Classification: Official
Publication reference: PRN02132

To:

• Provider chief nursing officers
• Provider chief finance officers
• Provider directors of workforce

cc.

• Provider chief executive officers
• Regional directors
• Regional chief finance officers
• Regional chief nurses
• Regional directors of workforce
• Integrated care board (ICB) chief executive officers
• ICB chief nurses
• ICB directors of workforce

Dear colleague

Graduation guarantee for newly qualified nurses and midwives

Across the country, newly qualified nurses and midwives are about to graduate, ready to join the health and care system. For some, this period brings uncertainty, limited roles in preferred specialties or gaps between qualifying and starting work.

This challenge reflects recruitment cycle timings and the distribution of vacancies and is compounded by record numbers of nurses and midwives employed in the NHS with improved retention rates. Today, the Secretary of State confirmed the Government’s Graduate Guarantee that this year every newly qualified nurse and midwife in England will have the opportunity to apply to join the health and social care workforce.

This is an opportunity to strengthen the NHS workforce and improve patient care by employing more newly qualified nurses and midwives. Recruiting more newly qualified staff instead of relying on temporary staffing brings long-term benefits, greater stability, lower costs, and stronger, more cohesive teams. Many trusts are already leading the way with creative solutions to support new graduates into roles. The NHS is now taking immediate steps, building on these local initiatives, and all NHS organisations must prioritise permanent appointments to further reduce agency spend and secure the future:

Proactive recruitment support

Recognising the level of vacancies that currently exist across all bands, NHS providers are encouraged to recruit newly qualified nurses before vacancies formally arise. This forward-thinking approach means graduates can transition seamlessly from training into employment, reducing uncertainty and ensuring continuous patient care capacity.

Our online student hub supports newly qualified nurses and midwives applying for their first roles by bringing together multiple job sites and offering practical guidance on applications, interviews, and preparing to start work.

Creating new opportunities

NHS providers are encouraged to adopt a time-limited approach to utilise existing vacant healthcare support worker roles to create time limited registered nursing posts. Regional teams will work with providers directly to explore if this approach works locally. This should include reverting posts back to support worker roles as vacancies arise and ensuring good preceptorship support is provided.

Strategic investment in midwifery

NHS England has reprioritised £8 million of non-recurrent funding for 2025/26 to support the temporary conversion of vacant maternity support worker posts to band 5 registered midwifery roles, creating opportunities for newly qualified staff. This is available to all trusts with maternity services. Trusts should engage with their regional teams to develop and agree plans including reverting posts back as vacancies arise.

Targeted reduction in agency staffing

By increasing permanent recruitment of newly qualified nurses and midwives this year, NHS organisations can significantly reduce reliance on high-cost agency staffing. This not only delivers better value for money but also improves team continuity and staff morale, reduces sickness and creates a more stable, high quality care environment.

Alongside these measures, a systematic approach is needed. We are asking:

• NHS providers to review band 5 nursing job descriptions to confirm suitability for newly qualified nurses
• NHS providers to engage with local universities and system partners to improve role signposting and access across the NHS, social care, and independent sectors
• NHS providers to consider the use of local relocation policies where appropriate
• NHS providers to consider opportunities to address hard to recruit areas, and which support the ambitions of the 10 Year Health Plan
• Integrated care boards to play an active role in vacancy management across health and care settings, collaborating with partners
• Regional teams to offer support to NHS providers and facilitate peer-to-peer networks to rapidly share best practice in supporting graduates into employment

Thank you for your continued commitment to supporting our workforce.

Yours sincerely,

Duncan Burton, Chief Nursing Officer for England NHS England
Elizabeth O’Mahony, Chief Financial Officer NHS England