EUROPEAN HEALTH INFORMATION GATEWAY

  • Associate professional nurses, practising, total number (Line chart)
Data set notes
European database on human and technical resources for health (HlthRes-DB)

HlthRes-DB provides a wide range of statistics on human and technical resources for health and offers data on non-monetary health care resources collected through the joint work of the Statistical Office of the European Union (Eurostat), the Organisation for Economic Co-operation and Development (OECD) and WHO/Europe. It contains nearly 200 indicators on human and technical resources for health.

Human resources indicators: Indicators include the number and density of a wide range of health personnel (such as physicians, nurses, midwives, dentists, pharmacists and health care assistants), according to three different concepts (those practising, professionally active and licensed to practice). Information on employment in hospitals and numbers of medical and other graduates is also available.

Technical resources data: Data include the number and density of hospitals and hospital beds, stratified by ownership of facility (public, non-profit-making private and for-profit private), in addition to the number of beds for long-term care.

HlthRes-DB also contains indicators on the availability of the following medical equipment: computed tomography (CT) scanners, magnetic resonance imaging (MRI) units, positron emission tomography (PET) scanners, gamma cameras, digital subtraction angiography units, mammographs, radiation therapy equipment and lithotriptors.

Coverage: HlthRes-DB contains data from the 53 Member States in the WHO European Region. To be updated yearly, usually in late summer, it is currently available in English and Russian.

More information: http://www.euro.who.int/en/data-and-evidence/databases/european-database-on-human-and-technical-resources-for-health-hlthres-db
Indicator notes
Associate professional nurses, practising, total number
Indicator code: assocnurs.pract

Practising associate professional nurses provide services directly to patients.
Inclusion
- Associate professional nurses (see definition below)
- Foreign associate professional nurses licensed to practice and actively practising in the country
Exclusion
- Professional nurses
- Students who have not yet graduated
- Nursing aids/assistants and personal care workers who do not have any recognized qualification/certification in nursing
- Midwives (unless they work most of the time as nurses)
- Nurses working in administration, management, research and in other posts that exclude direct contact with patients
- Unemployed nurses and retired nurses no longer practising
- Nurses working abroad

Associate professional nurses generally work under the supervision of, and in support of implementation of health care, treatment and referrals plans established by medical, nursing and other health professionals.
Inclusion
- Assistant nurse
- Enrolled nurse
- Practical nurse
Exclusion
- Professional nurse
- Clinical nurse consultant
- Specialist nurse
- Midwife (unless they work most of the time as nurses)
- Associate professional midwife
- Nursing aide
- Medical assistant
Note: The number should be at the end of the calendar year.
Country notes
Albania
Metadata for practising nurses:
Source: Ministry of Health. Metadata for associate professional nurses: Data not available.
Andorra
Metadata for practising nurses: NA Metadata for associate professional nurses: NA
Armenia
Metadata for practising nurses:
Source of data: Republican Research and Information Health Centre and the National Statistic Service of the Republic of Armenia, Report form of the Ministry of Health of the Republic of Armenia ? 17 “Health employment”, http://healthinfo.am/Statistical%20Report.htm, Statistical book, Armenia, English version (zip) 2009.
Reference period: 31 December.
Deviation from the definition: Data on professional nurses (ISCO-08 code: 2221) and associate professional nurses (ISCO-08 code: 3221) are missing because all nurses are considered to be professional. Data on foreign nurses and medical assistants are not available and thus not included. Metadata for associate professional nurses: No data available.
Austria
Metadata for practising nurses:
Source of data: Austrian Federal Ministry of Health, Hospital Statistics.
Reference period: 31 December.
Coverage:
- includes professional nurses employed in hospitals;
- includes associate professional nurses employed in hospitals;
- excludes midwives.
Deviation from the definition:
- Self-employed nurses and nurses employed in other institutions than hospitals are not included. Metadata for associate professional nurses:
Source of data: Austrian Federal Ministry of Health, Hospital Statistics.
Reference period: 31 December.
Coverage: Data include associate professional nurses employed in hospitals. 1 year of study is required to qualify as an associate professional nurse.
Deviation from the definition: Self-employed nurses and nurses employed in other institutions than hospitals are not included.
Azerbaijan
Metadata for practising nurses:
Source of data: The State Statistical Committee of the Republic of Azerbaijan.
Reference period: data as of December 31.
Note:Division on Professional and Associate professional nurses does not exist in the country, Metadata for associate professional nurses:
Note:Division on Professional and Associate professional nurses does not exist in the country,
Belarus
Metadata for practising nurses:
Source of data: National Statistics Committee of Belarus http://belstat.gov.by/; National Archives of the Republic of Belarus http://narb.by/
Reporting period: 31 December.
Break in time series: 1998, 2010. Beginning in 1998, includes data on paramedics. In 2009, the post of the assistant physician for outpatient care was also included. Both of these categories are included in the 2010 data. Metadata for associate professional nurses:
Note: This category does not exist in the Republic of Belarus.
Belgium
Metadata for practising nurses:
Source of data: Data come from PlanCad infirmier (SPF Sante Publique, INAMI and Datawarehouse Marche du travail et Protection sociale), under the supervision of SPF Sante Publique.
