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Matt Haig: ‘There is no more shame in mental illness than having tonsilitis’

The problem we have with talking about mental health is that we still don’t think of it as an equal priority with physical health. This is wrong not simply because it leads to less money being spent on mental health service provision by governments, but also because it fails to see that the whole idea of mental health shouldn’t be an isolated one.

As a species, we love to divide things up. We draw a straight line in a map between the Atlantic and Indian Oceans while the water remains oblivious. We also draw a line between the mental and physical and base our entire system of healthcare on that false division.

Once upon a time, the medical world detailed the makings of the human body by saying there were four distinct humours. Every single health complaint could be explained as an excess or deficiency of one of four distinct bodily fluids – black bile, yellow bile, phlegm and blood. And these in turn were related to the four elements, as well as the four seasons and the four ages of man.

If in those golden olden days you were feeling depressed, or melancholic, that was down to an overload of black bile. In fact, the very word melancholia, as with melancholy, stems via Latin from the ancient Greek words melas kholē, which literally meant “black bile”. It seems funny, now, this idea. But in one way at least it was more advanced than much of our present approach. Namely, it did not see a rigid divide between physical and mental health. Mental illness was seen to have physical roots, and was associated with the four elements.

Now, of course, if you visit your doctor about persisting feelings of worthlessness and despair and the futility of existence they will be unlikely to talk of bile of any kind. But then, before we think we are at the end of progress, and have all the answers, we should remember that our doctors might not talk about your body at all.

And yet everything I have come to learn about my own experience of mental health and illness has taught me that this is also a mistake. Even if you have the idea that mental illness is solely an illness of the brain, the brain is a physical thing. The brain is the body. Mental health is physical health. Bodies and minds interact.


You can’t draw a line between a body and a mind any more than you can draw a line between oceans

I would go even further. I don’t want to get too cross-legged on a Himalayan mountain top, but mental health isn’t just brain health. Mental health is intricately related to the whole body. And the whole body is intricately related to mental health. You can’t draw a line between a body and a mind any more than you can draw a line between oceans.

It’s comforting to realise that many cognitive scientists these days acknowledge this. Thoughts aren’t just the products of brains, and vice versa. As Guy Claxton – himself a cognitive scientist – writes in Intelligence in the Flesh, “the body, the gut, the senses, the immune system, the lymphatic system, are so instantaneously and so complicatedly interacting with the brain that you can’t draw a line across the neck and say ‘above the line it’s smart and below the line it’s menial’.” In short: “we don’t just have bodies. We are bodies.”

The word “holistic” is so often associated with scientifically dubious kinds of therapies, but the science is slowly leading us towards a more holistic view of minds and bodies, so our healthcare needs to acknowledge that. We need to realise the physical nature of mental illness and the mental nature of physical illness. Mental hospitals and physical hospitals should all be mental-physical hospitals (but maybe they should be called something catchier).

A happy side product of erasing the line between mind and body, a line that has been boldly drawn since Descartes, would be to destigmatise mental health by placing it on an equal footing with stigma-free physical issues such as asthma and arthritis. It would also lead to a better health service. If mental health was understood in physical terms, it would stop being the poor relation of health when it comes to government funding.

Ultimately, it wouldn’t just help doctors and nurses to understand us better. It would also change the way we view ourselves. The idea that our minds are in our control, and that free will is all, still pervades, and makes people feel a kind of guilt or shame for being ill. A guilt that in itself exacerbates symptoms. We need to truly understand the way minds and bodies interact with each other, and how both are affected by the world.

So a new, more integrated, healthcare system would not only be good because it would help patients, it would also help anyone feeling distress to understand that there is no more shame to be felt than if they had tonsillitis. Illness is illness, and health is health. There can be no “mind over matter” when we understand that mind is matter.

How to Stop Time by Matt Haig is published by Canongate. To order a copy for £7.99 (RRP £12.99) go to bookshop.theguardian.com or call 0330 333 6846. Free UK p&p over £10, online orders only. Phone orders min p&p of £1.99.

The week in TV: Broken; The Betrayed Girls, The Windsors and more

Broken (BBC1) | iPlayer
The Betrayed Girls (BBC1) | iPlayer
The Windsors (C4) | All4
Rock’n’Roll Guns for Hire: The Story of the Sideman (BBC4) | iPlayer
The Highland Midwife (C5) | My5

Broken, which ended its too-short run just as we were all beginning to fall a little bit in love with it, has brought a uniqueness to British TV this year in somehow managing to be both Kafkaesque and Capraesque. The former, in its portrayal of the savage non-choices daily facing the poor – the chronicling of such Sisyphean travails writer Jimmy McGovern has dedicated much of his life to – in tandem with the spirited evisceration of every political mindset that can ever judge, with squirrely impossibility, that the poor are poor because they’re taking all our money.

