The headline figures

The Nursing and Midwifery Council register reached 867,935 people in its 2025 to 2026 annual data, the highest total reported by the regulator. The number rose by 1.7 per cent over the year, compared with growth of 3.3 per cent in the preceding period. A record total and slower growth are not contradictory. More people joined or returned than left, so the register expanded, but the balance was smaller than before. The change matters because workforce plans formed during several years of rapid international recruitment cannot assume that the same rate will continue.1, 2

First time joiners fell by 21.4 per cent and leavers rose by 5.3 per cent in the reported period. Joiners and leavers measure flows, while the total register is a stock at a point in time. The relationship is also affected by people returning after a break and by the timing of renewal or registration. A large percentage movement in one flow does not translate directly into the same percentage movement in the total. Analysts should use the NMC tables rather than subtracting press release percentages, and they should specify whether they are discussing first registration, readmission, departure or net change.1, 2

The register also became more ethnically diverse. The NMC reported 293,778 professionals from Black, Asian and ethnic minority backgrounds, representing 33.8 per cent of the total and passing one third for the first time. That is a substantial change in the composition of the regulated professions. It does not show whether representation is equal across fields, seniority, employers or locations, nor whether staff have equal experiences of progression and regulation. Those questions require linked or separate data. The register provides a denominator and trend that organisations can use to ask them more accurately.1, 2

The regulator’s publication covers nurses, midwives and, in England, nursing associates. Aggregating them is useful for the NMC’s total workload but can obscure different trends. Adult nursing, mental health nursing, learning disability nursing, children’s nursing, midwifery and nursing associate parts have distinct education routes and labour markets. Country of training and address also matter. A responsible account begins with the total and then examines the relevant table before making a claim about a profession or nation. A change driven by one large part of the register should not automatically be attributed to every group.1, 2

A register is not an employment count

Being on the NMC register means a person is eligible to practise under a protected professional title, subject to any conditions. It does not mean they are employed by the NHS, working in the UK, providing direct care or working full time. Registrants may work in social care, independent healthcare, education, research, regulation or roles outside clinical services. Some are on leave, between jobs or living abroad. The NMC records a non-UK address category, but an address is not a complete measure of labour market activity. Using the total as the number of nurses available for NHS shifts will overstate operational supply.2, 3

NHS workforce statistics answer a different question. They count staff employed by specified organisations and often report both headcount and full time equivalent values. They exclude parts of social care, independent provision and other employers, and coding can vary. Comparing the two datasets can still be useful if their scopes are kept visible. A growing register alongside persistent vacancies can arise because demand rises, registrants work fewer hours, people move between sectors or the geographic and professional mix does not match posts. It is not proof that registered people are refusing to work, and it is not proof that employers have created enough suitable jobs.2, 3

Full time equivalent is particularly important for service capacity. Two registered professionals each working half time count as two people on the register but roughly one full time equivalent in a workforce dataset. Sickness, parental leave, study and non-clinical responsibilities further affect hours available for direct care. Staffing need is also measured in skills and deployment, not simply totals. A theatre vacancy cannot necessarily be filled immediately by a registrant from another field or setting. Workforce plans should combine registration trends with employment, hours, vacancies, turnover, education and local service demand.2, 3

Registration data remain valuable because they cover the regulated population consistently across the UK. They can reveal long trends, entry routes and changes in origin that employer datasets miss. Their limits are a reason to link questions, not to dismiss the figures. Policymakers should state which data would confirm that registration growth is reaching understaffed services. Employers can compare national trends with their recruitment and retention. Researchers can avoid labels such as workforce crisis or surplus unless the measure genuinely supports them.2, 3

Why growth has slowed

The immediate arithmetic is fewer new entrants and more departures, but causes require more evidence. International recruitment policy, visa rules, ethical recruitment restrictions, employer demand and processing times can alter overseas entry. Domestic joining depends on university intake, completion, the timing of graduation and registration. Departure can reflect retirement, health, career change, relocation, dissatisfaction, temporary lapses or a decision not to renew while out of practice. The annual report can describe patterns and survey responses, yet it cannot assign a single motive to everyone in a category.1, 2

International recruitment contributed strongly to register growth in recent years. A fall from an unusually high period may be expected without indicating that international entry has stopped. It can still expose a workforce strategy that relied on continued acceleration. Ethical policy also matters. Recruitment should not undermine countries with their own workforce shortages, and overseas professionals need fair employment and development after arrival. A sustainable plan cannot treat the international register as an unlimited reserve. It must connect domestic education, retention and targeted ethical recruitment rather than using one route to compensate indefinitely for weakness in another.1, 2

Leaver surveys help interpret decisions but are voluntary and subject to response bias. People with a strong experience may be more likely to answer, while contact details and question timing affect participation. Responses about retirement, workplace culture, health or workload describe stated reasons and may overlap. They should be published with response rates and methods. Employers should compare them with exit interviews and local turnover, taking care that staff feel safe to be honest. A national percentage cannot tell a board why a particular team lost experienced nurses.1, 2