Estimation method: The 2010-2012 data have been estimated by the OECD Secretariat by using the 2009 share of practising nurses among all nurses licensed to practice. Metadata for associate professional nurses: Data not available.
Bosnia and Herzegovina
Metadata for practising nurses:
Source: Public Health Institute of FB&H - Annual report health personnel with university degree by specialization and sex in FB&H Public Health Institute of Republica Srpska - Annual report health personnel with university degree by specialization and sex in Republica Srpska Metadata for associate professional nurses:
Source: Public Health Institute of FB&H - Annual report health personnel with university degree by specialization and sex in FB&H Public Health Institute of Republica Srpska - Annual report health personnel with university degree by specialization and sex in Republica Srpska

All nurses are classified as professional nurses. There is no category of associate professional nurse, and the whole time series is set to 0.
Bulgaria
Metadata for practising nurses:
Source of data: National Statistical Institute, Exhaustive annual survey
Reference period: 31st December
Coverage: All nurses (head counts) who worked on a basic labour contract in outpatient and inpatient establishments, as well as those who practice in other heath establishments - centres for emergency medical care, centres for transfusion haematology, homes for medical and social care for children, Hygiene-epidemiological inspections and others. On 01.07.2000 Bulgaria started Healthcare Reform: a new institution in the outpatient care was build
- the General Practitioner (GP), financing of curative medical care by the National Health Insurance Fund came into force. Specialists working in individual and group practices for specialized medical care, who have not signed contracts with the National Health Insurance Fund, are not covered in the exhaustive annual survey carried out by the BNSI, and neither nurses appointed by these physicians.
Break in time series: 2000. Metadata for associate professional nurses: The category Associate professional nurse does not exist in Bulgaria. Whole time series has been set to 0.
Croatia
Metadata for practising nurses:
Source of data: Croatian National Institute of Public Health, Health Manpower Register,
Reference period: data on December 31
Coverage: public and private health sectors included, private nurses have been included since 1993. Metadata for associate professional nurses:
Source of data: Croatian National Institute of Public Health, Health Manpower Register,
Reference period: data on December 31
Coverage: public and private health sectors included, private nurses have been included since 1993.
Cyprus
Metadata for practising nurses:
Source of data: 1980-2004: Public medical institutions, as regards the Public Sector From 2005: Inspectors of Private Medical Institutions (Ministry of Health), as regards the Private Sector
Reference period: 31st December of the reference year.
Estimation method: The figures referring to years 1980-2004 for the private sector , have been estimated since no actual data are available for this period. From 2006 onwards the reported numbers are actual. Numbers referring to the Public Sector are actual for all years and have been obtained from administrative sources supplied from the public medical institutions, whereas the numbers referring to the private sector from 2006 onwards have been obtained from administrative sources of the Inspectors of Private Medical Institutions (Ministry of Health).
Break in time series: 2005 due to a change in the data source. 2006 due to point deviation from the definition (point 3 below).
Deviation from the definition: For the Public Sector, the midwives are included. In Cyprus, all the midwives activated in the Public sector are nurses owning the extra qualification of midwifery and they hold the position of nursing officer. Hence, they have been included in the number of nurses. For the Private Sector, the midwives have been excluded. Assumed that in the Private Sector, there are no nurses holding administrative positions. All nurses have been considered as practising nurses. For 2005, the number of associate professional nurses refers only to the public sector, no data available for the private sector. Metadata for associate professional nurses: Data not available.
Czechia
Metadata for practising nurses: Czech Republic
Source of data: Institute of Health Information and Statistics of the Czech Republic; National Health Information System (Annual report on health personnel).
Reference period: 31st December.
Coverage:
- Until 1999, nurses working in other central organs not included. Since the year 2000, data cover nurses in total health services.
- Since 2004 data collected on basis of new legislation on non-medical professions.
- Double counting of nurses working in more than one health establishment.
- Data relate to nurses working in health establishments. Those working in social care sector are not included.
Break in time series: 2000 and 2004. Metadata for associate professional nurses: Czech Republic Data not available.
Denmark
Metadata for practising nurses:
Source of data: Statens Serum Institut, Labour Register for Health Personnel.
Reference period: 31st December.
Coverage: Nurses whose status in the Central Personnel Register is active, i.e. in the country (not dead or abroad); connected to HP1, HP2 or HP3 as either a) employed, b) employed, being on leave or
c) employed, receiving sickness benefit. Metadata for associate professional nurses:
Source of data: Statens Serum Institut, Labour Register for Health Personnel.
Reference period: 31st December.
Estonia
Metadata for practising nurses:
Source of data:
- Annual reports, National Institute for Health Development, Department of Health Statistics.
- 1980-2003 nurses and assistant doctors, data published by Statistics Estonia (http://pub.stat.ee/px-web.2001/I_Databas/Social_life/05Health/04Health_care_institutions/04Health_c are_institutions.asp).
Reference period:
- 1980-2012: 31st of December.
- Since 2013: November.
Coverage:
- Presents practising nurses who provide services directly to patients.
Break in time series: 1992, 2005, 2012 and 2013.
- The types of institutions included have changed over the period in question. Until 1991 data correspond more to professionally active nurses (practising + working in health sector).
- Since 1992, medical staff working in military, research or other areas have not been included.