The latter, the Frank Capra element, arrived at the very end of last week’s closer, as the parishioners queued to essentially absolve Father Michael of his sins, such as they ever were. I defy anyone not to have simultaneously smiled and blinked back tears during the last five minutes, and it was shamelessly, undeniably, a long shiver of feel-good – but McGovern has never exactly subscribed to the Ken Loach school, preferring instead to pepper his agitprop with warmth, wit and very human seasoning.

Sean Bean, in what some are calling the performance of his life, showed that he can turn his once chiselled chops from mournful beleaguered action hero to mournful beleaguered magi. That’s not meant to diminish him: the jowly new plains of his face spoke volumes, mainly when he wasn’t doing any actual speaking himself, about conflicted men, and trying to do not just the right thing but for the right reason. Inter alia his character proved, by example, how religion can be a force for everyday good in society – not so much with the ecumenical niceties or the sweeping blandness, but simply by lifting a Hoover, pulling on the Marigolds, sliding someone an urgent fag, or taking a not even remotely metaphorical sledgehammer to the money-changers – a little over the top here but still, my, how we cheered. And we got a great cameo from Phil Davis as the tawdry slots boss, veering between wheedling reason and skull-beneath-the-skin anger. In fact the supporting cast, notably Anna Friel and Muna Otaru, have lent much to this triumph. Even the supporting music: Nina Simone’s bittersweet reworking of Randy Newman’s I Think It’s Going to Rain Today might have to become the theme song of 2017.

Former DC Maggie Oliver in The Betrayed Girls.


Former DC Maggie Oliver in The Betrayed Girls. Photograph: Grabs/BBC / Sandpaper Films

The Betrayed Girls, Henry Singer’s masterful account of the Rochdale grooming scandal, suffered only slightly from arriving the same year as the BBC drama Three Girls. If the first drew us wholly into the toxic circumstances of the scandal, the poverty of the girls’ horizons, this documentary more clearly let us sit back and assign blame. Firstly, of course, to the unconscionable perpetrators, married pillars of their community who came to view almost as a reward, as “downtime”, the concept of recreational paedophilia. But also to the legions of police, teachers, social workers and politicians who knew what was going on but froze witless in their fear – no, it was often simple discomfort, an emotion that doesn’t even attain the nobility of squeamishness – at the racial implications. Far easier to list the (very) few who were unafraid: DC Maggie Oliver, sexual health worker Sara Rowbotham, MP Ann Cryer, prosecutor Nazir Afzal, Andrew Norfolk of the Times. Incidentally, Maggie resigned from the police a few years ago. Sara was made redundant, later suffering depression and PTSD. Not one senior officer has faced so much as a reprimand.

The Windsors are back on our box, welcomely, and still happily unfettered by such restrictive critical considerations as, for instance, taste. The satirical royal soap takes a blunderbuss approach to its humour: precisely how sharp might you have to be to take the rip out of Charles’s ineffectuality or Theresa May’s bullying incompetence? But the delights arrive with the minor royals: a vicious Pippa, casting gypsy curses, or Beatrice and Eugenie (Celeste Dring and Ellie White), mangling every posh diphthong available into a gargoyled simulacrum of the English language and thus gently, gleefully, reminding us of that old head-scratching question: what are they all, y’know, for?

You could look a long way before finding a music-based programme with insights to rival some of those vouchsafed in Rock’n’Roll Guns for Hire, a great little documentary about the sidemen and women behind and beside some of rock music’s behemoths.

Differing from session musicians in that they don’t necessarily always play on recordings, the “sidies” have performed, often for as long as 30 years, on tour and on stage with the biggest names going. Bernard Fowler, who has to contend with the occasional naysayer – “but there’s no black guys in the Rolling Stones!” – and Crystal Taliefero (sax, drums, keyboards, everything, with Billy Joel), the sainted Steve Cropper, chubby white unlikely hero to generations of soul fans, Crystal Torres (Beyoncé), Lisa Coleman and Wendy Melvoin (Prince).

Sideman Earl Slick performing with David Bowie in 2003.


