Data extracted in December 2024.
Planned article update: August 2025.
Highlights
There were over 1 000 000 nurses in Germany in 2022, the highest number among EU countries.
Ireland recorded the highest number of midwives per inhabitant among the EU countries, 81.5 per 100 000 inhabitants. The next highest ratios were recorded in Poland and Sweden (2021 data), both 77 per 100 000 inhabitants.
In 2022, Belgium recorded the highest number of midwifery graduates relative to population among the EU countries, 5.5 per 100 000 inhabitants.
Graduates – nurses, 2022
This article presents an overview of European Union (EU) statistics on nursing and caring professionals. It provides information on specialist healthcare personnel, as well as data relating to nursing and midwifery graduates. Nursing and caring professionals provide services directly to patients in hospitals, ambulatory care and patients’ homes. Among others, these professionals include:
- qualified nurses[1];
- midwives;
- caring personnel (personal care workers in health services, working in hospitals, private homes and independent residential settings).
This article is 1 of a set of statistical articles concerning healthcare resources in the EU which forms part of an online publication on Health in the European Union – facts and figures.
Healthcare personnel
For healthcare personnel, Eurostat collects data for 3 concepts (the last of these is not collected for caring personnel):
- ‘practising’ – health care professionals providing services directly to patients;
- ‘professionally active’ – ‘practising’ professionals plus health care professionals for whom their medical education is a prerequisite for the execution of their job;
- ‘licensed’ – health care professionals who are registered and entitled to practise as health care professionals, including those for whom their nursing education is not a prerequisite for the execution of their job and those who are economically inactive (for example, unemployed or retired).
In this article, preference is given to the concept of ‘practising’ health care professionals.
Based on a sum of the available data (see Table 1 for more information concerning the data coverage for individual EU countries), in 2022 there were approximately 3.6 million practising nurses in the 26 EU countries for which data are available, and over 167 000 practising midwives (no data for Luxembourg). Among the 24 countries for which data are available, there were almost 3.6 million practising caring personnel (no data for Cyprus, Luxembourg and Sweden).
Healthcare personnel – practising nurses by age and gender
Practising nurses include nursing professionals:
- Nursing professionals (International Standard Classification of Occupations (ISCO 08) code 2221) assume responsibility for the planning and management of patient care, including the supervision of other healthcare workers, working autonomously or in teams with medical doctors and others in the application of preventive and curative care. Although nurses have traditionally provided care to patients under the guidance of a physician, they are increasingly permitted in many EU countries to practise independently as professionals. This however depends to some extent on their qualifications and level of training. Nursing professionals in the EU are required to complete a university course, with a minimum of 3 years, to degree level.
The number of nurses may vary between EU countries according to differences in healthcare systems and how nurses are classified. Equally, the number of nurses compared with other personnel (such as physicians) also varies between different providers of healthcare, for example between hospitals and long-term nursing care facilities.
In 2022, Germany had the highest number of practising nurses among EU countries, at just over 1 million; this was considerably higher than the 2nd highest count, recorded in France (598 915; 2021 data), which however, reported the total number of practicing nurses, not only the professional ones. In turn, the number of nurses in France was considerably higher than the next highest number recorded in Italy (384 882), while Spain (293 600) was the only other EU country to report more than 250 000 nurses. Cyprus and Malta recorded the smallest number of nurses, both less than 5 000.
Ireland had the highest number of nurses per inhabitant in the EU
Ireland had 1 312.7 practising nurses per 100 000 inhabitants, followed by Finland with 1 277.7 nurses per 100 000 inhabitants (2021 data). Germany, Belgium (2021 data), the Netherlands, Sweden (2021 data), Austria and Denmark (2021 data) all recorded more than 1 000 practising nurses per 100 000 inhabitants. In other words, there were 8 EU countries where at least 1.0% of the population were nurses.
_Health2024.png)
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_prs2)
Elsewhere, the number of practising nurses was generally within the range of 400 to 900 per 100 000 inhabitants in 2022. Croatia (235.7 per 100 000 inhabitants) and Greece (220.9 per 100 000 inhabitants; only people working in hospitals) recorded somewhat lower ratios, while the lowest ratio was in Romania, at 93.5 per 100 000 inhabitants.