- Until 2004, the source was an annual report on practising health care personnel based on their educational last or main qualification.
- From 2005, the head count distribution is made according to their main occupational activity.
- From 2012, the number of practising nurses does not include radiology nurses. Radiology nurses (by job specification - same as radiology technicians) are classified in the category of other health service providers.
Note: The decrease after 1991 was the result of the first reorganisation wave of health care system of the independent country. A large-scale legislative reform took place in the early 1990s. In 1991 the provider licensing system was enhanced, which was an important precondition for decreasing hospital network capacity to enable more efficient use of resources and to ensure quality. In 1994, after a detailed review of all providers, substandard providers were closed.
- The data collection methodology was changed in 2013. Aggregated data collection was replaced with data collection on a personal basis. From 2013, the predominant (main) area of practice is based on an occupation with the highest workload. Metadata for associate professional nurses: The category "associate professional nurses" does not exist in Estonia.
Finland
Metadata for practising nurses:
Source of data: THL Health Personnel Statistics; National Institute for Health and Welfare. The data for 2000 and 2005 onwards are based on the Employment Register kept by Statistics Finland.
Reference period: Data refer to information for the whole year.
Coverage: Data include nurses active in health care in Finland. Metadata for associate professional nurses:
Source of data: THL Health Personnel Statistics; National Institute for Health and Welfare. The data for 2000 and 2005 onwards are based on the Employment Register kept by Statistics Finland.
Reference period: Data refer to information for the whole year.
Coverage:
- Data include nurses active in health care in Finland.
- The data cover the number of nurses and public health nurses (codes 32311 and 32312 in the Statistics of Finland Classification of Occupations 2001).
France
Metadata for practising nurses: Data not available. Data are available for "professionally active" nurses (including nurses in administrative, academic or research functions who are not providing direct care to patients). Metadata for associate professional nurses:
Source of data: Ministere de la Sante et des Sports - Direction de la Recherche, des Etudes, de l'Evaluation et des Statistiques (DREES), Sous-Direction de l'Observation de la Sante et de l'Assurance maladie, Bureau des Professions de sante, Repertoire ADELI.
Note: There are no associate professional nurses in France.
Georgia
Metadata for practising nurses:
Note: Category “Practising Nurses” does not exist. Metadata for associate professional nurses:
Note: Category “Associate professional nurses” does not exist.
Germany
Metadata for practising nurses:
Source of data: Federal Statistical Office, Health Care Personnel 2015; special calculation by the Federal Statistical Office, http://www.destatis.de or http://www.gbe-bund.de.
Reference period: 31st December.
Coverage:
- Data include professional nurses with a 3-year education and associate professional nurses with a 1-year education (nurses, paediatric nurses and nurses for the elderly).
- Data (head-counts) contain the number of nurses actively practising in public or private hospitals, primary health care and other health facilities including self-employed. They provide services directly to patients.
- Excluded are midwives, nurses working in administration, research and in other posts excluding direct contact with patients, nurses working abroad, unemployed and retired nurses and students who have not yet graduated.
- From 2000 onwards data from Health Care Personnel have been completely revised. Therefore comparable data before 2000 are not available. Metadata for associate professional nurses: Germany
Source of data: Federal Statistical Office, Health Care Personnel 2015; special calculation by the Federal Statistical Office, http://www.destatis.de or http://www.gbe-bund.de.
Reference period: 31st December.
Coverage:
- Data include associate professional nurses with a 1-year education (auxiliary nurses and auxiliary nurses for the elderly).
- Excluded are professional nurses with a 3-year education, emergency medical assistants and midwives.
- From 2000 onwards data from Health Care Personnel have been completely revised. Therefore comparable data before 2000 are not available.
Greece
Metadata for practising nurses: Data not available. Metadata for associate professional nurses:
Source of data: Hellenic Statistical Authority (EL.STAT.).
Reference period: 31st of December.
Coverage: Associate nurses working in hospital sector (public and private) and associate nursing personnel working in Public Health Centers.
Hungary
Metadata for practising nurses:
Source of data: Hungarian Central Statistical Office; Report on personnel of health service.
Reference period: 31st December.
Coverage: From 1990: The report was made according to the 1990 account of the Central Statistical Office “Number of posts and the staff of ancillary workers by activity”. Nurse definition as of ISCO 88 (code 2230 and code 323) includes qualified nurses and associate nurses. Midwives are excluded. Caring personnel are excluded (ISCO 88 (code 5132) dieticians, assistants, nursing). Metadata for associate professional nurses:
Source of data: Hungarian Central Statistical Office; Report on personnel of health service.
Reference period: 31st December.
Coverage: From 1990: The report was completed according to the 1990 account of the Central Statistical Office "Number of posts and the staff of ancillary workers by activity". Nurses following the definition ISCO 88 (code 323 – general nurses and nursing assistants) are included. Break in series: In 2000, health and social services were separated. Nurses working in social services have not been included in the data since 2000. In the same year a new international methodology was introduced which caused an increase in the number of associate nurses.
Iceland
Metadata for practising nurses:
Source of data: Directorate of Health and Association of Icelandic Nurses.
Reference period: 31st December.
Coverage:
- Professional nurses: Four years of university education leading to a B.Sc. degree.
