Italy Hospital Staffing Market Overview, 2031

Key Insights

• The Italy hospital staffing market is a critical component of one of Europe's largest healthcare systems, serving approximately 1,117 hospitals across the country. The market comprises temporary and permanent placement services for nursing professionals, physicians, advanced practice professionals, allied healthcare professionals, and non-clinical administrative staff across public and private hospital settings. Italy's hospital sector includes 568 public structures and 483 private accredited facilities.
• Italy has 461,313 registered nurses as of June 2025, with an average age of 46.5 years and a net female prevalence of 76.4%. The country has approximately 315,000 active physicians, with a physician-to-population ratio of 5.4 per 1,000 inhabitants, significantly above the OECD average of 3.9. This substantial workforce base creates persistent demand for third-party staffing solutions to address vacancies, turnover, and geographic imbalances.
• Nurse staffing represents the largest professional category in the Italy hospital staffing market. The country faces a structural shortage of at least 65,000 nurses, with a ratio of only 6.5–7.8 nurses per 1,000 inhabitants compared to the OECD average of over 8 per 1,000. In some European countries like Germany and Finland, the ratio is nearly double that of Italy. Applications for nursing degree programs in 2025 saw an 11.3% decline compared to 2024, with only 18,790 applications for 20,409 available places.
• "Gettonisti" (locum/temporary physician and nurse staffing) is a rapidly growing segment in Italy. In the biennium 2024-2025, public healthcare entities spent over €1.064 billion on externalized healthcare personnel. In 2025 alone, public expenditure reached €568 million, up 15% from €496 million in the previous year. Medical staffing contracts rose from €31 million to €50 million in a single year, marking a 62% increase.
• Public hospitals account for the majority of hospital staffing spend in Italy, reflecting the predominance of the publicly funded healthcare delivery system. The national health service has approximately 191,000 beds for ordinary inpatient care, with 23.3% in accredited private facilities. Public healthcare employment totals 724,245 units, of which 670,803 are permanent, 38,568 are flexible workers, and 14,874 are university personnel.

Market Outlook

• According to the research report, "Italy Hospital Staffing Market Overview, 2031," published by Bonafide Research, the Italy Hospital Staffing Market is expected to reach a market size of more than USD 1500 Million by 2031. This growth is supported by persistent workforce shortages, an aging healthcare workforce, and the continued reliance on temporary staffing solutions across Italian hospitals.
• The Italian market is expected to benefit from sustained demand for locum tenens physician staffing, nursing agency staffing, and permanent placement services. The biennium 2024-2025 expenditure of over €1.064 billion on externalized healthcare personnel reflects the structural nature of the staffing crisis. A structural shortage of at least 65,000 nurses, combined with an aging workforce, creates sustained demand for agency staffing across both public and private hospitals.
• Physician shortages, particularly in emergency medicine and specialty care, are driving continued demand for locum tenens services. Emergency rooms currently rely on "gettonisti" for 20-30% of their shifts, with some facilities having locum doctors covering up to 80% of shifts. Approximately 40,000 physicians in the National Health Service are expected to retire within the next five years, with 30,000 of these not being replaced, intensifying the locum demand.
• Rising adoption of technology-enabled workforce solutions and digital platforms is increasing the efficiency of hospital staffing procurement. Italy is experiencing significant digital transformation in healthcare workforce management, with the TSI Health Hub project redesigning the NHS workforce across six strategic areas including professional profiles, digital transformation, and artificial intelligence.
• Workforce constraints in nursing and physician supply are expected to sustain demand for third-party staffing providers. The nursing workforce pipeline is severely constrained, with applications to nursing degree programs declining 11.3% in 2025 compared to the previous year. Approximately 40,000 physicians are expected to retire by 2030, exacerbating the structural shortage.