A comparison of the latest data for Ireland and Romania shows that there were 14 times as many nurses per 100 000 inhabitants in the former. Expressed in a different way, each practising nurse in Ireland covered an average of 76 inhabitants, while in Romania the same ratio was 1 069 inhabitants per nurse.
Among the 21 EU countries for which data are available for 2017 and 2022 (alternative reference years for some countries, see Figure 1 for more details), the number of practising nurses relative to population size fell in 4 during the period under consideration. The biggest decreases were reported in Malta and Lithuania, where the number of practising nurses fell by 25 and 21 per 100 000 inhabitants, respectively. There were smaller decreases recorded for Bulgaria (down by 4) and Sweden (down by 3, 2017 to 2021).
Comparatively, the number of nurses per 100 000 inhabitants increased in 17 countries. The largest increases were recorded in Austria where it increased by 385 nurses per 100 000 inhabitants (note the break in series; 2022 data is an estimate) and Slovenia where it increased by 170. The smallest increase, of 2 nurses per 100 000 inhabitants, was recoded in Cyprus.
Lithuania had the largest share of practising nurses aged 55 years or over
More than half (51.5%) of all practising nurses in Lithuania were aged 55 years or over; this was the only EU country (out of 17 for which data are available) where the share of nurses aged 55 years or over was above 40.0% in 2022. By contrast, nearly half the EU countries recorded a share over 40.0% for practising doctors aged 55 years or older (see the article on physicians for more information). In 5 countries, this share of older nurses was less than 20.0%, with the lowest share in Romania (10.9%). The highest shares of younger nurses (under 35 years) were recorded in Croatia (35.3%), the Netherlands and Spain (both 34.1%).
_Health2024.png)
In all EU countries for which data are available, more than 3 quarters of all practising nurses were women
The analysis presented in Figure 3 shows that, in 2022, more than 3 quarters of practising nurses were women in every EU country for which data are available. Around half (9) of the 17 EU countries for which data are available reported that more than 90.0% of nurses were women. The highest share was in Latvia, where 99.6% of nurses were women, whereas, the highest share of male nurses was recorded in Italy, at 23.1%. Conversely, the share of female practising physicians, in 2022, ranged from 39% to 73%.
_Health2024.png)
Healthcare personnel – midwives
As with nurses, practising midwives (ISCO 08 codes 2222 and 3222) plan, manage, provide and evaluate care services. Midwives do so before, during and after pregnancy and childbirth, providing delivery care for reducing health risks to women and new-born children; they may work autonomously or in teams with other healthcare providers.
The distribution of midwives across the EU countries was somewhat different to that for nurses: the highest number of practising midwives in 2022 was recorded in Poland (28 445), followed by Germany (26 000) and France (24 301), with the lowest number (269) recorded in Malta.
Among the EU countries, Ireland had by far the highest ratio of midwives relative to its population size, 81.5 per 100 000 inhabitants in 2022 – see Figure 4 for more information concerning the data coverage for individual EU countries. Poland (77.3 per 100 000), Sweden (77.0 per 100 000; 2021 data) and Belgium (73.3 per 100 000; 2019 data) were the only other EU countries to record ratios of more than 70 practising midwives per 100 000 inhabitants. At the other end of the range, the lowest ratios of the number of midwives to population were recorded in Romania and Slovenia, where there were, on average, 16.2 practising midwives per 100 000 inhabitants in 2022. The highest ratio (in Ireland) was 5.0 times as high as the lowest ratio (in Romania).
_Health2024.png)
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_prs2)
Healthcare personnel – caring personnel
Caring personnel include health care assistants in institutions (ISCO 08 code 5321) and home-based personal care workers (ISCO 08 code 5322):
- Health care assistants in institutions provide direct personal care and assistance with activities of daily living to patients and residents in a variety of health care settings such as hospitals, clinics and residential nursing care facilities; they generally work under the direct supervision of medical, nursing or other health professionals or associate professionals.
- Home-based personal care workers provide routine personal care and assistance with activities of daily living to people who need such care due to the effects of ageing, illness, injury, or other physical or mental conditions and are living in private homes and other independent residential settings.
Subject to data availability (see Table 1 for more information concerning the data coverage for individual EU countries), France (857 243; 2021 data), Germany (669 000; 2021 data), Italy (628 973) and Spain (569 867) had the highest number of caring personnel in 2022, followed at some distance by the Netherlands (258 000). The smallest numbers were recorded in Bulgaria and Croatia (both less than 800).
