Registered General Nurse
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Nursing in the United Kingdom is the profession of ''
registered nurse A registered nurse (RN) is a healthcare professional who has graduated or successfully passed a nursing program from a recognized nursing school and met the requirements outlined by a country, state, province or similar government-authorized ...
s'' and nursing associates in the
primary Primary or primaries may refer to: Arts, entertainment, and media Music Groups and labels * Primary (band), from Australia * Primary (musician), hip hop musician and record producer from South Korea * Primary Music, Israeli record label Work ...
and
secondary care Health care, or healthcare, is the improvement or maintenance of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is deliver ...
of patients. It has evolved from assisting
physician A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the Medical education, study, Med ...
s to encompass a variety of professional roles. Over 700,000 registered nurses practice in the UK, working in settings such as
hospital A hospital is a healthcare institution providing patient treatment with specialized Medical Science, health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically ...
s, health centres,
nursing homes A nursing home is a facility for the residential care of older people, senior citizens, or disabled people. Nursing homes may also be referred to as care homes, skilled nursing facilities (SNF), or long-term care facilities. Often, these terms ...
,
hospice Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life b ...
s, communities, military, prisons, and
academia An academy (Attic Greek: Ἀκαδήμεια; Koine Greek Ἀκαδημία) is an institution of tertiary education. The name traces back to Plato's school of philosophy, founded approximately 386 BC at Akademia, a sanctuary of Athena, the go ...
. Most are employed by the
National Health Service The National Health Service (NHS) is the term for the publicly funded health care, publicly funded healthcare systems of the United Kingdom: the National Health Service (England), NHS Scotland, NHS Wales, and Health and Social Care (Northern ...
(NHS). Nursing is split into four fields: adults, children, mental health, and learning disability. Within these nurses may work within specialties such as medical care or theatres, and may specialise further in areas such as cardiac care. Nurses often work in multi-disciplinary teams, but increasingly work independently, and may work in supporting sectors such as education or research. The UK-wide regulator for nursing is the
Nursing and Midwifery Council The Nursing and Midwifery Council (NMC) is the regulator for nursing and midwifery professions in the UK. The NMC maintains a register of all nurses, midwives and specialist community public health nurses and nursing associates eligible to pra ...
(NMC), and all nurses and nursing associates must be registered to practise.United Kingdom Governmen
Nurses, Midwives and Health Visitors Act, 1997.
London: HMSO, 1997.
Dental Nurses,
nursery nurse Early childhood education (ECE), also known as nursery education, is a branch of education theory that relates to the teaching of children (formally and informally) from birth up to the age of eight. Traditionally, this is up to the equivalen ...
s and veterinary nurses are not regulated by the NMC and follow different training, qualifications and career pathways.


History


Registration and regulation

There are currently two levels of nursing registration in the UK: registered nurses and nursing associates. To practise lawfully as a registered nurse, the practitioner must hold a current and valid registration with the
Nursing and Midwifery Council The Nursing and Midwifery Council (NMC) is the regulator for nursing and midwifery professions in the UK. The NMC maintains a register of all nurses, midwives and specialist community public health nurses and nursing associates eligible to pra ...
. The title "registered nurse" can only be granted to those holding such registration; this protected title is laid down in the Nurses, Midwives and Health Visitors Act 1979. However the title "nurse" is not legally protected, so anybody can call themselves a nurse. Brent East MP
Dawn Butler Dawn Petula Butler (born 3 November 1969) is a British Labour Party politician who is member of parliament (MP) for Brent East. She previously served as MP for Brent Central (2015–2024) and Brent South (2005–2010). Born in London to Jama ...
introduced a bill in Parliament in February 2025 to protect the title of 'nurse'.


Nursing and Midwifery Council

The core function of the NMC is to establish and improve standards of nursing and midwifery care to protect the public. It achieves this by placing registered nurses on a register, which anyone can search. As of March 2024, there were 826,418 registered nurses, midwives and nursing associates on the NMC register. The powers of the NMC are set out in the Nursing and Midwifery Order 2001. Membership of the council comprises 6 lay and 6 registrant members appointed by the Privy Council, including at least one member from each of the four UK countries. The registrant members consist of nurses, midwives and nursing associates. The lay members currently include people with diplomatic, legal and business backgrounds.


Register

The NMC register is split into three main parts: Nurses, Midwives and Specialist Community Public Health Nurses (SCPHN). Within the registration it contains several "sub-parts" and qualifications e.g. sub part 1, sub part 2. Revalidation is a requirement for all NMC registered members to revalidate every three years in order to ensure their registration can be renewed. Revalidation was introduced in April 2016.


Code of conduct

The Professional standards of practice and behaviour for nurses, midwives and nursing associates, known as the Code was revised in 2018 replacing earlier publications in 2015 and 2008. The NMC code presents the professional standards that nurses, midwives and nursing associates must uphold in order to be registered to practise in the UK.


Legislation

Government legislation governing nursing in the United Kingdom includes: * Health and Care (Staffing) (Scotland) Act 2019 * Nurse Staffing Levels (Wales) Act 2016 * Nurses, Midwives and Health Visitors Act 1997 (repealed) * Nurses, Midwives and Health Visitors Act 1992 (repealed 19 June 1997) * Medicinal Products: Prescription by Nurses etc. Act 1992 * Nurses, Midwives and Health Visitors Act 1979 * Nursing Homes Act 1975 * Nurses Act 1943 * Royal National Pension Fund for Nurses Act 1936 *
Nurses Registration Act 1919 The Nurses Registration Act 1919 ( 9 & 10 Geo. 5. c. 94) was an Act of Parliament of the United Kingdom. The act was the culmination of a long campaign led by Ethel Gordon Fenwick to establish a register of nurses. The Minister for Health, Ch ...


