How can we keep NMC registered professionals in the UK?

NMC Nurse Register

There are currently over 779,000 NMC registered nurses in the UK, and less than half of them are employed by the NHS

If the NHS could attract just 10% of them to take permanent positions within the NHS, our current nurse shortage of 43,600 would end.

Rachael Bagshaw, Founder and CEO of Just R, explores the potential strategies to attract and retain these skilled professionals back to the NHS.

Data from March 2022 shows there were 779,000 nurses on the permanent NMC register. A record level. Of this number, 343,651 (Jan 2023) currently work within the NHS, showing us over 430,000 nurses on the NMC register are not working in permanent positions within the NHS. That is more than half the NMC register.

We must ask, where are they and what can the NHS do to tempt just 10% of them to fill the current vacancies?

Where are they?

This huge group are most likely to fall within the following categories:

  • Private Sector
  • Agency
  • Alternative Career
  • Early Retirement


Whilst overall people choosing to leave the NHS has decreased over the last 12 months, the number is still sitting at an all time high when compared to 2019-2021 data. Reasons for leaving include retirement, burnout, exhaustion, lack of support from colleagues, concerns about the quality of people’s care, workload and staffing levels. All of which contribute to the above being realistic options for staff looking for alternatives.

When I look at the reasons for people leaving the NHS, there are answers to all of them if NHS leaders applied greater creativity to their approach to retention.


So, what can the NHS do?

Quick Wins

A first and relatively easy step every NHS organisation can take is to gain greater control of their narrative, break down misconceptions and drive awareness of NHS benefits which may be unknown or misunderstood. By this, we mean creating a more clear understanding of:

  • Rates of pay and opportunities to earn additional income through overtime/bank
  • Pension and holiday packages
  • Career progression 
  • What is possible in terms of flexible working – with a greater number of substantive staff this should become a more realistic option.

The Longer-Term Strategy

The elephant in the room when it comes to staff retention is the culture and leadership within NHS organisations. This is not something which can change overnight, but to get to the root of staff retention challenges this absolutely must be addressed. 

The reality is the culture of many healthcare organisations is simply not a supportive one. Do not get me wrong, there are many stars which are shining the light with great examples of leadership, but most operate under a ‘sink or swim’ mentality, with report after report, survey after survey, revealing that skilled clinical workers are leaving due to burnout, workplace stress and even bullying. 

To build our NHS the right way we must start with culture. Building culture is no easy feat, but it is the core of every great organisation. 

The culture the NHS needs is one of learning, coaching and supporting innovation. These are the core values which will build the healthcare service we need now and in the future.


Tony Hsieh

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