The nursing and midwifery regulator has warned of potential “stormy waters ahead” over recruitment of overseas staff.

While around 18,000 more nurses, midwives and nursing associates are now on the register to work in the UK compared to a year ago, the Nursing and Midwifery Council (NMC) warned that travel restrictions and the long-term impact of Covid-19 may impact recruitment.

Its new annual report shows the number of people on its permanent register has seen its biggest annual rise, from 698,237 on April 1, 2019 to 716,607 on March 31 this year.

It said this is being driven by staff joining and staying from the UK and from countries outside the European Economic Area (EEA).

For example, 9,012 more nurses, midwives and nursing associates have joined from the UK while the number leaving the register from the UK has fallen to a five-year low of 21,306 compared with a peak of 29,434 in 2016/17.

At the same time, the number of nurses and midwives from outside the EEA has risen by 11,008 (15%).

Almost half of the total growth comes from people who originally trained in the Philippines and India, followed by Nigeria.

While the increased figures from within the UK and overseas are very welcome for everyone working in and using health and care services, there are potential stormy waters ahead

Meanwhile, the number of nursing and midwifery professionals from within the EEA continues to decline, partly impacted by Brexit, with a 5% drop this year to 31,385 on the register.

Andrea Sutcliffe, chief executive of the NMC, said: “Covid-19 has meant the vital skills, specialism and resilience of our nursing and midwifery professionals have never been more publicly recognised and valued.

“It’s therefore great to celebrate record numbers of people on the NMC register.

“However, while the increased figures from within the UK and overseas are very welcome for everyone working in and using health and care services, there are potential stormy waters ahead.

“As a result of the pandemic and subsequent travel restrictions, we may no longer be able to rely on the flow of professionals joining our register from overseas in the same way. Going forwards, the significant growth we’ve seen recently may not be sustained.

UK Government needs to do everything within its gift to help our existing workforce and ensure that nursing is attractive, well-paid and meaningfully supported. This is how to equip NHS and care services to help keep patients safe

“Nor can we afford to ignore existing pressures, exposed and exacerbated by Covid-19, which may challenge employers’ ability to retain our essential nursing and midwifery professionals as health and care services seek to recover.

“We all need to use the insight our registration data reveals to focus on creating the right environment, conditions and incentives to support the sustainable recruitment and retention of nursing and midwifery staff now and for the future.”

Dame Donna Kinnair, chief executive of the Royal College of Nursing (RCN), said: “We celebrate the diversity of our global profession and numbers are slowly moving in the right direction.

“But UK Government needs to do everything within its gift to help our existing workforce and ensure that nursing is attractive, well-paid and meaningfully supported. This is how to equip NHS and care services to help keep patients safe.”

Unison national nursing officer, Stuart Tuckwood, said: “Overseas nurses ​have been on the front line providing vital care throughout the pandemic.

“Ministers must make them feel welcome and treat them fairly by keeping promises to drop the health surcharge and provide refunds ​for fees already incurred.

“Although ​staffing numbers are heading in the right direction, there’s a long way ​​to go before the 100,000 vacancies across the NHS ​are filled.”

As we implement the new immigration system, we want employers to focus on investing in our domestic work force

NHS Employers chief Danny Mortimer has also reportedly warned that the industry could be further devastated by the UK’s proposed post-Brexit immigration bill.

Mr Mortimer told the BBC the potential points-based immigration system would not allow enough overseas workers to be recruited once the pandemic is over.

Social care positions do not pass the bill’s proposed minimum salary threshold to allow workers into the UK.

Mr Mortimer told the broadcaster: “If adult social care wasn’t in a precarious position before coronavirus, it certainly is now.”

A Home Office spokesman said: “The Migration Advisory Committee has been very clear in its assertion that immigration is not the answer to the challenges in the social care sector.

“As we implement the new immigration system, we want employers to focus on investing in our domestic work force.

“Additionally, the EU Settlement Scheme means that all EU and EAA citizens, and their family members, currently working in social care can stay in the UK and we are encouraging them to do so.”