Education


Non-registered staff education

Training is not mandatory for most people undertaking non-registered staff roles such as Healthcare Assistant. But the majority of NHS employers use "in-house" training for such staff, including induction programmes and ongoing education to achieve a recognised qualification. Some collaborate with local education colleges for theoretical input, and may award a recognised qualification. Some NHS employers ask for some type of health or social care qualification for recruits: for example, an SVQ/
NVQ National Vocational Qualifications (NVQs) are practical work-based awards in England, Wales, and Northern Ireland that are achieved through training and assessment. The regulatory framework supporting NVQs was withdrawn in 2015 and replaced by th ...
or HNC/ HND under qualification names including health care,
social care Social work is an academic discipline and practice-based profession concerned with meeting the basic needs of individuals, families, groups, communities, and society as a whole to enhance their individual and collective well-being. Social wo ...
, and health & social care. Many trusts and health boards create opportunities for these staff members to become qualified nurses. This is termed secondment (whereby the trust/health board continues to pay them for the duration of their training, and often guarantees employment following successful completion).


Pre-registration degrees

Registered nurses must complete a nursing degree programme recognised by the Nursing and Midwifery Council from an approved provider.
Project 2000 Project 2000 was a higher education scheme in the United Kingdom for nursing qualifications, introduced in 1990 by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC), later the Nursing and Midwifery Council (NMC) ...
began in 1990 and was designed to move nursing education from hospitals into universities. Prior to Project 2000, nurse education was the responsibility of hospitals and was not based in universities; many nurses who qualified prior to these reforms do not hold an academic award. As of September 2013, degree-level nurse training programmes were required, with no option to study for a diploma.


Format

Nursing courses adopt a 50/50 split of learning in university (lectures and examinations) and in practice (supervised patient care within a hospital or community setting). Nursing courses usually take three years and 4,600 hours. The first year is the common foundation program (CFP), which teaches basic knowledge and skills required of all nurses. Skills include communication, taking observations, administering medication, and providing personal care. The remainder of the program consists of training specific to the student's chosen branch of nursing. The four branches of nursing training offered at university level (not including midwifery) are: * Adult nursing * Child nursing * Mental health nursing * Learning disabilities nursing


Midwifery education

Midwifery Midwifery is the health science and health profession that deals with pregnancy, childbirth, and the postpartum period (including care of the newborn), in addition to the sexual and reproductive health of women throughout their lives. In many cou ...
training is similar in length and structure, but is sufficiently different that it is not considered a branch of nursing. 18-month programmes allow nurses already qualified in the adult branch to register as both a nurse and a midwife. Two year courses allow graduates of other disciplines to train as nurses. This is achieved by more intense study and a shortening of the common foundation programme.


Student Bursary

Student nurses in England and Wales receive no
bursary A bursary is a monetary award made by any educational institution or funding authority to individuals or groups. It is usually awarded to enable a student to attend school, university or college when they might not be able to, otherwise. Some awar ...
from the government to support them during their nurse training. Diploma students in England receive a universal bursary of £6,000 – £8,000 per year (with additional allowances for students with dependent children), while degree students may qualify for a means-tested bursary (often a considerably smaller amount). Degree students are, however, eligible for a
student loan A student loan is a type of loan designed to help students pay for post-secondary education and the associated fees, such as tuition, books and supplies, and living expenses. It may differ from other types of loans in the fact that the interest ...
, unlike diploma students. In
Scotland Scotland is a Countries of the United Kingdom, country that is part of the United Kingdom. It contains nearly one-third of the United Kingdom's land area, consisting of the northern part of the island of Great Britain and more than 790 adjac ...
and
Wales Wales ( ) is a Countries of the United Kingdom, country that is part of the United Kingdom. It is bordered by the Irish Sea to the north and west, England to the England–Wales border, east, the Bristol Channel to the south, and the Celtic ...
, all student nurses (regardless of which course they are undertaking) receive a bursary in line with the English diploma course. All student nurses in Wales study, initially, for a degree, but may choose to remain at Level 2, thereby achieving a diploma rather than a degree. It was announced in the
Chancellor Chancellor () is a title of various official positions in the governments of many countries. The original chancellors were the of Roman courts of justice—ushers, who sat at the (lattice work screens) of a basilica (court hall), which separa ...
's Spending Review of November 2015 that from 2017 the NHS bursary would be removed for future nursing, midwifery and allied health professionals in England. Welsh and Scottish students remain unaffected.