- Associate/Licensed practical nurses: Three years of education in secondary school (non-university) and 16 weeks of practical training in health institutions.  
- Figures refer to nurses who are members of The Association of Icelandic Nurses and associate practical nurses who are members of the Icelandic Union of Practical Nurses. Metadata for associate professional nurses:
Source of data: Directorate of Health - Association of Icelandic Nurses.
Reference period: 31st December.
Coverage:
- Associate/licensed practical nurses: Three years of education in secondary school (non-university) and 16 weeks of practical training in health institutions.
- As of 2006 a new “associate nurse bridge” programme of 4 semesters of education was offered for health assistants with at least five years working experience as caring assistants. In 2008, 107 (2007:8; 2006:3) graduated from this programme and 115 from the general programme for associate professional nursing. The big increase in the number of associate nurses between 2007 and 2008 is to some extent due to this new programme, as 107 associate nurses graduated from it in 2008 in addition to the 115 graduating from the ordinary programme in 2008. This is also reflected in the fact that The Directorate of Health gave licenses to 188 new associate nurses in 2008. The increase in 2008 may also be explained by a number of associate nurses returning to these jobs from work in different jobs prior to the economic collapse.
Ireland
Metadata for practising nurses: Data not available. Metadata for associate professional nurses: Associate professional nurses do not feature in the Irish Health Service (Source: HSE, Nursing Services Directorate).
Israel
Metadata for practising nurses:
Source of data: The data are based on the Labour Force Survey which is conducted routinely by the Central Bureau of Statistics and includes persons who had worked for at least one hour during the week before the survey, for pay, profit or other consideration. Occupation is determined by the type of work performed by the interviewed person at his place of work, without regard to what he studied if his work is not in that field. The classification of occupations is based on the classification of the International Labour Office (ILO): International Standard Classification of Occupations ISCO 88.
Coverage:
- The data are for all nurses.
- The sample of practising nurses is relatively small and therefore the data are subject to large variations due to sample errors and wide confidence intervals. Any data analysis should be carried out with caution.
Estimation method: Moving average of three years (numbers for previous, current and next years) was made in order to diminish the fluctuations in the numbers. For example, the number of practicing nurses in 1996 is an average of 1995-1997. The number for 2011 is an average of 2010-2012.
Break in time series:
- From January 2012, the Central Bureau of Statistics has made a transition from a quarterly system of measuring labour force characteristics to a new and improved system that better suits the latest international recommendations on employment and unemployment - Monthly Labour Force Survey. Therefore the 2012 (original) data refer to the entire labour force (including the military service) and not to the civilian labour force, as it was before.
- In addition to the transition to a monthly survey, in 2012 a new Standard Industrial Classification of Economic Activities based on ISIC was implemented as well as a new Standard Classification of Occupations based on ISCO-08. The (original) numbers for 2012 are still reported according to the previous classifications, but the (original) numbers for 2013 are based on the new classifications.
Further information: http://www.cbs.gov.il/publications/labour_survey04/labour_force_survey/answer_question_e_2012.pdf. http://www.cbs.gov.il/publications12/economic_activities11/pdf/e_print.pdf.
Note: The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements in the West Bank under the terms of international law. Metadata for associate professional nurses:
Source of data: The data are based on the Nurses License Registry maintained by the Nursing Division and the Health Information Division in the Ministry of Health, for which the demographic information is periodically updated from the Population Registry at the Ministry of Interior.
Reference period: End of the year.
Coverage:
- Data are for all associate nurses. Data refer to practical nurses. The number of midwives is not included in the number of nurses.
- The training of practical nurses in Israel ceased in 2005; since then new licenses are granted only to new immigrants. The training of practical nurses was done in two year nursing courses in professional high schools.
- Practical nurses work under the supervision of a registered nurse. They are employed mainly in geriatrics and psychiatrics and are allowed to give medicines orally and intramuscular injections. They are mainly involved in helping with daily activities, collecting tests, ADL, measuring blood pressure and temperature.
- Skilled auxiliary staff, hospital trained and working under the supervision of registered nurses, is not included in the data.
Note: The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements in the West Bank unde
Italy
Metadata for practising nurses: Data not available. Data are available for "professionally active" nurses (including nurses in administrative, academic or research functions who are not providing direct care to patients). Metadata for associate professional nurses: Data not applicable: In the Italian regulatory system, the category “Associate professional nurses” does not exist.
Kazakhstan
Metadata for practising nurses:
Source: Ministry of Health of the Republic of Kazakhstan.
Reference period: 31December.
Note: Division on Professional and Associate professional nurses does not exist in the country. All nurses are classified as professional nurses. Metadata for associate professional nurses:
Note: Division on Professional and Associate professional midwives does not exist in the country. All nurses are classified as professional nurses.
Kyrgyzstan
Metadata for practising nurses: NA Metadata for associate professional nurses: NA
Latvia
Metadata for practising nurses:
Source of data:
- Since 2005: Health Inspectorate of Latvia; Medical Persons' Register.
- 2004 and earlier: Health Statistics and Medical Technologies State Agency; Statistical Report No.17 "Report About Medical Staff".
Reference period: 31 December. Break in series: 2005: Change in data source.
