5th March 2026
there is widely considered to be a crisis in nursing recruitment and retention, particularly across the UK and Scotland. However, it is a complex situation and there are serious shortages in some areas and settings, while in others the issue is more about retaining experienced staff or managing recruitment funding rather than a complete absence of nurses.
A podcast with Prof Nicola Ranger, General Secretary and Chief Executive, Royal College of Nursing
In a frank exchange, Nicola reflects on the crisis of recruitment and retention, the fact that nurses spend too much of their time on pointless tasks, the unprecedented levels of low morale and the possibility of strike action.
And, she says there is an urgent need to reform nurse education, including in her personal view, a national exam for every nurse wanting to join the register.
This is a clarion call for reform within and beyond the profession and a warning of an existential threat to the NHS if the government does not invest and start to value nurses.
Listen to a podcast discussion HERE
A continuing shortage of nurses
Health services across the UK still have large numbers of nursing vacancies.
In England alone there were about 25,600 unfilled nursing posts in 2025, with a vacancy rate of around 6%.
Across the NHS overall, there have been over 100,000 staff vacancies, with nurses making up a large proportion of these posts.
In Scotland the situation is similar:
Surveys by the Royal College of Nursing show thousands of nursing posts remain unfilled across hospitals and community services.
At times more than 2,800 nursing posts were vacant in NHS Scotland, highlighting ongoing staffing pressures.
These shortages place pressure on existing staff and can affect patient care.
Recruitment difficulties in health and social care
The recruitment problem is especially serious in social care and care homes, which compete with the NHS for staff.
A national workforce report found:
75% of care providers report difficulty recruiting nurses.
Around 70% say nurses leave within the first five years of working in their organisation.
Many nurses move to NHS jobs where pay, career development and working conditions may be perceived as better.
Retention problems: burnout and workload
A major factor behind the crisis is retention rather than recruitment alone.
Studies and surveys show many nurses leaving the profession because of:
heavy workloads
stress and burnout
long hours and unpaid overtime
concerns about patient safety.
One survey found two-thirds of nurses reported working while unwell, largely due to staff shortages and pressure to cover shifts.
This creates a cycle:
Staff shortages increase workload
Higher workload causes burnout
Burnout leads nurses to leave
The shortage becomes worse.
Falling international recruitment
For years the NHS relied heavily on overseas nurses to fill workforce gaps.
However, recent immigration changes have caused a sharp drop in overseas recruitment:
The number of overseas nurses entering the UK fell by about 93% between 2022 and 2025.
Health experts warn that reducing international recruitment while domestic shortages persist could worsen staffing problems.
Workforce planning and training challenges
Another factor behind the crisis is long-term workforce planning.
Experts point to several issues:
not enough nurses trained in previous decades
removal of nursing bursaries in the past
ageing workforce and retirements
rising demand due to an ageing population.
Demand for healthcare services has grown faster than the supply of trained staff.
A mixed and evolving situation
Although the problems remain serious, there are some signs of improvement.
For example:
nursing vacancy rates in parts of the NHS have fallen compared with earlier years, showing that recruitment efforts are having some effect.
some areas of primary care in Scotland have seen declining vacancy rates for certain nursing roles.
However, professional bodies say that staffing levels are still below what health systems need.
Overall
There is strong evidence that the UK and Scotland are experiencing a significant nursing workforce challenge, often described as a recruitment and retention crisis.
The problem is not simply a lack of people entering nursing. Instead, it is driven by several connected issues:
large numbers of vacancies
difficulty retaining experienced nurses
high workloads and burnout
reduced international recruitment
long-term workforce planning problems.
Addressing the crisis will likely require better retention strategies, improved working conditions, expanded training, and more stable workforce planning over the coming years.