Post-registration education

Graduate courses require two years. They often require prior learning and relevant experience, often termed Accreditation of Prior and Experiential Learning (APEL). Registered nurses must update their skills and knowledge at the rate of at least 35 hours every three years, as part of its post-registration education and practice (PREP) requirements. Nurses can add certifications in areas such as
cannulation A cannula (; Latin meaning 'little reed'; : cannulae or cannulas) is a tube that can be inserted into the body, often for the delivery or removal of fluid or for the gathering of samples. In simple terms, a cannula can surround the inner or out ...
,
venepuncture In medicine, venipuncture or venepuncture is the process of obtaining intravenous access for the purpose of venous Sampling (medicine)#blood, blood sampling (also called ''phlebotomy'') or intravenous therapy. In healthcare, this procedure is p ...
, intravenous drug therapy, and male catheterisation are common among many others, such as
Advanced Life Support Advanced Life Support (ALS) is a set of life-saving protocols and skills that extend basic life support to further support the circulation and provide an open airway and adequate ventilation (breathing). Components Key aspects of ALS level care ...
. Many nurses who qualified with a diploma choose to upgrade their qualification to a degree via additional study. Many nurses prefer this to completing a degree initially, as nurses can study in a specialist field as a part of the degree. Financially, in England, it was more lucrative, as diploma students get the full bursary during their initial training, and employers often pay for the degree course as well as the nurse's salary.Nursing and Midwifery Education, 2007 To become specialist nurses (such as nurse consultants, nurse practitioners, etc.) or nurse educators, some nurses undertake further training above bachelor's degree level. Master's degrees exist in various healthcare related topics, and some nurses choose to study for PhDs or other higher academic awards.
District nurse District nurses work manage care within the community and lead teams of community nurses and support workers. In the United Kingdom, the role requires registered nurses to take a Nursing and Midwifery Council (NMC) approved specialist practitione ...
s and health visitors are also considered specialist nurses, and to become such they must undertake specialist training (often in the form of a top-up degree (see above) or post graduate diploma). All newly qualifying district nurses and
health visitor Health visitors are professional individuals engaged in public health work within the domestic setting, predominantly found in countries with state-funded health systems. They are distinct from district nurses, who provide clinical healthcare, do ...
s prescribe from the Nurse Prescribers' Formulary, a list of medications and dressings. Many of these (and other) nurses undertake training in independent and supplementary prescribing, which allows them to prescribe most drugs in the
British National Formulary The ''British National Formulary'' (BNF) is a United Kingdom (UK) pharmaceutical reference book that contains a wide spectrum of information and advice on prescribing and pharmacology, along with specific facts and details about many medicin ...
. This has been the subject of debate in medical and nursing circles. As of 2012 over 25,000 Nurse Prescribers had been qualified.


Overseas nurses

The
Nursing and Midwifery Council The Nursing and Midwifery Council (NMC) is the regulator for nursing and midwifery professions in the UK. The NMC maintains a register of all nurses, midwives and specialist community public health nurses and nursing associates eligible to pra ...
has a specific process for inducting Registered Nurses trained outside the UK. Prior to October 2016 an outside UK RN would have to undergo an Overseas Nursing Program known in short as the ONP. The ONP had to be undertaken by the candidate after NMC makes necessary checks and issue the candidate with a decision letter stating that the person may join a university to undertake the ONP. However, due to a shortage of nurses and increasing standards in nursing a new process was introduced to include two part test of competence, including an OSCE. The process includes an English language test, the standards of which have been criticised for being too high.


Roles


Non-registered staff

Non-registered staff typically working in direct patient care (often on wards), performing tasks such as personal care (washing and dressing), social care (feeding, communicating to patients and generally spending time with them) and more specialised tasks such as recording observations or vital signs (such as temperature, pulse and respiratory rate, or TPR) or measuring and assessing
blood pressure Blood pressure (BP) is the pressure of Circulatory system, circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term ...
,
urinalysis Urinalysis, a portmanteau of the words ''urine'' and ''analysis'', is a Test panel, panel of medical tests that includes physical (macroscopic) examination of the urine, chemical evaluation using urine test strips, and #Microscopic examination, m ...
,
blood glucose monitoring Blood glucose monitoring is the use of a glucose meter for testing the concentration of glucose in the blood (Blood sugar level, glycemia). Particularly important in diabetes management, a blood glucose test is typically performed by piercing ...
, pressure sores (see
Waterlow score The Waterlow score (or Waterlow scale) gives an estimated risk for the development of a pressure sore in a given patient. The tool was developed in 1985 by clinical nurse teacher Judy Waterlow. It is available both on a two-sided score card and ...
) and carrying out procedures such as
catheterisation In medicine, a catheter ( ) is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. Catheters are man ...
and
cannulation A cannula (; Latin meaning 'little reed'; : cannulae or cannulas) is a tube that can be inserted into the body, often for the delivery or removal of fluid or for the gathering of samples. In simple terms, a cannula can surround the inner or out ...
). Some unregistered staff work as
phlebotomist Phlebotomy is the process of making a puncture in a vein, usually in the arm, with a cannula for the purpose of drawing blood. The procedure itself is known as a venipuncture, which is also used for intravenous therapy. A person who performs a ...
s,
ECG Electrocardiography is the process of producing an electrocardiogram (ECG or EKG), a recording of the heart's electrical activity through repeated cardiac cycles. It is an electrogram of the heart which is a graph of voltage versus time of ...
technicians, and smoking cessation therapists beyond the hospital. Others expand their ward-based role to include such tasks. Few areas of nursing cannot be legally performed by suitably trained non-registered staff. They legally must be supervised (either directly or indirectly) by a registered nurse. In 2019 it was reported that mental health support workers were increasingly covering shifts because of the shortage of mental health nurses. Non-registered staff have various job titles such as "clinical support worker", "care assistant", "nursing assistant" and "healthcare assistant" (HCA). Typically they are on pay band 2 or 3, although senior healthcare assistants can be on band 4.


Registered nurses

Registered nurses traditionally qualify as a staff nurse on a ward, although it is increasingly common for newly-qualified nurses to enter an area such as community nursing directly. From there, nurses can progress into leadership and management roles such as ward sisters or matrons, or specialise in areas such as community nursing or advanced practice.


