The Royal College of Nursing (RCN) has published the results from it biennial survey.

10 years on from the first  RCN UK-wide Employment Survey, more than 21,000 members from across all health and care settings shared their experiences.

Members highlighted pay fairness as their single biggest concern, with two-thirds of respondents saying their pay does not reflect the responsibilities, skills and risks.

The results show that four in 10 nursing staff are considering or planning to leave their roles for reasons that include feeling undervalued, low pay, excessive pressure and emotional exhaustion. Only one-third recommend nursing as a career.

Professor Nicola Ranger, RCN General Secretary and Chief Executive, said: “Ten years on from our first employment survey and the results continue to paint a worrying picture – many nursing staff are considering or actively planning to leave their roles.

“The current pay framework is broken and long overdue reform to the pay structure is needed. No annual cost of living pay increase is ever going to be enough to deliver the fundamental change we need.

“Despite these challenges, nursing is an amazing profession. Our challenge now is to make the next 10 years better than the last, for nursing as a profession but crucially for patients too.

“This means securing fair pay and recognition for all of nursing; investment for safe staffing, including mandated minimum nurse-to-patient ratios in all settings; and action from employers to make workplaces safer, with every member of the nursing workforce supported, valued and protected."