Revalidation and the annual fee can influence whether people retain registration when they are not currently using it, but changes should not be inferred without analysis. The NMC register includes professionals making individual decisions under different circumstances. Policy announcements, employer restructures and cost pressures may occur in the same year without causing the observed movement. Trend data over several periods, broken down by field, age, training route and country, provide a stronger basis. The 1.7 per cent figure is a signal to investigate assumptions, not a diagnosis by itself.1, 2

Diversity and workforce experience

Passing one third is relevant to every organisation that employs or regulates nursing and midwifery professionals. Governance bodies, education providers and senior teams should compare their own representation with the populations from which they recruit. A diverse register does not guarantee inclusive workplaces or fair progression. Data on disciplinary referrals, fitness to practise, pay, promotion, bullying and access to development may reveal different outcomes. Those measures need careful adjustment and interpretation, but avoiding them leaves the headline detached from experience.1, 2

Country of training is not the same as ethnicity, and the categories should not be used interchangeably. UK trained professionals can belong to any ethnic group, and internationally educated professionals are also diverse. Combining the measures can hide unequal experiences or invite stereotypes about competence and language. The NMC tables define their variables, while employer equality data may use different groupings. Analysis should state those definitions and avoid comparisons where categories do not align. Small numbers may need aggregation to protect confidentiality, especially at local or specialty level.1, 2

Professional support should respond to actual needs rather than assume one programme suits everyone within a broad category. International joiners may need a structured local induction and support with UK systems, while all new employees need safe preceptorship and supervision. Staff experiencing discrimination require a trusted reporting route and action on patterns. Career development should be transparent and available across shift patterns and employment settings. The register’s changing composition makes those ordinary workforce practices more urgent, but the case for them comes from fairness and patient safety, not from treating diversity as a problem to manage.1, 2

Regulatory fairness also matters because the NMC holds the common register. The regulator has faced scrutiny over culture and case handling, and it publishes equality information to examine stages of fitness to practise. Register growth increases the number of people relying on timely registration, advice and investigation. Diversity analysis should consider whether processes produce unexplained differences and whether communication is accessible. A representative workforce can lose trust if regulatory experience is not equitable. The annual register data provide part of the baseline against which reform can be assessed.1, 2

What policymakers should watch next

The next annual and mid-year releases should be read as a sequence. One period can be affected by graduate registration timing or administrative changes. Consistent decline in first time joiners, rising departures or contraction in a field would be more consequential than a single fluctuation. The NMC warns that a 12 month view is more reliable than a six month snapshot for new entrants because UK graduates often join during a concentrated part of the year. Reports should compare like periods and note revisions rather than build a trend from mismatched dates.1, 2, 3

Education planners need to connect applicant, enrolment, completion and registration data. A training place does not become a registrant automatically, and a registrant does not necessarily join the service that funded or expected the place. Attrition should be examined by stage and group so support can address genuine barriers. Expanding intake without enough educators and placements can lower completion or strain care settings. Reducing intake because the register is currently at a record high could create a delayed shortage. Pipeline decisions need several years of demand scenarios.1, 2, 3

Employers should focus on retention measures they can influence. Safe staffing, predictable rotas, development, flexible work, health support, fair pay processes and effective management can affect whether a professional remains in a job or the sector. Register data cannot rank those actions for a local service. Staff feedback and turnover analysis can. Boards should look at voluntary leaving, movement within the organisation, absence and vacancy duration by role and protected characteristic. A national record should not be used to discount local warnings that a team cannot recruit or retain the skills it needs.1, 2, 3

The accurate summary is neither uncomplicated success nor immediate contraction. More people than ever are eligible to practise, and the regulated professions are more ethnically diverse. At the same time, growth has roughly halved, first time entry has fallen and departures have increased. Because registration is not employment, the figures cannot settle whether services have enough staff. They do show that workforce strategies must test their assumptions about future supply. The most useful response is to join register, education and employment evidence while preserving what each dataset actually measures.1, 2, 3

Public dashboards could make that joined view easier without pretending the datasets share one definition. A dashboard can present registration, NHS employment, social care estimates, student progression and vacancies in adjacent panels with dates and scope visible. Users should be able to download the underlying tables and see revisions. Commentary should identify gaps, especially for independent and social care employment, rather than calculate a false residual between register and NHS totals. Better presentation will not solve workforce shortages, but it can prevent decisions based on a number that measures the wrong population and can show where additional collection is justified.1, 2, 3

Each release should also preserve an accessible archive. Revised tables can correct errors, but users need version notes so an earlier report can be reproduced. Machine readable formats, stable variable names and clear geographic definitions reduce accidental misinterpretation. Professional bodies and news organisations should link directly to the report used and state its reference date. These small practices matter when a percentage is repeated in workforce plans for years. They let readers distinguish a current estimate from a historical snapshot and check whether a later publication changed the conclusion.1, 2, 3