Specialist nurses and advanced practice

Specialist roles can include
clinical nurse specialist A clinical nurse specialist (CNS) is an advanced practice nurse who can provide advice related to specific conditions or treatment pathways. According to the International Council of Nurses (ICN), an Advanced Practice Nurse is a registered nurse w ...
s, who may run clinics and provide specialist nursing support to wards, or specialist community public health nurses (SCPHNs) such as
health visitor Health visitors are professional individuals engaged in public health work within the domestic setting, predominantly found in countries with state-funded health systems. They are distinct from district nurses, who provide clinical healthcare, do ...
s. SCPHNs form a separate part of the NMC register. Advanced nursing practitioners, sometimes known as advanced clinical practitioners, normally study a postgraduate qualification and take on a more medical role. They are the equivalent of
nurse practitioner A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, prescribe medications an ...
s elsewhere. As of 2025, the NMC is consulting on how to effectively regulate


Nursing organisations and trade unions

As of 2024 over 200 organisations are related to nursing as regulated by the Nursing and Midwifery Council, not including nursing departments in universities or in the NHS. These include professional bodies, nursing specialties, charities, and migrant support networks. Four
trade union A trade union (British English) or labor union (American English), often simply referred to as a union, is an organization of workers whose purpose is to maintain or improve the conditions of their employment, such as attaining better wages ...
s represent nurses, the
Royal College of Nursing The Royal College of Nursing (RCN) is a registered trade union and professional body in the United Kingdom for those in the profession of nursing. It was founded in 1916 as the College of Nursing, receiving its royal charter in 1928. Queen Eliz ...
(RCN)
Unite the Union Unite the Union, commonly known as Unite, is a trade union in the United Kingdom and Republic of Ireland, Ireland, formed on 1 May 2007 by the merger of Amicus (trade union), Amicus and the Transport and General Workers' Union. A general union ...
,
UNISON Unison (stylised as UNISON) is a Great Britain, British trade union. Along with Unite the Union, Unite, Unison is one of the two largest trade unions in the United Kingdom, with over 1.2 million members who work predominantly in public servic ...
and GMB. The RCN has a dual role as both a
professional body A professional association (also called a professional body, professional organization, or professional society) is a group that usually seeks to advocacy, further a particular profession, the interests of individuals and organisations engaged in ...
and a trade union.


Protests and industrial action

Whilst nurses are not known for striking or taking industrial action, there have been many occasions when nurses have gone on strike, often over pay and conditions. The
Royal College of Nursing The Royal College of Nursing (RCN) is a registered trade union and professional body in the United Kingdom for those in the profession of nursing. It was founded in 1916 as the College of Nursing, receiving its royal charter in 1928. Queen Eliz ...
had a no-strike policy for 79 years until 1995, when the policy was dropped due to pay disputes at the time. * In 1939 rallied together as it was reported in the ''Daily Mirror'' that many nurses were leaving the role and were enduring financial hardship. * In 1948, following the establishment of the NHS, nurses realised that their pay had decreased, which led to strike action. * In 1962 many nurses marched to Trafalgar Square as part of pay disputes under the banner of "Empty Purses Mean Less Nurses". * In 1970 many nurses protested at pay and conditions. * In 1973 it was reported that over 7,000 nurses marched in Sheffield. * In 1974 several protests took place by nurses over pay and conditions. * In 1976 many nurses took part in a low pay strike. * In 1982 there was a National Health Service day of action with 120,000 workers marching at various locations around the country including many nurses. * In 1988 Nurses went on strike in 1988 over pay and proposed changes to the NHS. * In 2011 Unison nurses protested and marched over pay. * In 2014 Midwives and some nurses went on strike over pay. * In 2015 nursing students protested outside the Department of Health over the removal of the NHS student bursary. * In 2016 nursing students marched to Downing Street to protest over the removal of the NHS student bursary. The protest was attended by Shadow Health Minister Heidi Alexander MP, Wes Streeting MP, Representatives of
UNISON Unison (stylised as UNISON) is a Great Britain, British trade union. Along with Unite the Union, Unite, Unison is one of the two largest trade unions in the United Kingdom, with over 1.2 million members who work predominantly in public servic ...
,
Unite the Union Unite the Union, commonly known as Unite, is a trade union in the United Kingdom and Republic of Ireland, Ireland, formed on 1 May 2007 by the merger of Amicus (trade union), Amicus and the Transport and General Workers' Union. A general union ...
and
Royal College of Midwives The Royal College of Midwives (RCM) is a British midwives organisation founded in 1881 by Louisa Hubbard and Zepherina Smith. It has existed under its present name since 1947 and is the United Kingdom's only trade union or professional organisati ...
.