The number of caring personnel per 100 000 inhabitants in Finland was considerably higher than in the other EU countries
Finland had 2 255.9 caring personnel per 100 000 inhabitants in 2021, which was by far the highest ratio among the EU countries (see Table 1 for more information concerning the data coverage for individual EU countries). Denmark (1 548.9 per 100 000 inhabitants in 2021) and the Netherlands (1 457.6 per 100 000 inhabitants in 2022) were the only other EU countries to record at least 1 400 caring personnel per 100 000 inhabitants. In 4 EU countries, this ratio was below 100 per 100 000 inhabitants in 2022: Greece (64.3 per 100 000 inhabitants; only people working in hospitals), Poland (33.7 per 100 000 inhabitants), Croatia (19.2 per 100 000 inhabitants) and Bulgaria (11.5 per 100 000 inhabitants).
Employment in hospitals
Table 2 focuses on nurses, midwives and health care assistants employed in hospitals. This coverage of healthcare personnel differs from Table 1 in that it includes the narrower concept of health care assistants rather than caring personal.
Among the EU countries, Germany recorded the highest absolute number of nurses and midwives employed in hospitals (547 000), while France (383 501) and Italy (281 162) were the only other EU countries (for which recent data are available) to record more than 200 000 nurses and midwives in 2022. A similar analysis for health care assistants working in hospitals reveals the highest counts were in France (250 433) and Spain (147 877); none of the other EU countries for which there are recent data recorded more than 75 000 health care assistants working in hospitals.
The availability of data converted into full-time equivalent units indicates that employment in hospitals was generally close to full-time. For nurses and midwives, the number in full-time equivalents was equal to at least 80% of the number in head counts for 10 of the 13 EU countries for which data are available. Falling just below this range were Estonia (79.5%), the Netherlands (78.3%) and Germany (74.2%). For health care assistants, both measures are available for 12 EU countries, 10 of which recorded ratios between full-time equivalents and head counts of at least 75%. By contrast, in Denmark (68.3%) and the Netherlands (61.2%), a smaller proportion of health care assistants employed in hospitals appeared to work on a full-time basis.
Source: Eurostat (hlth_rs_prshp2)
Relative to population size, among the 15 EU countries for which recent data are available, the number of nurses and midwives (in full-time equivalents) employed in hospitals generally ranged from 257.7 per 100 000 inhabitants in Hungary to 621.4 per 100 000 inhabitants in Denmark, with Romania (71.7 per 100 000 inhabitants) well below this range.
Data in full-time equivalents are available for 14 EU countries in relation to the number of health care assistants employed in hospitals. In 2022, there were fewer than 100 health care assistants in hospitals per 100 000 inhabitants in Germany, Belgium (2021 data), the Netherlands and Austria, while the majority of the remaining EU countries reported ratios between 116 and 251 health care assistants in hospitals per 100 000 inhabitants. At the top of the range, France and Malta reported, respectively, 341.2 and 372.9 health care assistants in full-time equivalents in hospitals per 100 000 inhabitants.
Health graduates
Table 3 focuses on graduates for the 2 most qualified occupations covered by this article, namely nurses and midwives.
Among the 26 EU countries for which data are available (no recent data for France), there were more than 110 000 nurses who graduated in 2022 (2021 data for some EU countries) – see Table 3 for more information concerning the data coverage for individual EU countries. When expressed per 100 000 inhabitants, the number of nurses graduating in 2022 peaked in Finland (67.0 per 100 000 inhabitants) and the Netherlands (62.1 per 100 000 inhabitants). The lowest ratio of nurses graduating per 100 000 inhabitants was recorded in Slovenia (2.8 per 100 000 inhabitants).
Between 2012 and 2022, there was a mixed development in the number of nurses graduating in EU countries (see Table 3 for more information concerning the data coverage): half recorded increases while half recorded decreases. Croatia and Bulgaria recorded particularly high growth rates, as their numbers of graduates were, respectively, 2.9 and 2.1 times as high in 2022 (as in 2012). By contrast, the largest declines in the number of nursing professional graduates were recorded in Cyprus (down by 3 quarters) and Romania (down by more than half; note that there is a break in series).