Note: Decrease in the number of nurses in year 2009 is due to restructuring of health care institutions. Metadata for associate professional nurses: All nurses have been classified as Professional nurses. Therefore, value of this time series is 0 for all years.
Lithuania
Metadata for practising nurses:
Source of data: Health Information Centre of Institute of Hygiene, data of entire annual survey of health establishments. Report “Health Statistics of Lithuania”, available from http://sic.hi.lt/html/en/hsl.htm
Reference period: 31st December
Coverage: The number of practising nurses at the end of the year includes all professionally active nurses excluding those working in administration, health education and research. Metadata for associate professional nurses: There is no such category in Lithuania.
Luxembourg
Metadata for practising nurses:
Source of data: Direction de la Sante - Service des statistiques. Register of doctors and health professionals.
Coverage:
- Head counts.
- Since 2010: Nurses working in administration and research have been excluded.
- Data should be considered with care due to methodological issues encountered during census series concerning midwives, nurses and pharmacists.
Break in time series: 2003, 2005 and 2010.
- 2003 and 2005 due to adjustments to the methodology. Metadata for associate professional nurses:
Source of data: Direction de la Sante - Service des statistiques. Register of doctors and health professionals.
Malta
Metadata for practising nurses:
Source of data:
- Starting from 2009 data was collected by the Directorate for Health Information and Research from all establishments and departments within the Maltese healthcare system.
- Before 2009: the source is Directorate Nursing Services.
Reference period: 31st December.
Coverage: Numbers quoted refer only to nurses employed in state institutions. The 2001 figures relate to nurses working in Main Public Hospital and Primary Care. 2002 figures include nurses employed within the entire public sector. 2004 data includes nationwide active nurses. Starting from 2009, data refers to nurses employed in both, state and private institutions, but does not include self-employed nurses. Figures for 2011 onwards also include service contracts. Figures are calculated estimates, based on Full Time Equivalence, Break in the series: 2001, 2004 and 2009. Metadata for associate professional nurses: The category 'Associate professional nurse' does not exist in Malta.
Monaco
Metadata for practising nurses: NA Metadata for associate professional nurses: NA
Montenegro
Metadata for practising nurses:
Source of data: The source for all data submitted is the Institute of Public Health. Some additional information can be found in Health Statistical Yearbooks available at http://www.ijzcg.me/
Reference period: December 31st.
Coverage: Only data from the public sector.
Deviation from the definition: Laboratory technicians are included from 2005 till 2011, but not for previous years. Physiotherapy technicians are included for 2011 and also for previous years. Data for practicing nurses and professionally active nurses cannot be split at the moment. Metadata for associate professional nurses:
Note: The category does not exist.
Netherlands
Metadata for practising nurses:
Source of data: Social Statistical Database of Statistics Netherlands, BIG register (official register of health care professionals) plus estimates (see coverage).
Reference period: The last Friday before Christmas.
Coverage:
- Practising nurses are estimated by calculating all registered nurses who are economically active in ISIC / NACE 86, 87, 88 or 7820 (working for temporary employment agencies) (85 and 7450 in ISIC 3 or NACE 1) multiplied by a factor (number of nurses in a function as nurse / number of employees with education as a nurse). That factor is derived from the Report Regiomarge on the labour market in Health Care, Social Care and Welfare by Prismant.
- The same report provides the shares of professional and associate professional nurses. Metadata for associate professional nurses:
Source of data: Social Statistical Database of Statistics Netherlands, BIG register (official register of health care professionals) plus estimates.
Reference period: The last Friday before Christmas.
Coverage:
- Practising nurses are estimated by taking all registered nurses who are economically active in ISIC / NACE 86, 87, 88 or 7820 (working for temporary employment agencies) (85 and 7450 in ISIC 3 or NACE 1) multiplied by a factor (number of nurses in a function as nurse / number of employees with education as a nurse). That factor is derived from the Report Regiomarge on the labour market in Health Care, Social Care and Welfare by Prismant.
- The same report provides the shares of professional and associate professional nurses.
- Associate professional nurse: education at level "4".
Norway
Metadata for practising nurses:
Source of data: Statistics Norway; Statistics on health-care personnel. Administrative registers. See http://www.ssb.no/hesospers_en/.
Reference period: 3rd week of November.
Coverage:
- The figures provided give the number of practising nursing within HP1-HP3. There is no guarantee that these professionals actually work in patient care as data refer to the education the nurses have rather than the job they hold within HP 1-3.
- From 2009, data include all personnel within HP1-HP4.
Break in time series: 2009. Metadata for associate professional nurses: Norway has no occupation corresponding to ISCO-08 code: 3221.
Poland
Metadata for practising nurses:
Source of data: Ministry of Health, Ministry of Interior, Ministry of National Defence and Central Statistical Office.
Reference period: 31st December.
Coverage: Data regarding nurses are based on head counts. Nurses are counted in the main workplace. Nurses working in nurseries include midwives. Nurses working in prisons are excluded.
Breaks in time series:
- Since 2004: Nurses working in private medical offices as a main workplace are included, as well as nurses working in the Ministries of National Defence and Interior and Administration.
- Since 2005: Nurses working in facilities of stationary social welfare and in nurseries are included.
Note: The category “Associate Professional Nurse” does not exist in Poland. Metadata for associate professional nurses: The category “Associate professional nurses” does not exist in Poland.
