Several European countries are struggling to replace nurses who retire, migrate or leave the profession. This is according to new WHO research based on data reported by 18 EU countries between 2015 and 2025. As part of the EU-funded Nursing Action project, the analyses provide countries with guidance and evidence on how to ensure a well-resourced and well-supported nursing workforce.
The findings show that around half of the countries surveyed may not be producing enough nursing graduates to replace those who retire, migrate or otherwise leave the profession. Where major shortages persist, at least 8 new graduates are required to join the workforce each year for every 100 active nurses to ensure the national nursing workforce remains sustainable.
This is particularly important for European countries, where on average 23% of current practising nurses are aged 55 years or older, increasing the urgency of workforce renewal efforts. Migration also continues to shape workforce dynamics across the WHO European Region, with several countries relying heavily on foreign-trained nurses.
Access to real-time data critical to address bottlenecks
To better understand how countries are developing and retaining future nurses, WHO/Europe followed the nursing education pipeline in 18 countries, from application to graduation and entry into the profession. Despite most participating countries knowing the number of graduates per year, many countries found it challenging to find all the information needed to understand vital trends along the entire pipeline.
In a context of increased demand for services, ageing populations and health threats, countries need more trained nurses in the right place with the right skills. Therefore, health ministries need to be able to access data to address bottlenecks in real time.
The findings suggest that although several countries are on track to ensure long-term nursing workforce sustainability, many countries may face challenges in renewing their nursing workforce over the long term.
Findings
On average, there are 4.1 new nursing graduates each year for every 100 active nurses, although an 11-fold variation exists between countries. Other significant results from the WHO/Europe analyses are:
- Countries have increased nursing education places over the last decade; however, large (up to 15-fold) variations exist between the countries analysed.
- Applicant numbers to nursing education courses vary widely among the Nursing Action countries, with one third of countries having more than 100 applicants per 100 000 population. However, it is important to highlight that interest in nursing studies among young people is generally declining.
- Non completion of nursing education within the expected time frame varies substantially, from 4% to 43%. This shows that significant losses or delays exist along the education pipeline, which reduces effective workforce supply.
Strengthening data for better nurse workforce planning
The Nursing Action initiative has helped strengthen the evidence base for decision-making by supporting countries to improve data governance, harmonize indicators, improve data quality – including the WHO/Europe, Eurostat and OECD joint data collection – and strengthen analytical capacity within countries.
The analyses also identify important gaps in nursing education data. In many countries, education pipeline data are not systematically collected, information is fragmented across institutions, and definitions vary, making comparisons and workforce planning difficult.
The findings highlight that strategic investment in better data and monitoring can support more effective planning, helping countries build the nursing workforce needed to meet future health challenges.