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North-South Divide in NHS Career Progression
3 Feb
Summary
- Staff in affluent regions are more likely to advance to nursing roles.
- South East workers are nearly twice as likely to gain registered positions.
- Training pathways could worsen regional inequalities, IFS warns.

NHS clinical support staff in affluent regions are more likely to transition into nursing and other registered professional roles than their counterparts in less affluent areas. A report from the Institute for Fiscal Studies (IFS) highlights that trusts in higher-wage regions face greater competition for staff, incentivizing them to invest in training opportunities.
Specifically, analysis showed that workers in the South East were almost twice as likely to move into a registered position compared to those in the North East. This trend was also more pronounced in mental health trusts. The IFS cautions that expanding this training route, which has seen significant growth over the past decade, could lead to government "trade-offs" between addressing workforce shortages and tackling regional inequalities.
The report indicates that 16% of new nursing recruits in 2024 came from clinical support roles, a substantial increase from 4% in 2014. The IFS suggests that while these pathways are valuable for staff retention and development, they disproportionately benefit areas already experiencing higher wages and better training access. The government's 10-year health plan aims to further expand these opportunities, but careful consideration is needed to balance workforce needs with broader social objectives.