Portugal
Metadata for practising nurses: Data are available for “professionally active” nurses (including nurses in administrative, academic or research functions who are not providing direct care to patients). Data revised for 2012 Metadata for associate professional nurses:
Source of data: Statistics Portugal and the Council of Nurses.
Note: The category “Associate professional nurses” does not exist in Portugal.
Republic of Moldova
Metadata for practising nurses:
Source of data: Ministry of Health of the Republic of Moldova, National Centre for Health Management, Annual statistical report N17 “On staff and cadres of health institutions”. http://cnms.md/areas/statistics/anyar/.
Reference period: Data as of December 31.
Coverage: Data exclude Transnistria.
Deviation from the definition: Foreign nurses are not included. Feldshers are included. Metadata for associate professional nurses: This category does not exist in the country.
Romania
Metadata for practising nurses:
Source of data: National Institute of Statistics, Activity of Sanitary Units – annual survey performed by NIS.
Reference period: data as of 31st December.
Coverage: The data cover public and private sector. Data from 2000 till 2009 refers to ancillary medical staff. Since 2010 the data refer only to nurses. The ancillary medical staff includes: medical assistants, pharmacy assistants, nurses, infant care personnel, sanitary technicians, laboratory assistants, registering clerks, masseur, autopsy assistant and statistician specialised in health statistics, medical physical trainer, ergo therapy trainer and other categories of medical staff with equivalent upper secondary level of education. The data include also associated nurses from dentists units and pharmaceutical units. It would be specified that for midwives and nurses the level of education is ISCED 3 or 4 and ISCO codes are 3231 and 3232. Until 2007 ancillary medical staff working in administration, research and in other posts that exclude direct contact with patients could not be totally excluded. Number of nurses decreased in 2010 because in the period 2000-2009 data refer to ancillary medical staff (see definition above). Break in the series: 2010. Metadata for associate professional nurses:
Source of data: National Institute of Statistics, Activity of Sanitary Units – annual survey performed by NIS.
Reference period: data as of 31st December.
Coverage: The data cover all sanitary personnel from public and private sector. The data cover all public and private sector. Data from 2007 till 2009 refer to ancillary medical staff. Since 2010 the data refer to nurses. The ancillary medical staff includes: medical assistants, pharmacy assistants, nurses, infant care personnel, sanitary technicians, laboratory assistants, registering clerks, masseur, autopsy assistant and statistician specialized in health statistics, medical physical trainer, ergo therapy trainer and other categories of medical staff with equivalent upper secondary level of education. The data include associated nurses from dentists units and pharmaceutical units. It would be specified that for nurses the level of education is ISCED 3 or 4 and ISCO codes are 3231 and 3232. Number of nurses decreased in 2010 because in the period 2007-2009 data refer to ancillary medical staff (see definition above). Break in the series: 2010.
Russian Federation
Metadata for practising nurses:
Source of data: Annual reporting forms ?17 «Information about the medical and pharmaceutical personnel", Ministry of Health of the Russian Federation.
Reference period: 31 December.
Coverage: Includes only data for medical institutions of the Ministry of Health. Data from institutions of other ministries and private sector are not included.
Note: Nurses total includes nurses working with physicians of clinical specialties + junior nurses providing care for patients. Metadata for associate professional nurses:
Source of data: Annual reporting forms ?17 «Information about the medical and pharmaceutical personnel", Ministry of Health of the Russian Federation.
Reference period: 31 December.
Coverage: Includes only data for medical institutions of the Ministry of Health. Data from institutions of other ministries and private sector are not included.
San Marino
Metadata for practising nurses:
Source of data: Human Resources Office at the Social Security Institute.
Coverage: Data include only public sector’ health professionals. Metadata for associate professional nurses:
Source of data: Human Resources Office at the Social Security Institute. The category does not exist, whole time series set to 0.
Serbia
Metadata for practising nurses: Data not available. Metadata for associate professional nurses:
Source of data: Institute of Public Health of Serbia, National register on health care human resources. Data as of December 31. http://www.batut.org.rs/.
Coverage: Data for Kosovo-Metohija province are not included in the coverage of data for the Republic of Serbia. Data from health institutions under other ministries (military services, prisons, social services) than the Ministry of Health are not included. Data from private health sector are not included.
Deviation from the definition: Data include nurses with ISCED level 3 education.
Slovakia
Metadata for practising nurses: Data not available. Data are available for "professionally active" nurses (including nurses in administrative, academic or research functions who are not providing direct care to patients). Metadata for associate professional nurses: There is no distinction between professional and associate professional nurses in the Slovak Republic. All nurses are considered professional nurses.
Slovenia
Metadata for practising nurses:
Source of data: National Institute of Public Health, Slovenia; National Health Care Providers Database.
Reference period: 31st December.
Coverage:
- Practising nurses are those working in the health-care sector (primary and secondary care), including public health institutes and the health insurance institute.
- The National Health Care Providers Database is a registry with total (100 %) coverage of health workers. Metadata for associate professional nurses:
Source of data: National Institute of Public Health, Slovenia; National Health Care Providers Database.
Reference period: 31st December.
Coverage: The National Health Care Providers Database is a registry with total (100 %) coverage of health workers.
