First WHO/Europe policy brief to address ‘ticking timebomb’ nursing crisis across the region

In response to escalating pressure due to a shortage of nurses, rising care demands, and increasing burnout across the continent, the World Health Organisation Regional Office for Europe (WHO/Europe) has issued the region’s first-ever policy brief to tackle the current nursing crisis.

Central to the brief is the definition of safe nurse staffing as having the right number and skill-mix of appropriately educated and supported nurses to deliver safe care. Evidence consistently shows that when there are too few nurses without the right skill sets, risks to patients rise, and so do stress, injury, and mental ill-health among staff.

In 2022, WHO/Europe warned that healthcare workforce shortages were a “ticking timebomb”, with region-wide estimates pointing to an expected shortage of nearly one million health workers by 2030.

Further evidence from several European Union (EU) Member States highlights how worsening working conditions and increasing mental health pressures are contributing to rising levels of nurse burnout, staff attrition, and workforce shortages, with clear and direct implications for patient safety.

The brief comes as part of the Nursing Action project – a three-year initiative launched in 2024, led by WHO/Europe and funded by the European Commission under the EU4Health programme. Working with 21 EU Member States, the project supports the development and implementation of evidence-based strategies to recruit and retain nurses, improve working conditions, and strengthen the nursing workforce across the European region.

“Nurses account for more than half – 56 per cent – of the health workforce, the majority of whom are women. Safe nurse staffing is therefore not a luxury or administrative detail,” said Dr Hans Henri P Kluge, WHO Regional Director for Europe.

“It is a safety-critical investment – for patients and for the entire health system. If we are serious about patient safety in our health systems, we need to take concrete steps to adequately staff and support our workforce. The EU already faces a serious shortage of nurses; we simply cannot afford to drive them out of the profession.”

Drawing on global evidence and concrete examples from the participating countries in the EU-funded Nursing Action project, the brief sets out how investing in safe nurse staffing delivers measurable gains, including lower patient mortality, improved quality of care, stronger workforce wellbeing, and better overall health system performance. It stresses that safe nurse staffing spans everything from national-level workforce planning to day to day decisions in hospitals and community care settings.

“Nurses are the backbone of our health systems, yet they are among those most affected by workforce shortages and high job strain,” said Dr Sandra Gallina, Director-General for Health and Food Safety, European Commission. “Across the EU, we are facing a shortage of health professionals and nurses, who suffer from heavy workloads and mental health pressures, and the interest in nursing careers is declining. The Commission supports Member States in addressing this challenge through EU4Health initiatives such as Nursing Action, Joint Action HEROES, training projects, and support to address mental health issues.”

The brief identifies eight priority policy actions to support effective implementation across Member States:

✽ Treat nursing as safety-critical: Safe staffing is inseparable from patient safety and staff wellbeing. Health systems must protect nurses from harm – including burnout and poor mental health – if they want patients to be safe.

✽ Manage system complexity: Staffing is shaped by multiple factors including funding, digital technology, teamwork, and increasingly complex patient needs. There is no single quick fix.

✽ Build shared, long-term commitment: Lasting reform requires governments, employers, regulators, unions, and educators to work together – and stay the course.

✽ Use smarter data systems: Countries need reliable, interoperable staffing and workload data that support decisions without overburdening staff. Stronger national data also strengthens region-wide evidence.

✽ Strengthen monitoring and accountability: Clear standards, relevant regulation, and transparent reporting are essential to ensure
safe staffing.

✽ Invest wisely: Funding matters – but so do the rules and incentives that ensure safe staffing becomes a standard and widespread practice.

✽ Ensure high-quality education and training: Responsive education and continuous professional development enable nurses to meet real-world clinical demands and actively contribute to staffing decisions.

✽ Empower nurse leadership: Strong, supported nurse leadership, with real professional autonomy, is critical to translating evidence into safe, context-specific staffing decisions.

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