New analysis of the nursing care situation in Bremen
The gaps in long-term care provision in Bremen are widening – and are likely to be very difficult to close. This is the conclusion of a new analysis by the Bremen Chamber of Employees, which evaluated current data for Bremen. Despite the increasing need for professional care, the number of qualified caregivers in the state of Bremen has declined over the past ten years – with a significant drop since 2022. The Chamber of Employees anticipates that the situation for those requiring care will worsen.
Improve working conditions
“This also increases the workload for nursing staff,” says Elke Heyduck, Managing Director of the Bremen Chamber of Employees. “We could attract many more skilled workers to the social professions if we significantly improved working conditions. Part-time work is particularly prevalent in nursing in Bremen. This represents a resource we could utilize more effectively. But improvements for nursing staff, which were delayed due to the premature end of the traffic light system, must also be implemented quickly at the federal level.”
Only one in three people in need of care receives professional care
The number of people requiring care has more than doubled in recent years – from approximately 22,600 in 2013 to 47,600 in 2023. This is due to the increasing number of elderly people, but also to the fact that since 2017 more people have been entitled to benefits from long-term care insurance. The number of those receiving professional care – that is, from outpatient services or in a nursing home – only rose from about 12,500 to 14,900.
Family members often have to take over caregiving responsibilities
At the same time, several hundred nursing home beds in Bremen remain unoccupied due to a lack of staff. As a result, family members, mostly women, are increasingly having to provide care. "If professional nursing support is lacking, more employees will have to leave the profession or reduce their working hours – and these skilled workers will then be missing in other sectors," emphasizes Elke Heyduck, underscoring the importance of the nursing sector for all other industries. Approximately 12,500 nursing staff subject to social security contributions work in the state of Bremen. Of these, around two-thirds are qualified professionals – and only about one in five is male. Since 2013, the number of nursing staff in Bremen has increased by only nine percent – compared to 25 percent nationwide. The decline observed in Bremen since 2022 is particularly concerning.
Many employees work part-time
At the same time, the proportion of part-time employees remains consistently high. Only one in four nursing assistants, but almost one in two skilled nursing staff, work full-time. Significant potential for growth exists here: In Bremen alone, 1,500 additional full-time skilled workers with professional experience could be made available if nursing staff who have changed jobs returned and those currently working part-time increased their hours.
High demands, lots of stress
Working conditions in nursing are often particularly challenging: employees usually work shifts and also on weekends, with a large proportion regularly working nights. They are required to provide care under time pressure and work overtime more frequently than average. At the same time, the physical and psychological demands are high: more than half assume they will not be able to continue in their job until retirement age, as the employee survey by the Chamber of Employees shows.
Goal: To improve conditions and retain nursing staff
“We must retain nursing staff and ensure better working conditions,” said Heyduck. This depends on adequate staffing levels, reliable working hours, respectful leadership, strengthened teamwork, and better pay. The Bremen Chamber of Employees demonstrated this in its study, “I’ll work as a nurse again when…”. Many employees are already nearing retirement: approximately 30 percent of nursing staff are 55 years or older. However, significantly fewer young nurses are entering the profession. These skilled workers will therefore be virtually irreplaceable in the coming years, and Bremen has the highest proportion of employees over 50 in Germany.
More and more support staff in nursing care
Employment growth in the nursing sector is minimal and, moreover, is solely due to an increase in auxiliary staff. While in 2013 only one in five nursing staff was an auxiliary worker, ten years later it's almost one in three. During the same period, the number of qualified nurses has actually decreased by seven percent, while it has increased by 18 percent nationwide. Nursing care is therefore increasingly less frequently provided by qualified nurses with three years of training. "If more auxiliary staff are to bring about improvements in the future, then they must also be well-trained. Otherwise, the burden on qualified nurses cannot be reduced," says Elke Heyduck.
Bremen is not training enough people
In Bremen, approximately 530 nursing professionals would need to be successfully trained each year to maintain the status quo if future demand for skilled workers is to be met by those trained locally. However, only 316 people successfully completed the new generalist nursing training program in its first year. The proportion of trainees with foreign citizenship has increased – from just under eight percent between 2013 and 2023 to 26 percent.
The demands of the Chamber of Employees
- Adequate funding is essential for a sustainable improvement in the long-term care situation. For this, a solidarity-based long-term care and health insurance system at the federal level is just as important as greater state participation in the investment costs of care facilities and hospitals.
- Nationwide regulations for staffing levels in hospitals and nursing homes must be urgently introduced and implemented quickly. The instruments already exist, but the legal and practical implementation is taking far too long.
- The framework conditions of training need to be further improved , for example through improved language support, psychosocial support and learning support – and above all, ensuring practical instruction in companies.
- To prevent rising personnel costs in nursing homes from leading to increased financial burdens for those in need of care, long-term care insurance should be further developed into a comprehensive insurance system , and co-payments should initially be capped and limited.
- The training for nursing assistants/caregivers needs to be improved : The proposed legislation for a standardized, 18-month nursing assistant training program across Germany was not passed. Nursing assistants/caregivers are increasingly being employed in the care sector. The state government is urged to establish a high-quality and accessible training program for nursing assistants and to advocate for a uniform regulation at the federal level: A minimum of 18, ideally 24 months, should be the nationwide standard.
The Chamber Compact “Care in Bremen – Care Gaps Are Hard to Close” can be downloaded here: www.arbeitnehmerkammer.de/downloads
Source: Bremen Chamber of Employees, “More people in need of care, but fewer skilled workers – New analysis of the care situation in Bremen,” press release , February 6, 2025