In a bold overhaul of NHS recruitment, the government will now allow hospitals to hire newly qualified nurses and midwives before official vacancies are listed.
Known as the “graduate guarantee”, the policy will see fresh graduates offered positions based on projected demand rather than waiting for current vacancies. The Department of Health and Social Care (DHSC) says this will keep skilled talent within the health service and strengthen NHS staffing nationwide.
This proactive approach marks a shift from the vacancy-led hiring model that has left many graduates without work. It is expected to unlock thousands of nursing jobs UK–wide, giving trusts the ability to plan for future needs and maintain safe staffing levels.
A new online hub will also be introduced, giving nursing and midwifery graduates clear guidance on job applications and career opportunities.
Alongside the recruitment reform, £8 million will be invested in temporarily upgrading vacant maternity support worker posts to band 5 midwifery roles. This aims to strengthen frontline services and open more midwifery careers to those ready to join the workforce.
The move follows discussions between ministers, the Royal College of Midwives (RCM) and the Royal College of Nursing (RCN).
Nursing courses saw record enrolments during the COVID-19 pandemic. However, fewer professionals are leaving the field, meaning some regions have up to three times as many graduates as available jobs — creating barriers for those starting their careers.
Health Secretary Wes Streeting said: “It is absurd that we are training thousands of nurses and midwives every year, only to leave them without a job before their career has started.
No one who dedicates themselves to a nursing or midwifery career should be left in limbo when their skills are so urgently needed in the effort to rebuild our NHS.
I am sending a clear message to every newly qualified nurse and midwife: we’re here to support you from day one so you can provide the best care for patients and cut waiting lists.”
According to the DHSC, this change will ensure healthcare workers are more evenly spread across NHS services, helping to reduce recruitment bottlenecks.
Professor Nicola Ranger, RCN general secretary, welcomed the change but stressed the need for results.
“Our student members have led the way in calling for ministers and healthcare leaders to provide certainty and clarity on jobs. Today’s announcement is welcome news that should provide hope to students as they come towards the end of their education and training.
When the health service urgently needs nursing staff, it was absurd to leave people in limbo. The test of this will be if students can find jobs, vacant posts are filled, and patients receive the care they deserve.”
RCM chief executive Gill Walton echoed the sentiment: “We’re pleased that the government has listened to the voices of student midwives who are desperate to start their career, only to find those opportunities blocked.
I know today’s announcement will come as a relief to so many of the RCM’s student midwife members. These are people, mainly women, who have worked incredibly hard to complete their degree and are trained and ready to support our current midwifery workforce at a time when so many maternity services are under pressure.
Ensuring we have the right midwifery staff, in the right places, at the right time with the right education and training has never been so crucial as services are striving to improve safety.”
With waiting lists still high and NHS staffing under intense pressure, ministers hope that hiring graduates early will be a decisive step towards improving patient care.