Nearly 400 nursing and midwifery graduates in Wales remain without employment in the National Health Service (NHS) after the completion of the initial recruitment process, raising fresh concerns over workforce planning, healthcare staffing shortages, and the future of newly qualified healthcare professionals.
Health Education and Improvement Wales (HEIW), the body responsible for workforce education and planning across NHS Wales, confirmed that 703 newly qualified healthcare professionals were successfully matched with entry-level Band 5 positions. However, 383 graduates—including nurses, midwives and operating department practitioners (ODPs)—did not secure employment during the first phase of recruitment.
The outcome has prompted strong criticism from professional healthcare bodies and unions, which argue that the situation contradicts the ongoing staffing challenges facing hospitals and maternity services throughout Wales.
Workforce Planning Fails to Match Employment Demand
The graduates affected completed university programmes funded through the NHS Wales bursary scheme, under which tuition costs are covered in return for a commitment to work within the Welsh NHS for at least two years following graduation.
However, workforce projections made approximately four years ago no longer reflect current healthcare recruitment conditions. According to HEIW, several developments have significantly altered staffing requirements since those forecasts were produced.
The organisation explained that improved staff recruitment and retention across health boards have reduced workforce turnover, resulting in fewer vacancies than originally anticipated. At the same time, increasing financial pressures on health boards have limited their ability to recruit additional staff despite continuing service demands.
HEIW noted that these combined factors have substantially reduced the number of suitable Band 5 positions available for newly qualified healthcare professionals during the current recruitment cycle.
Majority of Unsuccessful Applicants Are Newly Qualified Nurses
Of the 383 graduates who remain without employment following the initial allocation process, the majority are qualified nurses. The group also includes 70 newly qualified midwives and seven operating department practitioners.
HEIW confirmed that a second allocation phase is currently underway and will match graduates to approximately 131 remaining nursing vacancies before the end of July. Although this will reduce the overall number of unemployed graduates, hundreds could still remain without permanent NHS positions.
The organisation acknowledged the disappointment experienced by graduates who have completed demanding healthcare degrees only to face uncertainty regarding their professional future.
Alex Howells, Chief Executive of HEIW, said the organisation recognises the challenges confronting unsuccessful applicants and confirmed that healthcare partners will work together to improve future workforce planning while supporting those currently seeking employment.
Improved Staff Retention Reduces Available Vacancies
One of the primary reasons behind the recruitment shortfall is improved retention among existing NHS staff.
Several Welsh health boards have reported significantly lower staff turnover compared with previous years. In some organisations, experienced healthcare professionals are choosing to remain in post rather than retire or seek alternative employment.
For example, Cwm Taf Morgannwg University Health Board has recorded a substantial decline in staff turnover over recent years, reducing the number of entry-level vacancies available for new graduates.
While improved retention represents a positive development for workforce stability, healthcare leaders acknowledge that it has unintentionally created difficulties for newly qualified professionals entering the workforce.
Simultaneously, rising operational costs and financial constraints have forced health boards to carefully manage recruitment budgets, further limiting employment opportunities.
Healthcare Unions Call for Immediate Government Action
The recruitment outcome has drawn sharp criticism from leading nursing and midwifery organisations, which argue that Wales continues to experience significant workforce shortages despite the limited availability of graduate positions.
The Royal College of Nursing (RCN) Wales has urged the Welsh Government to intervene immediately, describing the situation as unacceptable given the increasing pressure facing frontline healthcare services.
Nicola Williams, Executive Director of Nursing at RCN Wales, said hospitals continue to rely heavily on temporary staffing while permanent nursing vacancies persist across the healthcare system.
She argued that preventing newly qualified nurses from entering the workforce undermines efforts to improve patient care and places additional strain on existing healthcare professionals.
The Royal College of Midwives (RCM) Cymru echoed those concerns, highlighting the continuing staffing pressures affecting maternity services throughout Wales.
Julie Richards, Director of RCM Cymru, questioned how graduate midwives could remain unemployed while maternity units continue to experience workforce shortages and increasing clinical demand.
She said the situation sends conflicting messages, particularly after repeated national reviews identified staffing shortages as a major challenge affecting maternity safety.
Maternity Reviews Highlight Continuing Workforce Challenges
Concerns regarding graduate employment emerge shortly after independent assessments of maternity and neonatal services concluded that urgent improvements in staffing levels remain necessary.
Healthcare reviews have consistently found that increasing patient complexity has not been matched by corresponding workforce growth, creating additional pressure on existing clinical teams.
Professional organisations argue that employing newly qualified nurses and midwives would represent an important step toward addressing these longstanding workforce shortages while supporting patient safety.
Instead, hundreds of graduates now face uncertainty despite completing qualifications specifically designed to meet NHS workforce needs.
Welsh Government Seeks Long-Term Solutions
The issue has prompted discussions at the highest levels of the Welsh Government.
Earlier this month, Health Minister Mabon ap Gwynfor convened a national summit involving health boards, universities, HEIW and professional organisations to examine the employment challenges affecting healthcare graduates.
The meeting focused on identifying immediate employment opportunities while developing more accurate workforce planning models to prevent similar situations in future recruitment cycles.
Following the summit, the Welsh Government confirmed that actions agreed during the discussions would be implemented across the country.
Officials have also instructed HEIW to establish a national support programme for graduates who remain without employment.
The initiative will include a single point of contact to provide career guidance, maintain communication with graduates and connect them with emerging NHS employment opportunities as vacancies become available.
Additionally, graduates affected by the recruitment shortfall are expected to receive greater flexibility regarding the NHS Wales bursary conditions that require recipients to work within Wales following qualification.
Calls for Better Workforce Forecasting
Healthcare leaders and professional organisations agree that the current situation demonstrates the urgent need for more responsive workforce planning.
While improved staff retention represents positive progress for NHS Wales, experts argue that graduate recruitment strategies must better anticipate changes in workforce dynamics, financial conditions and service demand.
With hospitals continuing to experience workforce pressures and growing demand for healthcare services, many believe newly qualified nurses and midwives represent a valuable resource that should be integrated into the NHS workforce as quickly as possible.
As the second recruitment phase continues, hundreds of graduates remain hopeful that additional vacancies will become available. Nevertheless, the unprecedented number of qualified healthcare professionals left without immediate employment has intensified scrutiny of workforce planning across NHS Wales and reinforced calls for long-term reforms that better align education, funding and recruitment with the healthcare system’s future needs.