Sideman Earl Slick performing with David Bowie in 2003. Photograph: KMazur/WireImage

They were, almost to a man and woman, self-effacing, happy to stand, literally, in the shadows, contentedly unrecognised, anxious only that the tour dates might dry up and the money run out. This was winningly fronted by Earl Slick (real name, um, Frank Madeloni), guitarist to Bowie and laid-back to the point of catalepsy, and, as might have been expected, much interest focused on the big-name stars and fascinating glimpses of the egos involved. I suspect Bowie rated Slick, but Bowie also, a little more, rated Bowie. I’m sure Otis Redding rated Cropper, not least for writing Knock on Wood (simply by reversing the chords from In the Midnight Hour ). Lisa and Wendy hinted, not all that subtly, at more than one over-precious hissy fit from Prince. As so often, Keith Richards charmed. “Sidies… the better you are at your job, the less people notice you. And that’s the point, heh heh. But Bernard Fowler – he is a Stone, now. Brother Bernard’s a rock, man.”

The Highland Midwife was an unexpected treat from C5. What this doc lacked in the scripted dramas of Call the Midwife – and it lacked a lot here – it made up for in simple watchability: for the views, certainly, but also for the oddly captivating small dramas of every single birth.

The fathers’ dilemmas, the mothers’ fears, the simple logistics and tiny burbling panics necessitated by having chosen to live four hours from the nearest hospital. The crucial personalities of the midwives themselves, who surely by the end know every inch of their charges, down to the fusty back of the teabag cupboard. And we were reminded, should we have needed it, that for all a mother’s preparations – hopeful winsome notes to self, felt-tipped and stuck to banisters and bathroom mirror, “my birth will be easy, for my baby is loved” and other such sub-Hallmark toshness – every mother is, at least once in her life, reduced to a wrack of shuddering agony, her entire body glimmering with pain.

Anastasia’s little Olya will grow up speaking Russian, English and Scots Gaelic. Which is nice.

More patients waiting longer than a week for GP appointments

Growing numbers of patient are waiting a week or more to see their GP or are unable to get an appointment at all, according to a major annual report.

A survey of more than 800,000 patients in England reveals that the proportion of patients waiting longer than seven days to see a doctor has risen 56% in five years – with 20% waiting this period compared to 12.8% in 2012.

The number unable to get an appointment has also risen to 11.3%, an increase of 27% since 2012. Of those who were not able to get an appointment or found the appointment offered was not convenient, 14.6% did not see or speak to anyone as a result.

Rising numbers are also struggling to even get through to surgeries over the phone, according to findings of the annual GP survey in 2017. The poll, published by NHS England with Ipsos Mori, also found fewer patients are seeing their preferred GP.

Prof Helen Stokes-Lampard, chair of the Royal College of GPs, said it was “very concerning” that more people had to wait longer for appointments, putting it down to a “decade of under-investment”.

“It is particularly worrying that some patients are deciding not to seek medical advice at all if they are not able to get an appointment initially,” she said.

There are an estimated 370 million patient consultations a year, up by 60 million on five years ago. Stokes-Lampard said: “GPs are working flat out to provide care for as many patients as we possibly can, but there are limits beyond which we can no longer guarantee safe care.”

Despite declining access, however, overall satisfaction with GPs remains high, with 85% of people rating their experience as good. A further 92% also had confidence and trust in the last GP they saw.

Rachel Power, chief executive of the Patients Association, said that it was reassuring that patient satisfaction was holding up, but described the findings of long waits for appointments as “worrying”.

“We know there are multiple pressures on general practice in terms of both its workforce and the ageing profile of patients. There will be no solution unless and until the government gets serious about investing in the NHS, and even then the path back to consistently high quality in services will be a long one,” Power said.

The survey showed 27.8% of those surveyed said they found it difficult to get through to their doctor on the phone, this was a 50% increase from 2012.

People were also asked how often they see or speak to their preferred GP, of who 383,770 answered. Of these, 56% see their preferred GP always or a lot of the time, down from 65% in 2012. Almost one in 10 patients said they never or almost never get to see the GP of their choice.

NHS England’s GP Forward View pledges to provide an extra £2.4bn a year for general practice and 5,000 additional GPs by 2020. Stokes-Lampard called for this to be delivered as a “matter of urgency”.

Dr Arvind Madan, director of primary care for NHS England, said: “General practice is the foundation of the NHS and this survey shows patients appreciate the fantastic job GPs and the wider primary care workforce are doing in times of real pressure with more patients having increasingly complex conditions.

“Access to GPs is already expanding with 17 million people now able to get an appointment in the evening and at weekends, and everyone will be able to by March 2019.”

More nurses and midwives leaving UK profession than joining, figures reveal

More midwives and nurses are leaving the profession in the UK than joining for the first time on record, with the number departing having risen by 51% in just four years.

