The RCN published survey data in December 2025 showing two-thirds of nursing staff feel their pay doesn’t reflect their responsibilities. Four in ten are actively considering leaving their current role.

That’s a striking number. But I think the more useful question is what’s sitting underneath it — because “considering leaving” covers a lot of ground.

Some of that four in ten will leave. Some won’t. Some are venting. Some have already started looking. Some are waiting for a specific thing to change — a shift pattern, a manager, a band review — and if it does, they’ll stay.

The challenge is that many organisations don’t have granular enough data to know which of those groups they’re dealing with, or where those people sit. Exit surveys capture something, but they capture it too late and with well-documented response bias — people rarely say on the way out what actually drove them out.

What makes this particularly pointed in 2026 is the NMC registration data. The register grew 0.8% in the most recent period, down from 1.8% the period before.

 

That doesn’t necessarily mean global nurse supply has materially weakened. In part, it reflects a slowdown in international recruitment flows after a period where government support, post-pandemic demand and funded recruitment programmes significantly accelerated international joining volumes.

 

But operationally, the effect is similar: the external labour pool available to backfill vacancies is not expanding at the same rate it was. For employers, that increases the cost of turnover and extends the time needed to replace experienced staff — even while overall vacancy rates appear to improve.

 

There’s also something important sitting at the intersection of these datasets. If four in ten nurses are considering leaving, the register is growing more slowly, and specialist vacancies remain persistently difficult to fill, then retention and recruitment stop being separate workforce problems.

 

They’re the same pressure point viewed from opposite ends.

The organisations likely to outperform over the next few years will not necessarily be the ones recruiting the fastest. They’ll be the ones identifying dissatisfaction earlier, intervening sooner, and reducing avoidable attrition before vacancies emerge in the first place.

 

One of the more interesting dynamics here is that healthcare still lags behind many private-sector organisations in how it approaches workforce attrition.

 

In sectors like financial services, technology and professional services, employee turnover is increasingly treated as a predictive analytics problem rather than a retrospective HR metric. Organisations are investing heavily in tools that identify early disengagement patterns before resignations happen — tracking indicators such as internal mobility requests, manager changes, sickness absence, overtime dependency, engagement deterioration and workload pressure.

Platforms such as Workday Peakon, Visier, Microsoft Viva Insights and SAP SuccessFactors are now widely used in large enterprises to model attrition risk and identify workforce hotspots in near real time.

 

By contrast, many healthcare organisations still rely heavily on lagging indicators: vacancy rates, annual staff surveys and exit interviews. The challenge with that approach is that by the time those signals appear clearly in the data, operational pressure has often already escalated.

 

I don’t think there’s a clean answer here. But I do think organisations that are tracking early attrition indicators — not just exit data, but engagement signals, internal transfer requests, sickness patterns — are working with a fundamentally different picture than those relying on lagging indicators alone and are more likely to be able to manage workforce pressure effectively over the next few years.