Increasing shortage of nursing and healthcare staff

BIBB analysis in the specialist journal BWP shows possible compensatory mechanisms

© Ingo Bartussek -

The result of an analysis conducted by the Federal Institute for Vocational Education and Training (BIBB) in the latest issue of the Institute’s specialist journal “Vocational Training in Research and Practice” (BWP) reveals that, if the current trends on the labour market continue, a nationwide shortage in nursing and healthcare professions not requiring a medical practice licence could occur in the future. According to the projection, labour demand will outstrip supply by around 270,000 persons by the year 2035. The reasons for this include comparatively weak wage development in this occupational field and a constant increase in demand for nursing and healthcare services. The BIBB analysis therefore also turns its attention to possible compensatory measures.

Demand for nursing and healthcare services is expected to grow in the wake of demographic developments in Germany. Securing a supply of skilled workers in this area is associated with considerable challenges. The qualifications and occupational field projections conducted by BIBB and the Institute for Employment Research (IAB), which form the basis of the analysis, show the possible long-term development of supply and demand in the relevant professions.

In the occupational field of “nursing and healthcare occupations not requiring a medical practice licence”, it is clear within the foreseeable future that not enough skilled workers and an insufficient number of persons from other occupational fields (to the extent that the latter can be deployed at all given the strict regulation of work entitlement) will be available to cover the requirement for specialist staff. This squeeze could not even be resolved by longer working times because capacities based on numbers of hours would also be exhausted.

The projection contains two main compensatory mechanisms investigated by BIBB which also exert an influence on this development to a certain degree. These are wage development and the occupational mobility of the labour supply. Because of unfavourable wage development, the “stayer” rate in the nursing and healthcare professions, i.e. the proportion of those who remain in the occupation in which they have trained, will fall by around four percentage points by 2035 whilst occupational mobility will rise accordingly. This will decrease the supply of skilled workers, something which is viewed critically by BIBB experts in light of the limited access opportunities to many of these professions for staff from other occupations. Nevertheless, the stayer rate will remain at the very high level of 70 percent. This shows both the effectiveness of measures to retain existing personnel and that it is particularly worthwhile to undergo training in this area. The fact is that most persons completing training would remain within the occupational field.

Ultimately, according to the BIBB results, remuneration has a major part to play in structuring the occupational field in an attractive way. However, other important influencing factors for securing a supply of skilled staff include an improvement in working conditions and in opportunities for advancement. In his Editorial to the 1/2017 issue of BWP, which is entitled “Nursing occupations”, BIBB's Deputy President and Director of Research Reinhold Weiß concludes: “Better payment, more recognition and an improved work-life balance are all at the top of the wish list for employees in this sector.”

Background Information:

The BIBB-IAB qualifications and occupational field projections (QuBe Project) use model calculations as a basis for showing how the supply of and demand for qualifications and occupations may develop on a long-term basis whilst taking wage adjustments and changes of occupation into account. For further information, please visit:

The occupational field “nursing and healthcare occupations not requiring a medical practice licence”, which forms the object of investigation here, encompasses all professions in healthcare provision except doctors and dispensing chemists. According to the 2012 micro census, registered general nurses and geriatric nurses made up just under 55% of persons working within this field, the largest employee group. Medical assistants, occupations in non-medical treatments and alternative medicine and technical medical and pharmaceutical occupations accounted for further large proportions of workers in this field.

The article “Increasing shortage of nursing and healthcare staff” can be found here: A graphic is available at

Further articles on developments in the nursing professions are contained within the latest issue of BWP, which may be accessed at

Contact partner at BIBB:
Caroline Neuber-Pohl; e-mail:

Specimen copy requested if printed.