The figures, which will add to concerns about NHS staff shortages, show that 20% more people left the Nursing and Midwifery Council (NMC) register than joined it in 2016/17. The overall number of leavers was 34,941, compared with 23,087 in 2012/13.

While concerns have previously been raised about a large drop in EU registrants in the wake of the Brexit vote, the NMC figures, published on Monday, show that it is the departure of UK nurses – who make up 85% of the register – that is having the biggest impact. In 2016/17, 29,434 UK nurses and midwives left the register, up from 19,818 in 2012/13, and 45% more UK registrants left than joined last year.

Unions say there is a shortage of 40,000 nurses and 3,500 midwives in England alone and they, and NHS trusts, blamed the pay cap and workplace pressures.

Saffron Cordery, director of policy and strategy at NHS Providers, said: “The NHS is severely stretched and we need to keep and value our staff. This is important for the quality and particularly the continuity of care. We need to follow through on the investment in training staff by consolidating and building on their skills, motivating them and giving them reasons to stay in the NHS.”

After consecutive yearly rises in the number of people on the register since 2013, the number fell by 1,783 in 2016/17. It has dropped more steeply since then, by a further 3,264 in April and May.

The average age of those leaving the register has fallen from 55 in 2013 to 51. Of those who left in 2016/17, 2,901 were in the 21-30 age group, almost double the 2012/13 number.

Janet Davies, chief executive and general secretary of the Royal College of Nursing, said patients were paying the price of government policy. “The average nurse is £3,000 worse off in real terms compared with 2010,” she said. “The 1% cap means nursing staff can no longer afford to stay in the profession and scrapping student funding means people can no longer afford to join it.”

Davies said it was worrying that many were going abroad. The NMC logged 4,153 “verification requests” from overseas licensing authorities – mostly in Australia, the US and Ireland – in relation to UK registrants in 2016/17.

An NMC survey of more than 4,500 nurses and midwives who left the register over the previous 12 months found that about a half had retired. Among those who had not, the top three reasons cited for leaving were working conditions, including staffing levels (44%), a change in personal circumstances, such as ill health (28%), and disillusionment with the quality of patient care (27%). Other reasons included leaving the UK (18%) and poor pay and benefits (16%).

Jon Skewes, the Royal College of Midwives’s director for policy, employment relations and communications, said: “The incredible pressures midwives are under due to increasing demands on services are a factor here. This combined with years of pay freezes and pay restraint has left our health professionals demoralised and disillusioned.”

The number of EU workers – who make up 5% of the register – leaving increased to 3,081 from 1,173 in 2012/2013. There were 247 responses to the NMC survey from EU registrants, with 32% saying Brexit had persuaded them to consider working elsewhere.

A Department of Health spokeswoman said: “We are making sure we have the nurses we need to continue delivering world-class patient care – that’s why there are almost 13,100 more on our wards since May 2010 and 52,000 in training.”

The spokeswoman highlighted the NHS Improvement programme to increase staff retention, which launched last week. However, Cordery said it would have limited impact unless the pay cap and “unsustainable workplace pressures” were addressed.

More nurses and midwives leaving UK profession than joining, figures reveal

More midwives and nurses are leaving the profession in the UK than joining for the first time on record, with the number departing having risen by 51% in just four years.

The figures, which will add to concerns about NHS staff shortages, show that 20% more people left the Nursing and Midwifery Council (NMC) register than joined it in 2016/17. The overall number of leavers was 34,941, compared with 23,087 in 2012/13.

While concerns have previously been raised about a large drop in EU registrants in the wake of the Brexit vote, the NMC figures, published on Monday, show that it is the departure of UK nurses – who make up 85% of the register – that is having the biggest impact. In 2016/17, 29,434 UK nurses and midwives left the register, up from 19,818 in 2012/13, and 45% more UK registrants left than joined last year.

Unions say there is a shortage of 40,000 nurses and 3,500 midwives in England alone and they, and NHS trusts, blamed the pay cap and workplace pressures.

Saffron Cordery, director of policy and strategy at NHS Providers, said: “The NHS is severely stretched and we need to keep and value our staff. This is important for the quality and particularly the continuity of care. We need to follow through on the investment in training staff by consolidating and building on their skills, motivating them and giving them reasons to stay in the NHS.”

After consecutive yearly rises in the number of people on the register since 2013, the number fell by 1,783 in 2016/17. It has dropped more steeply since then, by a further 3,264 in April and May.