Student protests

In the November 2015 spending review,
George Osborne George Gideon Oliver Osborne (born 23 May 1971) is a British retired politician and newspaper editor who served as Chancellor of the Exchequer from 2010 to 2016 and as First Secretary of State from 2015 to 2016 in the Cameron government. A ...
stated that he would remove the NHS Student Bursary from 2017. This prompted several Nursing students to organise a political demonstration with other healthcare students at King's College London outside the
Department of Health A health department or health ministry is a part of government which focuses on issues related to the general health of the citizenry. Subnational entities, such as states, counties and cities, often also operate a health department of their o ...
in December 2015 which was attended by several hundred supporters. Kat Webb also decided to start a petition on the government's e-petition site, which received over 150,000 signatures The student bursary debate has been raised in parliament at
Prime Minister's Questions Prime Minister's Questions (PMQs, officially known as Questions to the Prime Minister, while colloquially known as Prime Minister's Question Time) is a constitutional convention (political custom), constitutional convention in the United Kingd ...
, and is the subject of the 'Early Day Motion (EDM) 1081 – THE NHS BURSARY', which was sponsored by
Wes Streeting Wesley Paul William Streeting (; born 21 January 1983) is a British politician who has served as Secretary of State for Health and Social Care since July 2024. A member of the Labour Party, he has been the Member of Parliament (MP) for Ilford ...
MP. In December 2015, several hundred people protested the recent removal of the NHS student bursary as announced in the November 2015 spending review. Over 7000 NHS students and supporters marched on
Downing Street Downing Street is a gated street in City of Westminster, Westminster in London that houses the official residences and offices of the Prime Minister of the United Kingdom and the Chancellor of the Exchequer. In a cul-de-sac situated off Whiteh ...
in January 2016. The protest was attended by Shadow Health Minister Heidi Alexander MP, Wes Streeting MP,
Natalie Bennett Natalie Louise Bennett, Baroness Bennett of Manor Castle (born 10 February 1966), is an Australian-British politician and journalist who was the leader of the Green Party of England and Wales from 2012 to 2016. Bennett was given a peerage in ...
, Sian Berry, representatives of
UNISON Unison (stylised as UNISON) is a Great Britain, British trade union. Along with Unite the Union, Unite, Unison is one of the two largest trade unions in the United Kingdom, with over 1.2 million members who work predominantly in public servic ...
,
Unite the Union Unite the Union, commonly known as Unite, is a trade union in the United Kingdom and Republic of Ireland, Ireland, formed on 1 May 2007 by the merger of Amicus (trade union), Amicus and the Transport and General Workers' Union. A general union ...
and
Royal College of Midwives The Royal College of Midwives (RCM) is a British midwives organisation founded in 1881 by Louisa Hubbard and Zepherina Smith. It has existed under its present name since 1947 and is the United Kingdom's only trade union or professional organisati ...
. The hashtag #bursaryorbust was the top trending Twitter. In February, NHS students walked out of placement in solidarity with the
junior doctor In the United Kingdom, a resident doctor, previously (until 2024) known as a junior doctor, is a qualified medical practitioner who is either engaged in postgraduate training or employed in a non-training post. The period of being a resident docto ...
's strike.


Workforce


Demographics

The Nursing and Midwifery Council report on registration data twice a year (April and September). The majority of the nursing profession are women at around 90% of the total workforce. In September 2023, 43.5 percent of the ~800,000 registered nurses and midwives were aged 21–40; the average age of registrants was 43 years, 10 months. The increase in the number of 21-40 year olds was partly due to the international joiners to the register, with an increase to 29.1 percent of all registered professionals from Black and minority ethnic backgrounds. 49.9% of new joiners were educated outside the UK As at September 2023 601,805 of registrants were Adult Nurses; 58,338 were Children's Nurses; 97,530 were Mental Health Nurses and 16,806 were Learning Disability Nurses


Workforce planning

In England,
Health Education England Health Education England (HEE) is an executive non-departmental public body of the Department of Health and Social Care. Its function is to provide national leadership and coordination for the education and training within the health and public ...
commission undergraduate and postgraduate education. This is an autonomous national body which works to "ensure that healthcare staff are recruited in the right numbers with the right values and behaviours to support the delivery of excellent healthcare and drive improvement". The number of commissioned places for nurses has varied year on year, as follows: Adult nursing education places commissioned each year


Nursing shortages

More than a third of nurses in training fail to complete the training course, as has been the case for more than a century. In January 2016 the RCN stated that more than 10,000 nursing posts went unfilled in 2015. This represented a 3% increase year on year from 11% in 2013, 14% in 2014 and 17% in 2015 of all London nursing positions and 10% as an average nationwide. The
Department of Health A health department or health ministry is a part of government which focuses on issues related to the general health of the citizenry. Subnational entities, such as states, counties and cities, often also operate a health department of their o ...
said it did not recognise the figures. The National Audit Office estimated a shortfall of 7% in the supply of nurses. From 2016/17 registered nursing numbers fell 3% along with a 23% rise in de-registrations. 17,000 nurse permanently unfilled vacancies were observed. In 2019 clinical pharmacology, spinal injuries, paediatric surgery, neurosurgery and neurology were the worst-affected specialities. They had an average of less than 90% of their planned nurse staffing levels. School nurses were also in short supply. Hospitals in England are required to report the number of nurses employed on each ward each month. After this was established, ward nurses increased by 13,500, although the numbers of community nurses declined.


Migration

A 2015
Organisation for Economic Co-operation and Development The Organisation for Economic Co-operation and Development (OECD; , OCDE) is an international organization, intergovernmental organization with 38 member countries, founded in 1961 to stimulate economic progress and international trade, wor ...
survey reported that 21.7% of NHS nurses were born abroad, compared with 26.9% in Ireland, 9.8% in Italy, 14% in Germany and 5.9% in France. The UK was also the highest exporter of nurses, with more than 50,000 working in other OECD nations. The
Migration Advisory Committee The Migration Advisory Committee is a non-departmental public body associated with the British Home Office. It was established in 2007. , the chair is Brian Bell, professor of economics at King's College London. Alan Manning was a previous chair. ...
criticised the Department of Health,
Health Education England Health Education England (HEE) is an executive non-departmental public body of the Department of Health and Social Care. Its function is to provide national leadership and coordination for the education and training within the health and public ...
, and
NHS trusts An NHS trust is an organisational unit within the National Health Services of England and Wales, generally serving either a geographical area or a specialised function (such as an ambulance service). In any particular location there may be several ...
for not recognising obvious warning signs and "reluctantly" agreed to keep nursing on the list of shortage occupations. An English language test is compulsory for all foreign nurses, even if they are from English-speaking countries. The process of registering as a nurse can take migrants up to a year and cost more than £3,000.


Nurse health


Campaigns

Nursing is subject to regular health campaigns. Scale ranges from nationwide to ward-based. * Sign up to Safety – National campaign to ensure staff coordinate their efforts and ideas around ensuring and enhancing safety. * NHS Change Day – Annual 1-day campaign to get staff contributing ideas to improve the NHS. * Antibiotic Guardian – Gathers pledges to slow antibiotic resistance. European Antibiotic Awareness Day (EAAD) is held on 18 November.