In 2022, there were considerably fewer midwifery graduates than nursing graduates in the EU: over 6 700 across 26 EU countries (no recent data for Portugal). When expressed per 100 000 inhabitants, the number of midwifery graduates in 2022 peaked in Belgium, at 5.5 per 100 000 inhabitants, while the lowest number was 0.4 per 100 000 inhabitants in Romania.
Between 2012 and 2022, there were 12 EU countries which recorded an increase in the number of midwifery graduates, 1 (Croatia) which had the same number in both years and 12 which recorded decreases; no data or incomplete data for Portugal and Slovenia. The biggest increase (in relative terms) was observed in Cyprus, as there were no midwifery graduates in 2012 compared to 19 in 2022. Elsewhere, the largest increase was recorded in Austria, where there were 2.2 times as many graduates in 2022 as in 2012. At the other end of the range, aside from Ireland for which there is a break in series, the biggest decreases in midwifery graduates between 2012 and 2022 were recorded in Czechia and Finland, both down by about a quarter.
Workforce migration – nurses
International health worker migration is a long-standing and growing phenomenon, within the EU and globally. Many healthcare staff within the EU may be trained in a country different to the one they are working in; this may refer to someone who was trained in one EU country and moved to work in another, or someone who may have studied outside the EU. An analysis of the place of training of nurses is available for 19 EU countries (see Table 4); this analysis distinguishes domestically trained and foreign-trained nurses. In 15 of these countries, more than 95.0% of nurses in 2022 had been domestically trained, with this share peaking at 99.9% in Romania. A slightly lower share was recorded in Italy (94.8%) and somewhat lower shares were recorded in Germany (90.1%) and Austria (86.6%). Ireland was below this, with a share of approximately half (50.9%).
Among the 19 EU countries for which recent data are available, the largest numbers of foreign-trained nurses were recorded in Germany (99 000), Ireland (33 270), Italy (23 764), France (19 876; 2021 data), Austria (14 560) and Belgium (9 978). Elsewhere, the number of foreign-trained nurses was below 5 000, with the lowest number recorded in Estonia (32).
As well as information on the stock of foreign-trained nurses, data are also available for the annual inflow of foreign-trained nurses. In 2022, 8 310 foreign-trained nurses started working in Germany, while 4 003 started in Ireland. In the 17 other EU countries for which data are available, the number was below 800, with Lithuania and Estonia recording less than 5.
The annual inflow of foreign-trained nurses in 2022 was equivalent to 5.9% of the whole stock of nurses in Ireland, which was a much higher ratio than in any other EU country. The second highest ratio was 0.8% in Germany, followed by 0.7% in Latvia and Austria; the 13 other EU countries for which data are available recorded ratios of at most 0.3%. The annual inflow of foreign-trained nurses in 2022 was equivalent to 57.1% of the stock of foreign-trained nurses in Poland, which was a much higher share than in any other EU country. The next highest share was 23.0% in Latvia, with shares below 15.0% recorded in the 15 other EU countries for which data are available.
Source data for tables and graphs
Data sources
Key concepts
Practising nurses, midwives and caring personnel provide services directly to patients. They include professional nurses and midwives, health care assistants and home-based personal care workers. Data on associate professional nurses (ISCO 08 code 3221) are not included.
Employment data cover the number of health care staff (head counts) and the number of people in full-time equivalents directly employed in hospitals (both general and specialised hospitals); self-employed people working in hospitals are also included, for example, those working with service contracts as health professionals.
Data on graduates for any given year cover the number of students who have graduated in either nursing or midwifery, so they may become a professional or associate professional nurse or midwife; the data for associate professional nurses are not shown in this article. The data exclude those who have graduated in other fields of studies which do not provide a recognised foundation for the practice of nursing or midwifery. Within the EU, Directive 2005/36/EC of the European Parliament and of the Council defines the training of nurses responsible for general care as comprising at least 3 years of study or 4 600 hours of theoretical and clinical training.
Data on workforce migration cover the stock of domestically and foreign trained nurses, as well as the annual inflow of foreign trained nurses. Data on the stock of nurses is broken down into those domestically trained and those foreign-trained, this includes those who are native-born but foreign-trained and by country of first qualification. Data on annual inflow of nurses cover the number of nurses who have obtained a recognised qualification in nursing in another country and are receiving a new authorisation in a given year to practice in the receiving country.
