An “alarming” new report has shown both EU and UK nurses increasingly quitting the NHS, fuelling the first drop in staff numbers for four years.

Figures released by the Nursing and Midwifery Council (NMC), which registers nurses before they are able to practise in the UK, show 35,363 nurses left the NHS between October 2016 and September 2017.

This compares to just 27,786 new nurses that joined in the same period.

This confirms analysis by The King’s Fund think-tank earlier this year predicting nurse numbers had fallen for the first time since 2013.

The Department of Health stressed that the drop represents “a mere 0.2%” of the nearly 700,000 nurses registered in the UK.

NHS leaders say the fall was “alarming” with the health service already struggling to fill vacancies and trying to respond to the “relentless rise in demand”.

The NMC analysis found the number of European nurses leaving jumped by two-thirds (67 per cent).

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More than four thousand left between October 2016 and September 2017, the first full year of data since Britain voted to cut ties with the EU, compared to 2,435 who gave up their license before –and immediately after – the referendum.

And this comes after the NMC released figures earlier this year showing the number of EU trained nurses coming to work in NHS had “plummeted by 96%”.

But Jackie Smith, chief executive of the NMC, said UK nurses leaving was also a factor.

Twenty-nine thousand UK trained nurses quit the register last year, 2,500 more than the previous year - and nearly 7,000 more than just two years ago.

“It’s worrying that we are seeing a continuing rise in nurses and midwives leaving the register,” she said. “And our data is clear that this is being driven by both UK and EU registrants”.

This follows years of the Government’s public sector pay cap and the scrapping of bursaries for student nurses have sparked protest from the nursing profession.

NHS Providers, the membership body for NHS trusts, said the Government had to give clarity on what staff could expect a pay rise.

Health secretary Jeremy Hunt said the pay cap has been scrapped, but that the Treasury wanted to see evidence of “productivity improvements” before any staff would benefit.

Director of policy and strategy at NHS Providers, Saffron Cordery, said: “Just as the health service is trying to respond to the relentless rise in demand and develop new approaches to care, we are seeing more nurses and midwives leaving the register than joining it.”

She called for urgent steps to end the “intolerable pressure” nurses were facing, including confirming EU staff’s right to remain after Britain leaves the EU.

A Department of Health spokesperson said: “These figures represent a mere 0.2% decrease in the 689, 738 nurses and midwives currently registered with the NMC and there are in fact more nurses on our wards since last year.”

It added that the Government had just announced a 25% increase of nurse training places, “the biggest in history”.

Since the removal of the bursary nurses will be eligible for up to £9,000 in tuition fees and can access the student loan system.

Siva Anandaciva, chief analyst at The King’s Fund think-tank said the numbers quitting the NHS were “deeply worrying”.