Minister for Health welcomes the publication of ‘A System Dynamics Model of Nursing and Midwifery Workforce Supply’

The Minister for Health Stephen Donnelly and the Minister for Public Expenditure and Reform, Michael McGrath, today, published ‘A System Dynamics Model of Nursing and Midwifery Workforce Supply’ as part of the 2022 Spending Review process to improve the evidence base for policy decisions.

The aim of this work is to provide an evidence base to help inform policymakers on the appropriate student intake for nurses in Irish higher education institutions.

The paper estimates that in 2021 approximately 46% of the Whole Time Equivalent (WTE) Nursing Workforce in Ireland were educated abroad. Ireland has committed to attaining self-sufficiency in health workforce requirements through the training of adequate local staff as part of the WHO Code of Practice on International Recruitment of Health Personnel. The Code centres on the topic of ethical international recruitment. Participating countries, including Ireland, have agreed to ending active recruitment of health personnel from developing countries, particularly those facing critical shortages. This paper demonstrates a need for large scale expansion in the number of nursing places in Ireland in order to meet this commitment.

Progress on this will better align student intake over the coming decades with the needs of the health system.

Highlights include the following findings:

Baseline Scenario: Based on a current intake of 2,000 undergraduate nurses per year and historical patterns of retention, the proportion of domestically educated Whole Time Equivalent (WTE) nurses will decrease from 54% in 2021 to approximately 38% in 2041.

Increasing the production of nursing graduates: Ireland produces 31 nursing graduates per 100,000 people each year. Gradually increasing this figure by 87% over 14 years to the level of the Netherlands (58 per 100,000) reduces Ireland’s reliance on foreign educated nurses relative to the baseline. In this scenario, approximately 50% of nurses in the WTE workforce would be domestically educated in 2041. Significantly increasing the production of nursing graduates by 251% to the per capita level of Australia (109 per 100,000), amongst the highest in the world, increases the share of domestically educated nurses to approximately 70% of the WTE workforce after 20 years. This compares with 38% in the baseline.

Minister for Health Stephen Donnelly welcomed the publication saying:

‘A System Dynamics Model of Nursing and Midwifery Workforce Supply’

This paper was produced by Irish Government Economic and Evaluation Service (IGEES) staff in the Department of Health’s Research Services Unit. The paper is published as part of the Spending Review process and has been subject to extensive peer review. The Spending Review is a key platform for evidence-informed policymaking across the Civil Service. This research was undertaken to aid strategic workforce planning in the health sector.

The paper provides an overview of relevant policies and analyses trends in the Irish nursing workforce.

I. Summary: This paper develops a nursing workforce supply model using systems dynamics modelling to examine the potential increases in student nurse intake required to reduce Ireland’s reliance on the recruitment of foreign educated nurses, meet future demand for nurses and address workforce challenges.

II. Findings: Based on current trends, the proportion of domestically educated nurses in the WTE workforce will decrease from 54% to approximately 38% over a 20-year projection period which will exacerbate the challenge of reaching national self-sufficiency. Ireland produces 31 graduate nurses per 100,000 people each year. Gradually increasing this figure by 87% over 14 years to the level of the Netherlands (58 per 100,000) decreases Ireland’s reliance on foreign educated nurses relative to the baseline. In this scenario, approximately 50% of nurses in the WTE workforce would be domestically educated compared to 38% in the baseline. Significantly increasing the production of nursing graduates by 251% to the per capita level of Australia (109 per 100,000), amongst the highest in the world, increases the share of domestically educated nurses to approximately 70% of the WTE workforce after 20 years. This compares with 38% in the baseline.

III. Policy Implications: This paper demonstrates the need to significantly increase Ireland’s student intake for nurses in Irish higher education institutions.