Healthcare resources
Statistics on healthcare resources (such as personnel and medical equipment) are documented in this background article on Healthcare non-expenditure statistics - methodology which provides information on the scope of the data, its legal basis, the methodology employed, as well as related concepts and definitions.
Common definitions have been agreed between Eurostat, the OECD and the World Health Organization (WHO) with respect to the employment of various health care professionals. There are 3 main concepts which are used to present these data. Eurostat gives preference to the concept of ‘practising’ nurses, midwives and caring personnel:
- ‘practising’ – health care professionals providing services directly to patients;
- ‘professionally active’ – ‘practising’ professionals plus health care professionals for whom their medical education is a prerequisite for the execution of their job;
- ‘licensed’ – health care professionals who are registered and entitled to practise as health care professionals.
Data on nurses, midwives and caring personnel are classified according to the International Standard Classification of Occupations (ISCO); they are defined under ISCO 08 as codes 222, 322 and 532:
- 222 nursing and midwifery professionals
- 2221 nursing professionals
- 2222 midwifery professionals
- 322 nursing and midwifery associate professionals
- 3221 nursing associate professionals
- 3222 midwifery associate professionals
- 532 personal care workers in health services
- 5321 health care assistants
- 5322 home-based personal care workers
- 5329 personal care workers in health services not elsewhere classified.
For country specific notes on these data collections, please refer to the annexes at the end of the national metadata reports accessible from links at the beginning of the European metadata report.
In particular, note that:
- data for Cyprus assume that all private sector nurses are practicing;
- data for personnel employed in hospitals in Lithuania are in full-time equivalents compiled relative to the number of contractual hours; some personnel may work 1.25 or 1.5 times the contractual hours and consequently the data in full-time equivalents may exceed data based on head counts;
- data for graduates for Poland count graduates at each level of ISCED;
- data for nurses for Portugal include nurses who hold a post/job for which a nursing education is not required.
Symbols
In tables, a colon ‘:’ is used to show where data are not available. Data in italics are estimates or provisional.
Context
There are concerns about a shortage of nursing and caring professionals in the EU. These may become exacerbated as the population continues to age and nurses and caring professionals move from employment into retirement or leave for other reasons.
A consequence of future demographic developments is that the number of elderly people (aged 65 years or more) in the EU is forecast to increase by 33% between 2024 and 2050 (Eurostat baseline projections 2023); during this period the share of the elderly in the total population is projected to increase from 21.5% in 2024 to 29.0% by 2050. This ageing of the EU’s population is likely to result in considerable demands for a range of services, as an increasing proportion of the population becomes frail and suffers from declining physical and mental health. European healthcare systems will therefore need to anticipate future skills requirements for health professionals – in particular, nurses and caring professionals – so these may be matched against the demands of an increasingly aged society, for example, a likely shift away from care in hospitals towards care in the home.
On 7 September 2022, the European Commission proposed a European care strategy. The Commission proposed actions to support EU countries in improving working conditions and work-life balance for carers and to ensure quality, affordable and accessible care services across the European Union.
Explore further
Other articles
Online publications
Healthcare human and physical resources
Methodology
General health statistics articles
Database
- Health (hlth)
- Health care (hlth_care)
- Health care resources (hlth_res)
- Health care staff (hlth_staff)
- Health graduates (hlth_rs_grd2)
- Health personnel (hlth_rs_prs2)
- Health workforce migration (hlth_rs_wkmg2)
- Hospital employment (hlth_rs_prshp2)
- Nurses by age and sex (hlth_rs_nurse)
- Health care staff (hlth_staff)
- Health care resources (hlth_res)
- Health care (hlth_care)
Thematic section
Selected datasets
Methodology
- Health care resources (ESMS metadata file – hlth_res)
External links
European Union, OECD and WHO
- European Commission – A European care strategy
- European Commission – Public Health – European core health indicators (ECHI)
- European Commission – Directorate-General for Health and Food Safety – Health workforce
- OECD / European Commission report ‘Health at a Glance: Europe’
- OECD – The future of health systems
- World Health Organization (WHO) – Health workforce
- WHO Global Health Observatory (GHO) – Global health workforce statistics database
Other external links
- ↑ The data on nurses published by Eurostat constitute the total number of professional nurses who fulfil the requirements of Directive 0036/2005/EC on the recognition of professional qualifications