Nurse health

Obesity and smoking have long been an issue in nurse health. The effect of nursing on nurses' physical and mental health has been a subject of research papers where the effect of shift work and working with chemicals such as in
chemotherapy Chemotherapy (often abbreviated chemo, sometimes CTX and CTx) is the type of cancer treatment that uses one or more anti-cancer drugs (list of chemotherapeutic agents, chemotherapeutic agents or alkylating agents) in a standard chemotherapy re ...
has been explored. In 2016 the government announced £600 million was to be spent on "tackling obesity and improving the well-being of its 1.3 million staff".


Compensation

Until October 2004, all nurses in the NHS were employed on a scale known as clinical grading (see below). Agenda for Change was developed by the NHS in response to criticisms that the old scale reflected length of service more than knowledge, responsibility and skills.


Clinical grading

This was known as the
Whitley Council Whitley may refer to: Places ;United Kingdom *Whitley, Berkshire, a suburb of Reading *Whitley, Cheshire, a village near Warrington *Whitley, Coventry, a suburb of Coventry, West Midlands *Whitley, Essex, near Birdbrook * Whitley, Wigan, Greater ...
system. This placed nurses (and some other hospital staff) on "grades" between A and I (with A being the most junior, and I the most senior). Unregistered staff were employed on grades A and B (occasionally grade C). Second level nurses were employed on various grades (usually between C and E), with first level nurses taking up grades D-I.


Agenda for Change

This system puts registered staff on bands 5–8, unregistered staff such as Healthcare Assistants take up bands 2–4. Band 9 posts are for the most senior members of NHS management. Each band contains a number of pay points. The idea of this system is "equal pay for work of equal value". There was a perceived discrepancy, under clinical grading, between ones grade (and therefore pay) and the work which one actually did, which Agenda for Change aimed to fix. Most NHS staff are now on the AfC system which took quite a long time to implement across the UK. A small percentage of staff went through an appeal procedure as they disagreed with the band that they have been placed on. In 2015–16 the minimum starting salary for a registered nurse will be £21,692 in England, Wales while in Scotland it will be £21,818. Northern Ireland have yet to announce their pay rates for 2015–16.


NHS Pay Review Body (NHSPRB)

The NHS Pay Review Body is an independent body that makes recommendations to the government on the pay of nurses and NHS staff. The government then makes the final decision. In 2014 the government rejected the NHSPRB recommendation for a 1% pay rise. In 2016 the government announced that nurses would receive a 1% pay rise which would take effect from 1 April 2016. The RCN Chief Executive Janet Davies stated that "The fact remains that pay awards for NHS staff have been severely constrained since 2010".


Pay disputes

There have recently been complaints of Agenda for Change being a sexist system, as nurses, who are mostly female, claim that, as a profession, they are under-valued using this system. In 2015 the RCN stated that Nurses had suffered a drop in pay equivalent to 9.8% in real terms since 2008.


Agency Nurse Pay Cap

In 2015 the government announced that there would be a gradual introduction of pay caps for agency nurses working under NHS England. Starting in November 2015, further caps came in February 2016 with the final cuts introduced in April 2016. The aim of the cap was to save £1bn over three years. The implications of the pay cap means that trusts will not be able to pay staff who work for an agency including doctors and nurses, more than 55% more for a shift than a permanent member of staff. Jeremy Hunt in his capacity as the Health Secretary said it would stop agencies "ripping off the NHS". In response a petition started on the government website which received over 10,000 responses.


Nurses finance situation

In 2016, several publications appeared in the media, claiming nurses depend on food banks and payday loans to survive. In October 2016,
Western Circle Western Circle (trading as Cashfloat) is a British payday loan company offering ''"short-term, high-cost credit"''. The interest charged by the lender is up to 277.40% pa. The interest is non-compound, as dictated by the FCA. The company declar ...
published research, claiming that the sector of NHS Nurses are heavily dependent on
payday loan A payday loan (also called a payday advance, salary loan, payroll loan, small dollar loan, short term, or cash advance loan) is a short-term unsecured loan, often characterized by high interest rates. These loans are typically designed to cover ...
. According to the research, the number of nurses using payday loans has doubled in 3 years, since 2013. This research brought the matter of the low wages nurses received in the UK to the attention of media outlets. The claims were that nurses' salaries were frozen for more than 6 years and in some cases, resulted in financial distress, clearly as wages have not kept pace with the cost of living increases in this time. The lack of pay increases for, particularly nurses within the NHS continues to be an important topic of public discussion in the UK.


NHS pension

The NHS pension is the main pension offered to NHS staff. There have been three distinct changes made to the NHS pension. The type of pension someone is enrolled onto is referred to by the year that it was introduced or changed 1995, 2008 & 2015.