Market Dynamics

Driver: Severe Workforce Shortages and Structural Vacancies
The Italy hospital staffing market is driven by chronic shortages of qualified healthcare professionals and persistently high vacancy rates. The country faces a structural shortage of at least 65,000 nurses. Italy has only 6.5–7.8 nurses per 1,000 inhabitants, compared to the OECD average of over 8 per 1,000. In European countries like Germany and Finland, the ratio is nearly double that of Italy. The situation is particularly critical in regions such as Lombardy, Sicily, and Campania, where the number of nurses per capita is among the lowest in the country. Nursing education is severely undersized by 5,880 places (-22%) compared to the national requirement. Applications to nursing degree programs in 2025 fell 11.3% to just 18,790 for 20,409 places. These workforce gaps compel Italian hospitals to utilize locum tenens physicians, agency nurses, travel staff, and permanent placement services to maintain patient care continuity and avoid service disruptions. In 2025 alone, public expenditure on externalized healthcare personnel reached €568 million, up 15% year-over-year.

Challenge: Rising Agency Staffing Costs and Budget Constraints
The most significant challenge in the Italian market is the high cost of agency staffing and its impact on hospital operating budgets. In the biennium 2024-2025, public healthcare entities spent over €1.064 billion on externalized healthcare personnel. The President of the National Anti-Corruption Authority has warned that this reliance on externalized personnel produces "onerous contracts for the public administration, inadequate services, and risks for patients". Generic personnel supply alone accounted for €947 million in the biennium, growing from €441 million to €506 million between 2024 and 2025. The "gettonisti" phenomenon has become systemic rather than a temporary COVID-era remedy, with public demand for externalized staff increasing 15% in 2025. Healthcare providers face growing budget pressure from regional governments seeking to contain healthcare spending. Hospitals are actively seeking to reduce their reliance on premium-rate agency staff through internal float pools, retention programs, and improved workforce planning. However, the structural shortage of nurses and physicians limits hospitals' ability to fully replace agency staff with permanent hires. The Italian Court of Auditors estimates an urgent need for 65,000 nurses, along with 20,000 family and community nurses, highlighting the scale of the challenge.

Trend: International Recruitment and Digital Workforce Management
The Italy hospital staffing market is experiencing significant transformation through international recruitment and digital workforce management. A landmark three-year protocol was signed on 2 December 2025 between Randstad Italia and the National Federation of Nursing Orders to facilitate the ethical insertion of foreign healthcare professionals into the National Health Service. The "Crossboarding" model establishes shared and objective selection criteria, assessing candidates on technical skills, language proficiency, and cultural and regulatory knowledge. In the last three years, over 1,000 healthcare professionals have been selected and trained by International Recruitment, an Openjobmetis Spa hub. At the same time, the TSI Health Hub project is redesigning the NHS workforce across six strategic areas: professional profile reorganization, digital transformation and AI, and career attractiveness. Expected outcomes by 2027 include the definition of a national reform framework. The healthcare professions reform, approved by the Council of Ministers on 4 September 2025, introduces incentives for personnel working in disadvantaged or high-complexity areas and includes a "penal shield" for healthcare workers. These trends are moving the market toward more structured, technology-enabled, and internationally sourced workforce strategies.

Policies

• The Italian Council of Ministers approved the reform of healthcare professions on 4 September 2025, introducing enabling laws dedicated to healthcare professions. The reform includes a "penal shield" for healthcare workers, defined as "an act of juridical civilization," and new regulations on training, competencies, and the use of artificial intelligence in medicine.
• The TSI Health Hub project, launched in November 2025, redesigns the National Health Service workforce across six strategic areas: professional profile reorganization; digital transformation and AI use; career attractiveness; and defined expected outcomes by 2027.
• The government has introduced incentives for personnel working in disadvantaged or high-complexity areas. The budget law for 2025 includes increased resources for the hiring of physicians and nurses and increased specificity allowances.
• The government is implementing measures to increase healthcare personnel, strengthen specialist training pathways, and introduce flexible work arrangements for medical residents in the National Health Service, with implementation required by 31 December 2026.
• The National Anti-Corruption Authority has published a report on "NHS Demand for Medical and Nursing Staff Supply Services," documenting the biennium 2024-2025 expenditure of over €1.064 billion on externalized healthcare personnel.
• The Senate approved a motion for the strengthening of the National Health Service, including measures to strengthen the healthcare workforce.
• The Ministry of Health and the National Federation of Nursing Orders (FNOPI) have established DataCorner, a new section on the FNOPI website that collects semi-annual data from the National Register, providing comprehensive statistics on the nursing profession.