The average age of those leaving the register has fallen from 55 in 2013 to 51. Of those who left in 2016/17, 2,901 were in the 21-30 age group, almost double the 2012/13 number.

Janet Davies, chief executive and general secretary of the Royal College of Nursing, said patients were paying the price of government policy. “The average nurse is £3,000 worse off in real terms compared with 2010,” she said. “The 1% cap means nursing staff can no longer afford to stay in the profession and scrapping student funding means people can no longer afford to join it.”

Davies said it was worrying that many were going abroad. The NMC logged 4,153 “verification requests” from overseas licensing authorities – mostly in Australia, the US and Ireland – in relation to UK registrants in 2016/17.

An NMC survey of more than 4,500 nurses and midwives who left the register over the previous 12 months found that about a half had retired. Among those who had not, the top three reasons cited for leaving were working conditions, including staffing levels (44%), a change in personal circumstances, such as ill health (28%), and disillusionment with the quality of patient care (27%). Other reasons included leaving the UK (18%) and poor pay and benefits (16%).

Jon Skewes, the Royal College of Midwives’s director for policy, employment relations and communications, said: “The incredible pressures midwives are under due to increasing demands on services are a factor here. This combined with years of pay freezes and pay restraint has left our health professionals demoralised and disillusioned.”

The number of EU workers – who make up 5% of the register – leaving increased to 3,081 from 1,173 in 2012/2013. There were 247 responses to the NMC survey from EU registrants, with 32% saying Brexit had persuaded them to consider working elsewhere.

A Department of Health spokeswoman said: “We are making sure we have the nurses we need to continue delivering world-class patient care – that’s why there are almost 13,100 more on our wards since May 2010 and 52,000 in training.”

The spokeswoman highlighted the NHS Improvement programme to increase staff retention, which launched last week. However, Cordery said it would have limited impact unless the pay cap and “unsustainable workplace pressures” were addressed.

More nurses and midwives leaving UK profession than joining, figures reveal

More midwives and nurses are leaving the profession in the UK than joining for the first time on record, with the number departing having risen by 51% in just four years.

The figures, which will add to concerns about NHS staff shortages, show that 20% more people left the Nursing and Midwifery Council (NMC) register than joined it in 2016/17. The overall number of leavers was 34,941, compared with 23,087 in 2012/13.

While concerns have previously been raised about a large drop in EU registrants in the wake of the Brexit vote, the NMC figures, published on Monday, show that it is the departure of UK nurses – who make up 85% of the register – that is having the biggest impact. In 2016/17, 29,434 UK nurses and midwives left the register, up from 19,818 in 2012/13, and 45% more UK registrants left than joined last year.

Unions say there is a shortage of 40,000 nurses and 3,500 midwives in England alone and they, and NHS trusts, blamed the pay cap and workplace pressures.

Saffron Cordery, director of policy and strategy at NHS Providers, said: “The NHS is severely stretched and we need to keep and value our staff. This is important for the quality and particularly the continuity of care. We need to follow through on the investment in training staff by consolidating and building on their skills, motivating them and giving them reasons to stay in the NHS.”

After consecutive yearly rises in the number of people on the register since 2013, the number fell by 1,783 in 2016/17. It has dropped more steeply since then, by a further 3,264 in April and May.

The average age of those leaving the register has fallen from 55 in 2013 to 51. Of those who left in 2016/17, 2,901 were in the 21-30 age group, almost double the 2012/13 number.

Janet Davies, chief executive and general secretary of the Royal College of Nursing, said patients were paying the price of government policy. “The average nurse is £3,000 worse off in real terms compared with 2010,” she said. “The 1% cap means nursing staff can no longer afford to stay in the profession and scrapping student funding means people can no longer afford to join it.”

Davies said it was worrying that many were going abroad. The NMC logged 4,153 “verification requests” from overseas licensing authorities – mostly in Australia, the US and Ireland – in relation to UK registrants in 2016/17.

An NMC survey of more than 4,500 nurses and midwives who left the register over the previous 12 months found that about a half had retired. Among those who had not, the top three reasons cited for leaving were working conditions, including staffing levels (44%), a change in personal circumstances, such as ill health (28%), and disillusionment with the quality of patient care (27%). Other reasons included leaving the UK (18%) and poor pay and benefits (16%).

Jon Skewes, the Royal College of Midwives’s director for policy, employment relations and communications, said: “The incredible pressures midwives are under due to increasing demands on services are a factor here. This combined with years of pay freezes and pay restraint has left our health professionals demoralised and disillusioned.”

