Rising demand for care: demographic change and medical progress
Demographic trends and medical advances have led to a continuous increase in demand for nursing staff in Germany for years. The ageing of society means that more and more people are in need of care and require nursing services. According to the Federal Statistical Office, around 5 million people were dependent on care services in December 2021, an increase of 20 % compared to 2019. The need has increased further in recent years due to the changed definition of the need for care and improved recording methods. In Germany, the number of people in need of long-term care is expected to rise to almost 7 million by 2070, provided that the age and gender-specific long-term care rates remain constant. This development poses major challenges for the German healthcare system, particularly with regard to ensuring a sufficient supply of nursing staff.
Shortage of skilled labour and legal reforms to increase the attractiveness of the nursing professions
The current shortage of skilled nursing staff is a key problem that is being exacerbated by the ever-increasing demand for nursing services. In 2022, nurses accounted for around 29 % of the total healthcare workforce in Germany, with an increase of around 22,000 new nurses compared to the previous year. Nevertheless, this increase is not enough to meet demand. With the Nursing Profession Reform Act, which came into force in 2020, the German government is attempting to make the nursing profession more attractive. By merging the training courses for healthcare and nursing, healthcare and paediatric nursing and geriatric nursing to create a general nursing specialist, a more flexible training programme was created that makes it easier to switch between these fields of work. Nursing trainees also receive a mandatory salary to make the profession more financially attractive. By the end of 2025, it will be examined whether there is still a need for specialised qualifications in geriatric and paediatric nursing.
Part-time work and gender distribution: challenges in the organisation of work
Working conditions in the care sector are strongly characterised by part-time work and a high proportion of women. More than 80 % of carers in Germany are women, and around 60 % of carers work part-time. This high level of part-time work has a significant impact on the skilled labour situation, as effective working hours are reduced overall and fewer full-time carers are available. Part-time employment is particularly widespread among female carers. The high proportion of part-time employees, particularly in outpatient and inpatient care, exacerbates the staff shortage and requires flexible working time models that make it possible to better fulfil care needs while offering an attractive work-life balance.
Deployment of foreign nursing staff and immigration of skilled labour
As the demand for nursing care cannot be met by the domestic labour force alone, Germany is increasingly relying on foreign nursing staff. The "Triple Win" programme in particular makes it possible to bring nurses from countries such as the Philippines and Vietnam to Germany in order to counteract the shortage of skilled workers. With the new Skilled Labour Immigration Act, which was reformed in 2023, the conditions for the immigration of qualified nursing staff have been made even easier. The proportion of foreign nursing staff has more than doubled in the last ten years and currently stands at around 16 %. This immigration makes an important contribution to care provision, but faces challenges such as language barriers and recognition procedures for foreign qualifications.
Salaries and working conditions: Improvements through legal measures
Pay in the care sector has increased at an above-average rate in recent years. The average gross monthly salary for full-time employees in care professions was around 3,700 euros in 2022, which represents an increase of around 5 % compared to the previous year. The higher salaries are due to several legal measures, including the Collective Bargaining Act, which ensures that care facilities pay their employees in line with collective agreements. Nursing staff in hospitals tend to earn more than their colleagues in outpatient and inpatient facilities. Despite this progress, wage differences between the various facilities remain, which poses a challenge for the care sector.
Further training and securing skilled labour: prospects for sustainable supply
To counteract the shortage of skilled workers, the care sector is increasingly focusing on further training and qualification programmes. Training to become a carer and retraining are increasingly being promoted, which opens up new opportunities for the unemployed and career changers. The integration rate of graduates in care professions is high: around 90 % of those who retrain as carers are employed six months after completing their training. The Qualification Opportunities Act and the reform of the nursing professions are helping to improve training and further education opportunities. Targeted measures for further training and the deployment of foreign nursing staff are important steps towards meeting the growing demand for nursing care in Germany in the long term and ensuring the quality of care in the long term.