Spain
Metadata for practising nurses:
Source of data: National Statistics Institute (INE), based on the Economically Active Population Survey. http://www.ine.es/jaxi/menu.do?type=pcaxis&path=/t22/e308_mnu&file=inebase&N=&L=0.
Reference period: Annual average. Three-year moving averages (e.g. data reported in 1996 is an average of 1995-1997).
Coverage:
- A significant revision of the numbers of nurses in previous years has been made in 2010 due to a clarification of definitions. The Spanish Working Group for the adaptation of ISCO-08 to our own classifications (CNO-11) determined that Spanish health professionals fit as follows:
a) The category 'associate professional nurses' (ISCO-08 code 3221) does not exist in Spain, so these series have been completely corrected.
b) The nursing aides working in Spain correspond entirely to the group 5 of the ISCO classification (ISCO-08 codes 5321, 5322) based on the tasks and functions they perform. Therefore, based on these criteria, the series for practising nurses, professionally active nurses, associate professional nurses and caring personnel have been updated in 2010 for the period 1995-2008.
- The data exclusively include professional nurses (midwives included) who are actively practising nursing in the health sector. The number of practising nurses was obtained by calculating the number of nurses employed in the health sector according to NACE rev.2 (chapter Q) since 2009, and similarly with NACE Rev.1 and NACE Rev.1.1 before 2009.
- Data analysis over time should be carried out with caution. Data are obtained from a survey and fluctuations in the data can occur for a number of reasons, one of them being the sampling errors. These variations can lead to false assumptions about trends. We advise users of time series data to carefully explore the relevant issues before drawing any conclusions about the reasons for year-on-year changes.
- Up to 2010, the data by occupation are classified according to the National Occupations Classification (CNO-94 Spain code 272), the Spanish equivalence of ISCO-88, code 2230.
- From 2011 onwards data are classified according to CNO-11 Spain, code 212. The CNO-11 code 212 is the Spanish equivalence of ISCO-08 code 222 (nursing and midwifery professionals).
- During the first quarter of 2005 various changes have been introduced into the Economically Active Population Survey:
1. New variables have been included in accordance with Eurostat (Statistical Office of the European Communities) requirements, set forth in Regulation 2257/2003.
2. A centralised procedure has been implemented for the process of the telephone interviews.
3. With the goal of further standardising the survey process, the questions of the questionnaire have been reformulated.
- The figures of practising midwives are not available, and it is not possible to subtract them from the total number of practising professional nurses.
- A university degree of 3 years is required to qualify as a nurse.
Deviation from the definition: Data include midwives.
Estimation method: In 2014, data series have been updated with Spanish population figures imported from Census 2011 and recalculated by using three-year moving averages in order to reduce the large year-to-year fluctuations in data derived from the LFS. The number reported in 1996 is an average of 1995-1997; the number for 2012 is an average of 2011-2013. Metadata for associate professional nurses:
Source of data: National Statistics Institute (INE), based on the Economically Active Population Survey. http://www.ine.es/jaxi/menu.do?type=pcaxis&path=/t22/e308_mnu&file=inebase&N=&L=0.
Coverage: A significant revision of the numbers of nurses in previous years has been made in 2010 due to a clarification of definitions. The Spanish Working Group for the adaptation of ISCO-08 to our own classifications (CNO-11) determined that Spanish health professionals fit as follows:
a) The category 'associate professional nurses' (ISCO-08 code 3221)
Sweden
Metadata for practising nurses:
Source of data:
- Before 1995: Data came from the register of certified nurses and population census 1990.
- From 1995: National Board of Health and Welfare, National Planning Support (NPS) register.
Reference period: 1st November.
Coverage:
- Practising nurses are defined as licensed nurses registered in NACE-codes that are considered to be within the health-care sector.
- 100 per cent coverage.
Break in time series: Figures on nurses before 1995 are not consistent with the data from 1995 onwards because of differences in sources and methodology. Metadata for associate professional nurses: Data not available.
Switzerland
Metadata for practising nurses:
Source of data: FSO Federal Statistical Office, Neuchatel; hospital statistics, statistics of medical-social institutions, community nursing statistics; yearly census.
Coverage: Annual full surveys on employment in hospitals, nursing homes and community nursing home services. The ambulatory health care sector is not yet covered.
Estimation method: Until 2009, estimations were made with data on professions from 75% of hospitals. Hospitals giving valid information on professions are reasonably assumed to be representative of the whole category (university hospitals, acute hospitals, psychiatric hospitals, rehabilitation hospitals, and other specialised hospitals).
Break in time series: Since 2010, hospital statistics have been revised; no estimation needed. Metadata for associate professional nurses:
Source of data: FSO Federal Statistical Office, Neuchatel; hospital statistics, statistics of medical-social institutions, community nursing statistics; yearly census.
Coverage: Full surveys on employment in hospitals, nursing homes and community nursing home services. The ambulatory health care sector is not yet covered.
Estimation method: Until 2009, estimations were made with data on professions from 75% of hospitals. Hospitals giving valid information on professions are reasonably assumed to be representative of the whole category (university hospitals, acute hospitals, psychiatric hospitals, rehabilitation hospitals, and other specialised hospitals).
Break in time series: Since 2010, hospital statistics have been revised; no estimation needed.