The number of EU workers – who make up 5% of the register – leaving increased to 3,081 from 1,173 in 2012/2013. There were 247 responses to the NMC survey from EU registrants, with 32% saying Brexit had persuaded them to consider working elsewhere.

A Department of Health spokeswoman said: “We are making sure we have the nurses we need to continue delivering world-class patient care – that’s why there are almost 13,100 more on our wards since May 2010 and 52,000 in training.”

The spokeswoman highlighted the NHS Improvement programme to increase staff retention, which launched last week. However, Cordery said it would have limited impact unless the pay cap and “unsustainable workplace pressures” were addressed.

More nurses and midwives leaving UK profession than joining, figures reveal

More midwives and nurses are leaving the profession in the UK than joining for the first time on record, with the number departing having risen by 51% in just four years.

The figures, which will add to concerns about NHS staff shortages, show that 20% more people left the Nursing and Midwifery Council (NMC) register than joined it in 2016/17. The overall number of leavers was 34,941, compared with 23,087 in 2012/13.

While concerns have previously been raised about a large drop in EU registrants in the wake of the Brexit vote, the NMC figures, published on Monday, show that it is the departure of UK nurses – who make up 85% of the register – that is having the biggest impact. In 2016/17, 29,434 UK nurses and midwives left the register, up from 19,818 in 2012/13, and 45% more UK registrants left than joined last year.

Unions say there is a shortage of 40,000 nurses and 3,500 midwives in England alone and they, and NHS trusts, blamed the pay cap and workplace pressures.

Saffron Cordery, director of policy and strategy at NHS Providers, said: “The NHS is severely stretched and we need to keep and value our staff. This is important for the quality and particularly the continuity of care. We need to follow through on the investment in training staff by consolidating and building on their skills, motivating them and giving them reasons to stay in the NHS.”

After consecutive yearly rises in the number of people on the register since 2013, the number fell by 1,783 in 2016/17. It has dropped more steeply since then, by a further 3,264 in April and May.

The average age of those leaving the register has fallen from 55 in 2013 to 51. Of those who left in 2016/17, 2,901 were in the 21-30 age group, almost double the 2012/13 number.

Janet Davies, chief executive and general secretary of the Royal College of Nursing, said patients were paying the price of government policy. “The average nurse is £3,000 worse off in real terms compared with 2010,” she said. “The 1% cap means nursing staff can no longer afford to stay in the profession and scrapping student funding means people can no longer afford to join it.”

Davies said it was worrying that many were going abroad. The NMC logged 4,153 “verification requests” from overseas licensing authorities – mostly in Australia, the US and Ireland – in relation to UK registrants in 2016/17.

An NMC survey of more than 4,500 nurses and midwives who left the register over the previous 12 months found that about a half had retired. Among those who had not, the top three reasons cited for leaving were working conditions, including staffing levels (44%), a change in personal circumstances, such as ill health (28%), and disillusionment with the quality of patient care (27%). Other reasons included leaving the UK (18%) and poor pay and benefits (16%).

Jon Skewes, the Royal College of Midwives’s director for policy, employment relations and communications, said: “The incredible pressures midwives are under due to increasing demands on services are a factor here. This combined with years of pay freezes and pay restraint has left our health professionals demoralised and disillusioned.”

The number of EU workers – who make up 5% of the register – leaving increased to 3,081 from 1,173 in 2012/2013. There were 247 responses to the NMC survey from EU registrants, with 32% saying Brexit had persuaded them to consider working elsewhere.

A Department of Health spokeswoman said: “We are making sure we have the nurses we need to continue delivering world-class patient care – that’s why there are almost 13,100 more on our wards since May 2010 and 52,000 in training.”

The spokeswoman highlighted the NHS Improvement programme to increase staff retention, which launched last week. However, Cordery said it would have limited impact unless the pay cap and “unsustainable workplace pressures” were addressed.

More nurses and midwives leaving UK profession than joining, figures reveal

More midwives and nurses are leaving the profession in the UK than joining for the first time on record, with the number departing having risen by 51% in just four years.

The figures, which will add to concerns about NHS staff shortages, show that 20% more people left the Nursing and Midwifery Council (NMC) register than joined it in 2016/17. The overall number of leavers was 34,941, compared with 23,087 in 2012/13.

While concerns have previously been raised about a large drop in EU registrants in the wake of the Brexit vote, the NMC figures, published on Monday, show that it is the departure of UK nurses – who make up 85% of the register – that is having the biggest impact. In 2016/17, 29,434 UK nurses and midwives left the register, up from 19,818 in 2012/13, and 45% more UK registrants left than joined last year.

