Nurses in care homes: there is a shortfall of almost 10,000

The role of family nurses remains unclear from a legal and contractual perspective. However, these professionals do exist; they are working on the ground and ‘must’ play a leading role in the launch of the Community Homes by 30 June. Setting aside the formal issues that remain unresolved, let us try to highlight some key practical and operational aspects currently at play across the region.

First and foremost, it is worth examining the figures and, in this regard, it may be useful to recall what we are talking about. The NRRP includes Mission 6, dedicated to health, with a total budget of 15.63 billion euros. The primary objective of Component C1 of this Mission is ‘Community Centres and Individual Care’, for which €2 billion has been allocated, divided into €500 million for new projects and €1.5 billion linked to the FSC (Fund for Development and Cohesion); the project is managed by the Ministry of Health and Agenas, the Agency for Regional Health Services. According to the latest figures from the Ministry of Health, by the end of 2022 there were 1,464 family and community nurses – though not present in all regions – and, based on Agenas reports on the implementation of Ministerial Decree 77/2022, the number of nurses in Community Centres (though not necessarily family and community nurses) would reach 1,920, including both full-time and part-time staff.

According to the aforementioned Ministerial Decree 77, there should be 19,657 so-called IFoCs (1 for every 3,000 inhabitants) and, based on the established parameters, there should be 11,433 in community homes. This means that in Community Care Homes alone, the shortfall is close to 10,000 staff. Even if we were to draw on nurses from other local nursing services (such as the ADI, for example) who can work in community care homes, the number of such staff – so as not to compromise the functioning of their original services – could be at most 844–1,265.

Nor does the patchy organisation of training courses help to provide a solution – albeit not an immediate one – to the shortage of family or community nurses. According to a web search of regional government websites, taking into account courses already underway, due to start or still only planned, between 2,065 and 2,302 family and community nurses are expected to be trained in the coming years; however, these will not be immediately integrated into the Community Care Centres (CdC). The picture is not uniform. Some regions, such as Sicily, Basilicata, Piedmont, Apulia, Lazio and the Marche, have recently introduced training programmes with fairly clear figures. Others, such as Lombardy, stand out not so much for a new regional programme with specific intake figures, but for an already established presence of the role and for company-run recruitment drives dedicated to family and community nurses. In other regions — Campania, Calabria, Valle d’Aosta, Bolzano, Trento, Molise and Abruzzo — there are master’s degrees, corporate courses or specialist programmes, but data on participants is not always publicly available and, above all, it is not always clear how many are actually assigned to the Community Centres or to the districts.

If Lombardy is also included in the tally, the picture changes. In this region, there are over 1,000 IFoCs already registered or recruited, with sources citing 1,057 staff as at 31 December 2022, in addition to specific company recruitment drives for 45 + 25 posts. In this case, the minimum figure – including the historic Lombardy region – is approximately 3,065 nurses, whilst the maximum figure – including Lombardy and documented recruitment drives – is approximately 3,372 nurses. This second figure does not merely account for newly qualified nurses, but also takes into account recent training programmes, planned posts, staff already registered or recruited, and company-specific recruitment drives.