Tajikistan
Metadata for practising nurses: NA Metadata for associate professional nurses: NA
The former Yugoslav Republic of Macedonia
Metadata for practising nurses: Data not available. Metadata for associate professional nurses: The category “Associated professional nurse” does not exist.
Turkey
Metadata for practising nurses: Data not available. Data are available for "professionally active" nurses (including nurses in administrative, academic or research functions who are not providing direct care to patients). Metadata for associate professional nurses: Nurses in Turkey are not employed and do not practice as “associate professional nurses”.
Turkmenistan
Metadata for practising nurses: Data not available. Metadata for associate professional nurses:
Note: division on Professional nurses and Associate professional nurses does not exist in Turkmenistan. All nurses have been classified as professional nurses and the time series for associate professional nurses is set to 0.
Ukraine
Metadata for practising nurses:
Source of data: Centre of Health Statistics, Ministry of Health. Reporting form 20 "Report of health care institutions” and 24 Reporting form "Report obstetric point" of the Ministry of Health and other agencies and private entities.
Reference period: 31 December.
Deviation from the definition: data on foreign nurses are not included. Starting from 2009 feldshers are included in this category. Nurses working in physiotherapy departments are not included (they are included in the number of practicing physiotherapists).
Break in time series: 2009, before 2009 data included only health professionals working in the institutions reporting to the Ministry of Health, starting from 2009 data coverage is complete. Metadata for associate professional nurses: The category does not exist. There is no division of nurses in Ukraine on professional and associate professional nurses.
United Kingdom
Metadata for practising nurses:
Source of data:
- England: Health & Social Care Information Centre: http://www.hscic.gov.uk.
- Wales: Welsh Government: http://gov.wales/statistics-and-research/?topic=Health+and+social+care&lang=en.
- Scotland: Information Services Division, Scottish Workforce Information Standard System.
- Northern Ireland: Department for Health, Social Services and Public Safety: http://www.dhsspsni.gov.uk/index/stats_research.
Coverage:
- Does not include private sector.
- Data for professional and associate professional nurses available for England, Scotland and Northern Ireland only.
- Scotland: From 2007 onwards, Professional nurses are categorised as those with Agenda for Change bands 5-9 and Associate professional nurses those with Agenda for Change bands 1-4. For 2000 to 2006 (pre Agenda for Change), professional nurses are categorised as registered nurses and associate professional nurses as unregistered nurses. Data exclude bank and agency staff.
- Northern Ireland: ‘Total nurses’ includes qualified and nurse support staff, ‘Professional nurses’ includes qualified nurses only (Band 5+) and ‘Associate Professional nurses’ include nurse support staff (nursing auxiliary roles Band 1-4). Data in general exclude bank and agency staff as well as staff on career breaks. Nurses are qualified following either a 3 year programme leading to registration as a nurse with the Nursing & Midwifery Council or a Diploma/Degree in Nursing Sciences in one of the following areas: adult, mental health, learning disability or children’s nursing. There are no national minimum qualifications for nurse support staff, but some will have a National Vocational Qualification.
- Wales: Data exclude bank staff.
Estimation method:
- Wales: Data prior to 2008 are estimates. Between 2007 and 2008, there was a large reduction in headcount numbers for non-medical staff in Wales, as records with whole-time equivalent (WTE) equal to 0 had been revised. This decrease was due to improvements in data quality, not a reduction in staff numbers, and 2008 headcounts are more accurate than previous figures. Therefore, the ratio between headcounts and WTE numbers for the affected staff categories in 2008 were calculated. These ratios were then applied to WTE figures for years prior to 2008 to produce estimates for those years.
- Wales: 2014 Welsh data was not available in time for this collection and so the previous year’s figure was used instead. This will be updated with the correct data in next year’s collection.
Break in time series:
- England: The decrease in the number of professional nurses in 2011 is due to the exclusion of some staff groups to better fit the required definition. The decrease in the number of associate professional nurses in 2011 is due to bank staff not being counted in England in 2011 as this collection has stopped.
-The GP practice nurses were not included in the 2011 figure so they have now been added in to the Total nurses and Professional nurses column for that year. In 2012 and 2013 the methodology were not consistent for calculating the total nurses figure so these data have been revised.
- Scotland: In 2014, figures for nurses have been added from 2000 to 2006. The methodology differs from the later years, since 2000-2006 figures are for employment rather than true headcount, and may double count nurses holding more than one post. Northern Ireland: In 2014 we have been able to properly identify all trainees and they have now been excluded, hence the decrease in the number provided for qualified midwives.
Note:
- From 2007 onwards, the sum of professional nurses and associate professional nurses is slightly different from the total number of nurses. This is due to double counting. Professional nurses are categorised as AfC Bands 5-9 and Associate professional nurses AfC Bands 1-4, and it is possible for someone to work two positions on different bands. Metadata for associate professional nurses: Source of da
Uzbekistan
Metadata for practising nurses:
Source of data: Institute of Health and Medical Statistics, the Ministry of Health of the Republic of Uzbekistan, reporting form 15-SSV “Report on Health personnel by categories”.
Reference period: 31 December.
Coverage: data include personnel working within the system of the Ministry of Health only. Metadata for associate professional nurses:
Note: there is no division of nurses on Professional and Associate professional in the country.