Unions say there is a shortage of 40,000 nurses and 3,500 midwives in England alone and they, and NHS trusts, blamed the pay cap and workplace pressures.

Saffron Cordery, director of policy and strategy at NHS Providers, said: “The NHS is severely stretched and we need to keep and value our staff. This is important for the quality and particularly the continuity of care. We need to follow through on the investment in training staff by consolidating and building on their skills, motivating them and giving them reasons to stay in the NHS.”

After consecutive yearly rises in the number of people on the register since 2013, the number fell by 1,783 in 2016/17. It has dropped more steeply since then, by a further 3,264 in April and May.

The average age of those leaving the register has fallen from 55 in 2013 to 51. Of those who left in 2016/17, 2,901 were in the 21-30 age group, almost double the 2012/13 number.

Janet Davies, chief executive and general secretary of the Royal College of Nursing, said patients were paying the price of government policy. “The average nurse is £3,000 worse off in real terms compared with 2010,” she said. “The 1% cap means nursing staff can no longer afford to stay in the profession and scrapping student funding means people can no longer afford to join it.”

Davies said it was worrying that many were going abroad. The NMC logged 4,153 “verification requests” from overseas licensing authorities – mostly in Australia, the US and Ireland – in relation to UK registrants in 2016/17.

An NMC survey of more than 4,500 nurses and midwives who left the register over the previous 12 months found that about a half had retired. Among those who had not, the top three reasons cited for leaving were working conditions, including staffing levels (44%), a change in personal circumstances, such as ill health (28%), and disillusionment with the quality of patient care (27%). Other reasons included leaving the UK (18%) and poor pay and benefits (16%).

Jon Skewes, the Royal College of Midwives’s director for policy, employment relations and communications, said: “The incredible pressures midwives are under due to increasing demands on services are a factor here. This combined with years of pay freezes and pay restraint has left our health professionals demoralised and disillusioned.”

The number of EU workers – who make up 5% of the register – leaving increased to 3,081 from 1,173 in 2012/2013. There were 247 responses to the NMC survey from EU registrants, with 32% saying Brexit had persuaded them to consider working elsewhere.

A Department of Health spokeswoman said: “We are making sure we have the nurses we need to continue delivering world-class patient care – that’s why there are almost 13,100 more on our wards since May 2010 and 52,000 in training.”

The spokeswoman highlighted the NHS Improvement programme to increase staff retention, which launched last week. However, Cordery said it would have limited impact unless the pay cap and “unsustainable workplace pressures” were addressed.

More nurses and midwives leaving UK profession than joining, figures reveal

More midwives and nurses are leaving the profession in the UK than joining for the first time on record, with the number departing having risen by 51% in just four years.

The figures, which will add to concerns about NHS staff shortages, show that 20% more people left the Nursing and Midwifery Council (NMC) register than joined it in 2016/17. The overall number of leavers was 34,941, compared with 23,087 in 2012/13.

While concerns have previously been raised about a large drop in EU registrants in the wake of the Brexit vote, the NMC figures, published on Monday, show that it is the departure of UK nurses – who make up 85% of the register – that is having the biggest impact. In 2016/17, 29,434 UK nurses and midwives left the register, up from 19,818 in 2012/13, and 45% more UK registrants left than joined last year.

Unions say there is a shortage of 40,000 nurses and 3,500 midwives in England alone and they, and NHS trusts, blamed the pay cap and workplace pressures.

Saffron Cordery, director of policy and strategy at NHS Providers, said: “The NHS is severely stretched and we need to keep and value our staff. This is important for the quality and particularly the continuity of care. We need to follow through on the investment in training staff by consolidating and building on their skills, motivating them and giving them reasons to stay in the NHS.”

After consecutive yearly rises in the number of people on the register since 2013, the number fell by 1,783 in 2016/17. It has dropped more steeply since then, by a further 3,264 in April and May.

The average age of those leaving the register has fallen from 55 in 2013 to 51. Of those who left in 2016/17, 2,901 were in the 21-30 age group, almost double the 2012/13 number.

Janet Davies, chief executive and general secretary of the Royal College of Nursing, said patients were paying the price of government policy. “The average nurse is £3,000 worse off in real terms compared with 2010,” she said. “The 1% cap means nursing staff can no longer afford to stay in the profession and scrapping student funding means people can no longer afford to join it.”

Davies said it was worrying that many were going abroad. The NMC logged 4,153 “verification requests” from overseas licensing authorities – mostly in Australia, the US and Ireland – in relation to UK registrants in 2016/17.