Segment Analysis

Italy Hospital Staffing Market By Staffing Service
• Locum Tenens Staffing: Locum tenens ("gettonisti") staffing is a critical and rapidly growing service segment in the Italian market, driven by persistent medical vacancies and rota gaps. Emergency rooms currently rely on locum doctors for 20-30% of shifts, with some facilities having locum doctors covering up to 80% of shifts. In 2025, medical staffing contracts rose from €31 million to €50 million in a single year, marking a 62% increase, while the number of procedures increased by 68%. Approximately 40,000 physicians in the National Health Service are expected to retire within the next five years, with 30,000 not being replaced. Locum tenens staffing enables hospitals to maintain patient access and service continuity while conducting permanent recruitment searches. Demand is strongest in emergency medicine, where the shift coverage deficit is most acute.
• Travel Staffing: Travel staffing is a growing service segment in the Italian market, driven by geographic imbalances in workforce supply and demand and the shortage of nursing professionals across the country. With 1,117 hospitals and a structural shortage of at least 65,000 nurses, hospitals in underserved regions require travel nurses to maintain operations. Travel staffing demand is sustained by persistent nursing shortages and the imperative for hospitals to maintain bed capacity and service lines.
• Per Diem Staffing: Per diem staffing provides hospitals with on-demand, shift-by-shift clinical staff to cover unexpected absences, sick calls, and immediate vacancies without long-term contracts. This segment is particularly important in the Italian context, where public healthcare entities spent €568 million on externalized personnel in 2025 alone. Per diem staffing offers hospitals flexibility to adjust staffing levels in response to daily census fluctuations and is widely used across both public and private hospitals to address immediate staffing gaps.
• Permanent Placement: Permanent placement services recruit and place healthcare professionals into long-term, full-time hospital positions. This segment is driven by the ongoing need for hospitals to build permanent workforce capacity and reduce reliance on agency staff. Permanent placement demand is particularly strong for nursing professionals, where Italy faces a shortage of 65,000 nurses, and for physicians, where 40,000 are expected to retire within five years. The government has committed to increased resources for physician and nurse hiring in the 2025 budget.
• Other Temporary & Contract Staffing: This segment includes fixed-term local contracts, seasonal staffing, project-based clinical assignments, and temporary staffing arrangements that do not fall under travel, per diem, or locum tenens categories. Generic personnel supply alone accounted for €947 million in the biennium 2024-2025, growing from €441 million to €506 million between 2024 and 2025.

Italy Hospital Staffing Market By Professional Category
• Nursing Professionals: The largest professional category in the Italy hospital staffing market. Italy has 461,313 registered nurses as of June 2025, with an average age of 46.5 years. The country faces a structural shortage of at least 65,000 nurses. Italy has only 6.5–7.8 nurses per 1,000 inhabitants, compared to the OECD average of over 8 per 1,000. Applications to nursing degree programs in 2025 fell 11.3% to just 18,790 for 20,409 places. The nursing workforce faces critical challenges: rising retirements, diminishing enrollments, and challenging working conditions. These factors create persistent demand for agency-supplied nursing staff across all hospital departments.
• Physicians: Italy has approximately 315,000 active physicians, with a physician-to-population ratio of 5.4 per 1,000 inhabitants, above the OECD average of 3.9. However, approximately 40,000 physicians in the National Health Service are expected to retire within the next five years, with 30,000 not being replaced. Of the 439,957 physicians registered with the professional register, 415,868 practice as physicians, and 24,089 as dentists. Physician staffing demand is driven by shortages in emergency medicine, where locum doctors cover 20-30% of shifts, and in primary and specialist care.
• Advanced Practice Professionals: Nurse practitioners and physician assistants are increasingly utilized in Italian hospital settings to address primary care gaps and support physician workloads. The healthcare professions reform approved in September 2025 includes provisions for expanded professional roles and competencies. The growing scope of practice for advanced practice professionals creates expanding demand for APP staffing across emergency departments, hospitalist services, and specialty clinics.
• Allied Healthcare Professionals: Allied health professionals, including laboratory technicians, radiologic technologists, respiratory therapists, and pharmacists, are essential to hospital operations. Demand for allied staffing is driven by the expansion of hospital services, increasing patient acuity, and the growth of outpatient and rehabilitation services. Italy's public healthcare system employs over 700,000 personnel across all professional categories.
• Non-Clinical & Administrative Professionals: Non-clinical staffing includes administrative, operational, financial, and technology professionals supporting hospital functions. Demand is driven by healthcare IT implementation, revenue cycle management, and administrative workforce needs. Non-clinical temporary agency spend includes administrative and support roles across both public and private hospitals.

