, from the Nuffield Trust, told the BBC the data is an “urgent wake-up call” and suggested there are “deep-rooted issues with working practices and employment conditions” that are leading nurses to quit.
The data also showed the proportion of nurses quitting in Scotland is almost exactly the same and, while similar data is not available in Wales and Northern Ireland, other indicators suggest they are seeing significant numbers leaving.
For the analysis, the Nuffield Trust used data provided by NHS Digital, which tracks the number of nurses joining and leaving over the course of the year.
It looked at those in permanent roles at NHS trusts that provide hospital, community and mental health care.
Nurses working in the community were the most likely to have left their job.
Dr Palmer said: “There has been a staggering jump in the number of NHS nurses leaving active service.
“Nurses are integral to the functioning of the health service, so it should be an urgent wake-up call that one in nine left their posts in the year.
“While every year we would expect nurses to retire, it is very concerning to see the numbers who cite the reasons for considering or actually leaving as health concerns or work-life balance.
“Across various staffing surveys and reports, there is now firm evidence which points towards deep-rooted issues with working practices and employment conditions that push much-needed nurses away from the profession.”
A Department of Health and Social Care spokesman said: “As the Health and Social Care Secretary has said, we are focused on delivering for patients on the issues they care about most. This includes easing pressure on ambulances, clearing the Covid backlogs, supporting discharge from hospital and ensuring improved access to doctors and dentists. All of this will be driven by a bolstered workforce.
“There are over 29,000 more nurses working in the NHS now compared with September 2019, so we are over halfway to delivering on our commitment to have 50,000 more nurses in the NHS by 2024.
“We have also commissioned NHS England to develop a long-term workforce plan to help recruit and retain more NHS staff.”