AN OPEN LETTER
Trained, qualified, unemployed.

To the Chief Nursing Officer for England and NHS England:

Almost every nursing student, at every stage of training, has been told by a patient that they will "never be out of a job." It is said with hope for our futures, and it also reflects a national belief: that the NHS is crying out for nurses and that employment upon qualification is all but guaranteed. The reality graduates have faced over the past two years is very different and it cannot continue to go unacknowledged. It stands in stark contrast to the expectation on which many students took out substantial loans and committed 2,300 hours to unpaid placements within the NHS – hours that, on another degree, could have been spent in paid employment to reduce the debt they accumulated.

We write as nursing students and newly qualified nurses who are continually confronted by the discrepancy between what we are told and what we experience.

We are told there are more jobs this year than last. Yet some of us have submitted upwards of 40 applications for a first post; some are relocating hundreds of miles to begin their careers; and some have given years to trusts that advertised a guaranteed job when their degrees began, only to be told that guarantee no longer holds.1 Some graduates from 2024 are still awaiting their first nursing job.

A recent analysis of Band 5 nursing posts advertised on NHS Jobs found only 25.9% were full-time, permanent and open to applicants without post-registration experience, while 33% required experience a newly qualified nurse cannot yet have.2 In the East of England, and Yorkshire and the Humber, the proportion of suitable posts falls to 13.3%; by population, London and the North East have roughly half the average availability.2 NHS Employers have themselves told the Pay Review Body that strict vacancy controls are making it difficult to recruit newly qualified nurses,3 and an RCNi investigation found that 59% of vacant Band 5 nurse posts – more than 5,000 – are never advertised at all.4 A vacancy is still included in NHS vacancy statistics whether or not it is ever advertised, and whether or not a newly qualified nurse is allowed to apply. Counted is not the same as available.

Nursing vacancies in England have fallen from around 40,000 three years ago to fewer than 22,000,5 yet the need has not halved. We are seeing newly qualified nurses stacking supermarket shelves while holding a PIN; some are moving abroad; and others are leaving the profession altogether, before they have even begun.

UNISON research found that at least 21,000 NHS posts are due to be cut by 2028, including thousands of clinical roles, with reductions being made through vacancy freezes and restructuring.6 Around 19,000 graduates qualify this summer,1 workforce growth is at an eight-year low7 and 57% of NHS leaders expect to reduce clinical staffing this year.8 The ambition to bring more care closer to home cannot be realised without a workforce to deliver it.

We are told mental health nursing has sufficient vacancies nationally. Yet in the analysis of Band 5 posts, mental health graduates face the poorest ratio of advertised roles to final-year students of any field,2 while demand for mental health support has risen 38% in three years, community teams have grown just 15%, and half of community mental health nurses say their caseloads are too high to keep patients safe.9

Simultaneously, education itself is being defunded. On July 6th, the Strategic Priorities Grant cut the funding for teaching every pre-registration nursing student in England by nearly 3%,10 a decision the Council of Deans of Health warns puts the viability of some courses at risk.11 Nottingham has suspended its children's and mental health nursing programmes;12 and the University of Wolverhampton is closing its Telford campus, the only provider of nursing degrees in Shropshire, leaving the county with no local access to nursing education.13,14 Senior nursing academics are being lost across the country, including at London South Bank University, one of the capital's largest providers of nurse education.15 Across the UK, the number of students accepted onto learning disability nursing courses has fallen by 40% in a decade, with fewer than 500 enrolling in 2025.16

The advice offered to students has been to be flexible: widen the search, look beyond hospitals, avoid holding more than one offer and contact regional teams if struggling. Each suggestion is reasonable on its own terms. Together, they ask us to absorb a structural failure, and to be flexible in ways that have limits the advice does not acknowledge. Many trusts recruit only from their partner universities, so a graduate willing to move across the country may find the doors closed regardless. We are not struggling because we are insufficiently flexible; we are struggling because the posts are not funded, not advertised, or not open to us.17

Why does responsibility fall on individual graduates to become endlessly adaptable and advocate tirelessly for their own futures, rather than on leadership to fund and employ the workforce it repeatedly says – and evidently does – need?

We ask this knowing what joining this profession has already cost us. We pay tuition fees of over £9,000 a year, funded by loans that accrue interest at up to 6.2% while we study – before we have earned anything as nurses.18 We pay our own professional memberships and complete unpaid placements that are variable in quality, often under-supervised and affected by the very staffing pressures we are training to help alleviate. Some of us have even been encouraged by supervisors on placement to reconsider whether nursing is the career we really want.19 Many work alongside those placement hours simply to eat and pay rent, some while supporting children or other dependants. Most will graduate in significant debt, for jobs that are not there.

The NMC's own UK-wide review has found marked variation in practice learning experiences and supervision.20 Its recent consultation proposed significant changes to how nurses are trained, including reducing the minimum programme hours required for registration.21 As the regulator reconsiders how we prepare the next generation of nurses, there remains no certainty over the availability of funded posts for them to enter when their training ends. Nor is it yet clear how changes to training requirements will be perceived by employers, at a time when newly qualified nurses are already being excluded from Band 5 posts for lacking experience they have had no opportunity to gain.

We recognise and support the ongoing review of Band 5 nursing roles22 – a long-overdue acknowledgement that many nurses have been carrying levels of responsibility far beyond those reflected in their current band. Recalibrating the value placed on nursing roles is imperative. But it also raises an important question about the resulting composition of the workforce. If roles are appropriately re-banded, there must still be enough funded Band 5 posts that are suitable for new registrants. We cannot address the chronic undervaluing of the profession without also protecting a route into it. Nurses deserve to be valued from the point of entry, not only once they have proved themselves beyond their band.

Most concerning is the impact on our patients. The failure to employ newly qualified nurses is inextricable from the staffing pressures already being felt across services. A recent RCN survey found a quarter of nurses felt their last shift was unsafe.7,23 NHS Alliance polling in May found 64% of NHS leaders expect to cut services this year.8 If this continues, wards will be staffed further below safe levels, with fewer experienced nurses left to teach those who come after us. We are training fewer nurses, cutting the funding for their education, employing fewer of the graduates we produce – without the transparency we all deserve.

We are therefore asking for:

1. Published, accessible data on Band 5 vacancies and advertising across England, broken down by field and region, including the proportion of unfilled posts never advertised.

2. An end to Band 5 job descriptions requiring post-registration experience, and funded first posts with preceptorship, sufficient for each year's qualifying cohort.

3. Workforce planning aligned with university recruitment in the forthcoming 10-year workforce plan,24 with enough funded posts to deliver the shift towards care closer to home, rather than cutting training places, and specific protection for learning disability, mental health and children's nursing.

4. Reversal or mitigation of the Strategic Priorities Grant cut, with supplementary funding to retain nursing academics.

5. A published plan to close the gap between nursing graduates and funded posts before the next cohort qualifies, with a clear account, to students and to the public, of how the current position is compatible with an NHS that remains chronically understaffed.

The public continue to place enormous trust in nursing. That trust cannot be taken for granted while the profession's members are losing faith in their own future within it. We are asking to be listened to, to be valued and to be given a real reason to stay. We did not train for this profession to leave it before we begin.

We hold ourselves to a duty of candour with those in our care. This letter extends that candour to the public about what is happening to nursing itself.

We invite students, nurses, educators, patients, carers and members of the public to add their names below.