Italy Hospital Staffing Market By Hospital Ownership
• Public & Government Hospitals: The largest hospital ownership segment for staffing spend in Italy. Italy has 568 public hospitals, with 1,029 public structures for hospital assistance overall. The national health service has approximately 191,000 beds for ordinary inpatient care. Public healthcare employment totals 724,245 units, of which 670,803 are permanent, 38,568 are flexible workers, and 14,874 are university personnel. Public hospitals face persistent staffing shortages that necessitate agency utilization, with public expenditure on externalized personnel reaching €568 million in 2025. The government's healthcare professions reform introduces incentives for personnel working in disadvantaged areas.
• Private Hospitals: Private hospitals represent a significant segment of the Italy hospital staffing market. Italy has 483 private accredited hospitals, with 577 private healthcare structures represented by the Italian Association of Private Hospitals, of which 93% are accredited with the National Health Service. Private accredited facilities have 56,000 beds, employing 12,000 physicians, 28,000 nurses and technicians, and 33,000 support staff. These facilities admit one million patients annually for eight million days of inpatient care. Private hospitals face competitive pressure to maintain bed capacity, service lines, and patient satisfaction, creating demand for travel nurses, locum tenens physicians, and permanent placement services.

Italy Hospital Staffing Market Economics

• Staffing agency bill rates vary significantly by professional category, specialty, and geographic location. Locum physicians command premium rates, with medical staffing contracts rising from €31 million to €50 million in 2025 a 62% increase. The ANAC report highlights that contracts for externalized personnel are "onerous for the public administration".
• Hospital procurement of staffing services is shaped by regional health authorities, the National Anti-Corruption Authority, and hospital-level contracting. The ANAC has documented the biennium 2024-2025 expenditure of over €1.064 billion on externalized healthcare personnel. The President of ANAC has warned that this reliance produces "contracts onerous for the public administration, inadequate services, and risks for patients".
• The economic value of agency staffing is measured in terms of avoided revenue loss from service disruptions, bed closures, and patient throughput reductions. With Italian hospitals facing a shortage of 65,000 nurses and approximately 40,000 physicians retiring within five years, maintaining bed capacity and service continuity is a critical operational priority.
• The cost of turnover is a significant economic factor in hospital staffing economics. The nursing workforce has an average age of 46.5 years, with rising retirements and diminishing enrollments creating structural workforce gaps. These factors create ongoing demand for temporary staffing solutions and permanent placement services.
• The economic impact of locum tenens and agency staffing is measured in terms of maintained patient access, preserved service lines, and avoided revenue loss from vacancies. In some emergency rooms, locum doctors cover up to 80% of shifts, highlighting the critical role of temporary staffing in maintaining hospital operations.


Considered in this report
• Historic Year: 2020
• Base year: 2025
• Estimated year: 2026
• Forecast year: 2031

Aspects covered in this report
• Hospital Staffing Market with its value and forecast along with its segments
• Various drivers and challenges
• On-going trends and developments
• Top profiled companies
• Strategic recommendation

By Staffing Service
• Travel Staffing
• Per Diem Staffing
• Locum Tenens Staffing
• Permanent Placement
• Other Temporary & Contract Staffing

By Professional Category
• Nursing Professionals
• Physicians
• Advanced Practice Professionals
• Allied Healthcare Professionals
• Non-Clinical & Administrative Professionals

By Hospital Ownership
• Public / Government Hospitals
• Private Hospitals