An NMC survey of more than 4,500 nurses and midwives who left the register over the previous 12 months found that about a half had retired. Among those who had not, the top three reasons cited for leaving were working conditions, including staffing levels (44%), a change in personal circumstances, such as ill health (28%), and disillusionment with the quality of patient care (27%). Other reasons included leaving the UK (18%) and poor pay and benefits (16%).

Jon Skewes, the Royal College of Midwives’s director for policy, employment relations and communications, said: “The incredible pressures midwives are under due to increasing demands on services are a factor here. This combined with years of pay freezes and pay restraint has left our health professionals demoralised and disillusioned.”

The number of EU workers – who make up 5% of the register – leaving increased to 3,081 from 1,173 in 2012/2013. There were 247 responses to the NMC survey from EU registrants, with 32% saying Brexit had persuaded them to consider working elsewhere.

A Department of Health spokeswoman said: “We are making sure we have the nurses we need to continue delivering world-class patient care – that’s why there are almost 13,100 more on our wards since May 2010 and 52,000 in training.”

The spokeswoman highlighted the NHS Improvement programme to increase staff retention, which launched last week. However, Cordery said it would have limited impact unless the pay cap and “unsustainable workplace pressures” were addressed.

More nurses and midwives leaving UK profession than joining, figures reveal

More midwives and nurses are leaving the profession in the UK than joining for the first time on record, with the number departing having risen by 51% in just four years.

The figures, which will add to concerns about NHS staff shortages, show that 20% more people left the Nursing and Midwifery Council (NMC) register than joined it in 2016/17. The overall number of leavers was 34,941, compared with 23,087 in 2012/13.

While concerns have previously been raised about a large drop in EU registrants in the wake of the Brexit vote, the NMC figures, published on Monday, show that it is the departure of UK nurses – who make up 85% of the register – that is having the biggest impact. In 2016/17, 29,434 UK nurses and midwives left the register, up from 19,818 in 2012/13, and 45% more UK registrants left than joined last year.

Unions say there is a shortage of 40,000 nurses and 3,500 midwives in England alone and they, and NHS trusts, blamed the pay cap and workplace pressures.

Saffron Cordery, director of policy and strategy at NHS Providers, said: “The NHS is severely stretched and we need to keep and value our staff. This is important for the quality and particularly the continuity of care. We need to follow through on the investment in training staff by consolidating and building on their skills, motivating them and giving them reasons to stay in the NHS.”

After consecutive yearly rises in the number of people on the register since 2013, the number fell by 1,783 in 2016/17. It has dropped more steeply since then, by a further 3,264 in April and May.

The average age of those leaving the register has fallen from 55 in 2013 to 51. Of those who left in 2016/17, 2,901 were in the 21-30 age group, almost double the 2012/13 number.

Janet Davies, chief executive and general secretary of the Royal College of Nursing, said patients were paying the price of government policy. “The average nurse is £3,000 worse off in real terms compared with 2010,” she said. “The 1% cap means nursing staff can no longer afford to stay in the profession and scrapping student funding means people can no longer afford to join it.”

Davies said it was worrying that many were going abroad. The NMC logged 4,153 “verification requests” from overseas licensing authorities – mostly in Australia, the US and Ireland – in relation to UK registrants in 2016/17.

An NMC survey of more than 4,500 nurses and midwives who left the register over the previous 12 months found that about a half had retired. Among those who had not, the top three reasons cited for leaving were working conditions, including staffing levels (44%), a change in personal circumstances, such as ill health (28%), and disillusionment with the quality of patient care (27%). Other reasons included leaving the UK (18%) and poor pay and benefits (16%).

Jon Skewes, the Royal College of Midwives’s director for policy, employment relations and communications, said: “The incredible pressures midwives are under due to increasing demands on services are a factor here. This combined with years of pay freezes and pay restraint has left our health professionals demoralised and disillusioned.”

The number of EU workers – who make up 5% of the register – leaving increased to 3,081 from 1,173 in 2012/2013. There were 247 responses to the NMC survey from EU registrants, with 32% saying Brexit had persuaded them to consider working elsewhere.

A Department of Health spokeswoman said: “We are making sure we have the nurses we need to continue delivering world-class patient care – that’s why there are almost 13,100 more on our wards since May 2010 and 52,000 in training.”

The spokeswoman highlighted the NHS Improvement programme to increase staff retention, which launched last week. However, Cordery said it would have limited impact unless the pay cap and “unsustainable workplace pressures” were addressed.