A sharp and alarming drop in the number of international nurses and midwives registering to work in the UK is threatening to exacerbate the National Health Service's severe staffing crisis. Health leaders have issued a stark warning that the NHS's long-standing reliance on overseas professionals is under severe strain, with stricter immigration policies poised to make a critical situation worse.
A Dramatic Drop in International Arrivals
New data from the Nursing and Midwifery Council (NMC) reveals a near halving in the number of foreign nurses and midwives joining the UK register. Between 1 April and 30 September 2025, just 6,321 international professionals joined for the first time. This represents a staggering 49.6% decrease compared to the same period last year, when 12,534 joined.
This collapse means international recruits now make up only 31.1% of new joiners, down from a typical figure of around 50%. The NMC suggests this shift could be driven by factors including better earning potential in other countries, recent visa changes, and a government focus on boosting domestic recruitment.
Paul Rees, Chief Executive and Registrar of the NMC, stated: “The high-growth era of international recruitment appears to be ending. At the same time, domestic recruitment is steady.”
Experts Sound Alarm Over Workforce Shortfalls
Healthcare unions and think tanks have reacted with profound concern, describing the figures as a dashboard flashing red for the future of patient care. They argue that domestic training and recruitment cannot possibly fill the void left by the shrinking international pipeline, especially with tens of thousands of nursing posts already vacant.
Lynn Woolsey, Chief Nursing Officer at the Royal College of Nursing, warned: “International recruitment is collapsing, even before further hostile immigration policies come in... At the current rate, the number of domestic nurses joining will nowhere near make up for the collapse in overseas nursing staff coming to the UK.”
Suzie Bailey of The King’s Fund think tank echoed this, stating: “Our health and care system has relied on international recruitment for generations. Recent proposals to cut immigration, tighten visa rules, and even deport those living here legally risk deepening workforce shortages and putting patient safety at risk.” She added that such policies could create fear and make dedicated staff feel unwelcome, leading to longer patient waits.
Broader Workforce Challenges and Systemic Racism
While the NMC register holds a record 860,801 nurses, midwives, and nursing associates, the overall growth rate has slowed sharply. Alongside the recruitment crisis, the regulator highlighted a deeply troubling issue of racism within the sector.
The register has become more ethnically diverse, with a third of professionals now from Black, Asian, or minority ethnic backgrounds. However, the NMC reports that these individuals are often “held back by their experiences of racism and other forms of discrimination.” Shockingly, Mr Rees noted that some registrants see the situation as worse now than at any time in the last three decades, suggesting a crisis point has been reached.
The call from health leaders is now unequivocal: the government must produce a serious, fully-funded plan to grow the domestic workforce and reconsider immigration policies that threaten the very foundation of NHS staffing. Without urgent action, they warn, the ability to provide safe, high-quality care to patients will be fundamentally compromised.