Nursing Journals

As at 2023 British nursing journal titles included: * British Journal of Cardiac Nursing * British Journal of Community Nursing *
British Nursing Index The British Nursing Index (BNI) is a bibliographic database of nursing and midwifery journal articles. The index contains details of English language articles from 1985 to the present, and is updated monthly. , the database covers more than 700 ...
* Cancer Nursing Practice *
Nursing Times ''Nursing Times'' is a website and monthly magazine for nurses, which is published in the United Kingdom. It covers original nursing research and best practice for nurses at all stages in their career, as well as daily news, opinion and other inf ...
*
Nursing Standard ''Nursing Standard'' is a weekly professional magazine that contains peer-reviewed articles and research, news, and career information for the nursing field. The magazine was founded in 1987. It is published by RCNi. The magazine is abstracted and ...
* Emergency Nurse *
Evidence-Based Nursing (journal) ''Evidence-Based Nursing'' is a peer-reviewed healthcare journal covering the field of evidence-based nursing. It is published quarterly by the BMJ Publishing Group and RCN Publishing. It is abstracted and indexed by Index Medicus (MEDLINE), S ...
*
Gastrointestinal Nursing ''Gastrointestinal Nursing'' is a monthly peer-reviewed nursing journal covering research and clinical work on the practice of gastrointestinal nursing. It is published by MA Healthcare. It is indexed in Scopus Scopus is a scientific abstract ...
* Learning Disability Practice *
Mental Health Practice ''Mental Health Practice'' is a monthly nursing journal covering the practice of mental health nursing published by RCNi The Royal College of Nursing (RCN) is a registered trade union and professional body in the United Kingdom for those in t ...
* Nurse Researcher * Nursing Children and Young People * Nursing in Practice * Nursing Management (journal) * Nursing Older People *
Nursing Standard ''Nursing Standard'' is a weekly professional magazine that contains peer-reviewed articles and research, news, and career information for the nursing field. The magazine was founded in 1987. It is published by RCNi. The magazine is abstracted and ...
*
Nursing Times ''Nursing Times'' is a website and monthly magazine for nurses, which is published in the United Kingdom. It covers original nursing research and best practice for nurses at all stages in their career, as well as daily news, opinion and other inf ...
*
Primary Health Care (magazine) ''Primary Health Care'' is a professional magazine published 10 times a year by the RCNi, part of the Royal College of Nursing group. It publishes news, features, and clinical articles relevant to the practice of community health nursing in the U ...


Government publications

Significant government publications on nursing and midwifery include: * Athlone Report Ministry of Health and Board of Education ''Interim Report of the Interdepartmental Committee on Nursing Services'' – nursing recruitment, retention and skills 1939 *
Nurses Salaries Committee The Nurses Salaries Committee was the first official body to fix salary scales and conditions for nursing in England. It was founded in 1941, and ceased its activity with its last report in 1943. Henry Betterton, 1st Baron Rushcliffe or Rushcliffe, ...
or Rushcliffe Report was established in October 1941 and published two reports in 1943. * Ministry of Health, Department of Health for Scotland, and Ministry of Labour and National Service (Wood Committee) 1947 ''Report of the Working Party on the Recruitment and Training of Nurses'' - a government report on the recruitment and training of nurse *
Salmon Report The Salmon Report (1966) or the Salmon Report on Senior Nursing Staff Structure was the report of a committee established to bring standardisation in structure and pay for senior hospital nurses in England and Scotland. The report recommended chan ...
on Senior Nursing Staff Structure 1966 * Mayston Report on Management Structure in the Local Authority Nursing Services 1969 * Briggs Report of the Committee on Nursing in the United Kingdom, 1972 which reviewed the role of
nurses Nursing is a health care profession that "integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alle ...
and
midwives A midwife (: midwives) is a health professional who cares for mothers and newborns around childbirth, a specialisation known as midwifery. The education and training for a midwife concentrates extensively on the care of women throughout their ...
in hospitals and in community care. It made recommendations on
education Education is the transmission of knowledge and skills and the development of character traits. Formal education occurs within a structured institutional framework, such as public schools, following a curriculum. Non-formal education als ...
, training, and professional regulation. The report was accepted in 1974. *
Cumberlege Report 1986 The Cumberlege Report (1986) or Neighbourhood nursing: a focus for care was the report of a Department of Health and Social Security (DHSS) committee advocating that community nurses in the United Kingdom be permitted to prescribe from a restrict ...
or Neighbourhood nursing: a focus for care was the report of a Department of Health and Social Security (DHSS) committee advocating that community nurses be permitted to prescribe from a restricted list of treatments. *
Front Line Care (Report) The Front Line Care report was a Prime Minister's independent commission on the future of nursing and midwifery in England. It was published in 2010, followed by the United Kingdom, UK Government's response in 2011. It was the first overarching gove ...
into nursing and midwifery was published in 2010. The chair of the commission was
Ann Keen Ann Lloyd Keen (''née'' Fox; born 26 November 1948) is a British Labour Party politician, who served as Member of Parliament (MP) for Brentford and Isleworth from 1997, until she was defeated by Conservative candidate Mary Macleod in 2010. ...
MP who trained as a nurse. The government response, led by
Anne Milton Anne Frances Milton (''née'' Turner; born 3 November 1955) is a British former politician and lobbyist who served as List of education ministries, Minister of State for Skills and Apprenticeships from 2017 to 2019. She was Member of Parliament ...
and published in April 2011.


Significant Nursing Reports

Significant reports from the
Royal College of Nursing The Royal College of Nursing (RCN) is a registered trade union and professional body in the United Kingdom for those in the profession of nursing. It was founded in 1916 as the College of Nursing, receiving its royal charter in 1928. Queen Eliz ...
, include: * Horder Committee established in 1941 to consider ways and means of implementing the recommendations of the Athlone Report, especially regarding the proper control of the Assistant Nurse. In July 1941, renamed the Special Reconstruction Committee on the Assistant Nurse and in January 1942 renamed the Nursing Reconstruction Committee, Assistant Nurse Sub-committee. The report was published in 1949. *
Platt Report 1964 The Platt Report (1964) or the Platt Report(s) on the Reform of Nursing Education was the report of Harry Platt upon the investigations of a committee established by the Royal College of Nursing (RCN). It made recommendations about how nurses sh ...
on the Reform of Nursing Education * Judge Report of a Commission on Nursing Education 1985 * Wills Commission on the Future of Nursing Education 2012 ''Quality with Compassion: the future of nursing education'' led by
Phil Willis George Philip Willis, Baron Willis of Knaresborough (born 30 November 1941, Burnley) is a politician in the United Kingdom. He is a Liberal Democrats (UK), Liberal Democrat member of the House of Lords, and was Member of Parliament (MP) for Ha ...
Additional reports relating to nursing in the UK include: * Lancet Commission on Nursing (1932) – looked at the reasons for the shortages of applicants to nursing * UKCC for Nursing Midwifery and Health Visiting. The Report of the Post-Registration Education and Practice Project. 1990


