Nursing workforce and NCDs – a double crisis

20 Feb 2024
Chris Melson

Nursing workforce and NCDs – a double crisis

What is the issue? 

Nurses are leaving their jobs 

Europe, including the UK, is facing a nursing workforce crisis. With nurses reporting leaving their jobs as a result of burnout, low pay, unsafe working conditions and limited career opportunities, health systems across the continent are beginning to feel the effects. Between 20% and 61% of nurses in various European countries have stated they are considering quitting their jobs or leaving the nursing profession altogether. In England, for example, the National Health Service (NHS) reported 40,000 nursing vacancies in June 2023, despite efforts to boost recruitment. This number constitutes around a tenth of the NHS’s nursing workforce. The World Health Organization has called the global shortage a ‘ticking time bomb’ which is threatening to stifle the ability of health systems to deliver safe and effective care. 

Non-communicable diseases are rising 

Meanwhile, the burden of non-communicable diseases (NCDs) – such as cancer, cardiovascular disease and chronic respiratory disease – continues to rise sharply. NCDs are the leading cause of death in Europe and are some of the costliest conditions to treat. As populations age, the demand for complex care of people with multiple NCDs is set to increase. This places additional pressure on health systems that are already struggling to overcome backlogs and long waiting times exacerbated by the disruption to services caused by the COVID-19 pandemic. 

Nurses and NCD care 

Nurses are pivotal to the effective delivery of NCD services. They conduct screening procedures, educate patients on prevention, and facilitate the continuity of care between healthcare professionals across different parts of the health system. With fewer nurses and growing rates of NCDs, effective and high-quality NCD care is at risk. It is clear that addressing the nursing crisis should be considered a key priority to tackle the burden of NCDs. 

What can be done? 

A holistic approach to workforce retention  

Keeping nurses in their jobs is essential, and significant changes are needed to support this. Current levels of pay do not adequately reflect the high level of education needed to become a nurse. This compensation should be increased to a fair and appropriate level and should seek to be relatively equitable across geographical regions. Health systems should offer nurses flexible working conditions and encourage a good work-life balance to mitigate the risk of burnout and work absences. Finally, there should be a clear path in all health systems for professional development and progression for nurses. For example, the role of an advanced practice nurse (APN) has greater levels of responsibility and specialist skills and may help to mitigate the lack of capacity in other parts of the health workforce. At present, not all European regulatory and governmental bodies recognise the APN role, leaving nurses in some countries with more limited career opportunities. 

Healthy nurses, better outcomes 

Nursing is an incredibly demanding occupation that can have a significant impact on the mental health of those who undertake it. This was particularly acute during the COVID-19 pandemic, which produced a prolonged period of stress for nurses. Ensuring the wellbeing of nurses – through the measures laid out above and the provision of mental health support – is critical to retention. Healthy nurses are more likely to perform better and have higher job satisfaction, ultimately leading to improvements in the delivery of care and health outcomes. 

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Nurses are critical in addressing Europe’s NCD challenge 

Nurses are key to addressing long waiting times and backlogs in NCD care, and maintaining a strong nursing workforce can also help prevent future NCD cases. Nurses’ role in delivering screening, health promotion and managing modifiable behavioural risk factors (such as smoking, drinking and exercise) is at the core of effective NCD prevention, and is essential to improving the chance of early diagnosis and treatment. 

This perspective particularly emphasises the need to make changes to ensure nursing is a fulfilling and desirable profession. This can be achieved by improving pay and working conditions, opening up new opportunities for skills development and career progression, empowering nurses to lead, and harnessing the opportunities of digital tools. It is time to call on European policymakers to make nursing a priority and improve pay, working conditions and professional opportunities. By investing in nurses, we invest in better healthcare for everyone. 


If you would like to read more about the nursing workforce crisis, see HPP’s think piece ‘Overcoming the nursing workforce crisis in Europe to improve care for people with non-communicable diseases’ here.