Nursing in culture

Nursing in the UK has been represented across popular books, television and films, including: * ''Mrs Gamp'' – Sarah or Sairey Gamp is a nurse in the novel
Martin Chuzzlewit ''The Life and Adventures of Martin Chuzzlewit'' (commonly known as ''Martin Chuzzlewit'') is a novel by English author Charles Dickens, considered the last of his picaresque novels. It was originally serialised between January 1843 and July 1 ...
by Charles Dickens, first published as a serial in 1843–1844. Mrs. Gamp, as she is usually referred to, is dissolute, sloppy and generally drunk. She became a notorious stereotype of untrained and incompetent nurses of the early Victorian era, before the reforms of campaigners like Florence Nightingale. The caricature was popular with the British public. * '' Sue Barton'' – a British series of seven career novels aimed at teenage girls, beginning with Sue as a ''Student Nurse'' and working through different roles up to the final book as ''Staff Nurse''. The books were written from 1936 to 1952, and republished several times up to 1991, with more recent vintage editions being available. *
Carry On Films ''Carry On'' is a British comedy franchise comprising 31 films, four Christmas specials, a television series and stage shows produced between 1958 and 1992. Produced by Peter Rogers, the ''Carry On'' films were directed by Gerald Thomas and st ...
– In total there were 31 British comedy films (1958–1992), their humour was in the British comic tradition of music halls and bawdy seaside postcards. Four of these focused on hospital settings; ''
Carry On Nurse ''Carry On Nurse'' is a 1959 British comedy film, the second in the series of 31 ''Carry On'' films (1958–1992). Of the regular team, it featured Joan Sims (in her ''Carry On'' film debut), Kenneth Williams, Kenneth Connor and Charles Hawtr ...
'' (1959), ''
Carry On Doctor ''Carry On Doctor'' is a 1967 British comedy film, the 15th in the series of 31 ''Carry On'' films (1958–1992). It is the second in the series to have a medical theme. Frankie Howerd makes the first of his two appearances in the film series ...
'' (1967), ''
Carry On Again Doctor ''Carry On Again Doctor'' is a 1969 British comedy film, the 18th release in the series of 31 ''Carry On'' films (1958–1992). It was released in December 1969 and was the third to feature a medical theme. The film features series regulars S ...
'' (1969), and ''
Carry On Matron ''Carry On Matron'' is a 1972 British comedy film, the 23rd release in the series of 31 ''Carry On'' films (1958–1992). It was released in May 1972. It was directed by Gerald Thomas and features series regulars Sid James, Kenneth Williams, ...
'' (1972). * ''Casualty''–a BBC drama series airing from 1986 to 2023 focusing on a hospital accident and emergency department. Casualty had a spin off
Holby City ''Holby City'' (stylised on-screen as HOLBY CIY) is a British medical drama television series that aired weekly on BBC One. It was created by Tony McHale and Mal Young as a Spin-off (media), spin-off from the established BBC medical drama '' ...
airing from 1999 to 2021. * ''24hrs in A&E'' – a
Channel 4 Channel 4 is a British free-to-air public broadcast television channel owned and operated by Channel Four Television Corporation. It is state-owned enterprise, publicly owned but, unlike the BBC, it receives no public funding and is funded en ...
British documentary airing from 2011 to 2023 focusing on Accident and Emergency department of a hospital. Initially set in
King's College Hospital King's College Hospital is a major teaching hospital and major trauma centre in Denmark Hill, Camberwell in the London Borough of Lambeth, referred to locally and by staff simply as "King's" or abbreviated internally to "KCH". It is managed by ...
, Camberwell; from the 7th series it was set in
St George's Hospital St George's Hospital is a large teaching hospital in Tooting, London. Founded in 1733, it is one of the UK's largest teaching hospitals. It is run by the St George's University Hospitals NHS Foundation Trust. It shares its main hospital site i ...
, Tooting and then from Season 30 Queens Medical Centre, Nottingham * ''Getting On'' – a satirical
BBC The British Broadcasting Corporation (BBC) is a British public service broadcaster headquartered at Broadcasting House in London, England. Originally established in 1922 as the British Broadcasting Company, it evolved into its current sta ...
sitcom based on a geriatric ward in an NHS hospital. It is written by its core cast, Jo Brand, Vicki Pepperdine, and Joanna Scanlan. Three series were aired between 2009 and 2012. * ''
Call the Midwife ''Call the Midwife'' is a British period drama television series about a group of nurse midwives working in the East End of London in the late 1950s, 1960s and 1970s. The principal cast of the show has included Jessica Raine, Miranda Hart, ...
'' – a
BBC The British Broadcasting Corporation (BBC) is a British public service broadcaster headquartered at Broadcasting House in London, England. Originally established in 1922 as the British Broadcasting Company, it evolved into its current sta ...
period drama series about a group of nurse
midwives A midwife (: midwives) is a health professional who cares for mothers and newborns around childbirth, a specialisation known as midwifery. The education and training for a midwife concentrates extensively on the care of women throughout their ...
working in the East End of London in the late 1950s and 1960s.


References

{{DEFAULTSORT:Nursing In The United Kingdom Healthcare occupations in the United Kingdom