Hospital Staffing Shortages. Why They’re Escalating and What Needs to Change.

Hospitals are struggling to attract and retain the right healthcare professionals, impacting patient care and organisational stability. Which roles are in shortage and most affected, why recruitment process challenges are growing, , and what strategic solutions and HR Teams in hospitals can do to support a sustainable workforce, improve patient outcomes and adopt to build a resilient, well-supported workforce.

Introduction: A System at Breaking Point

Staffing shortages in hospitals are not new but the scale and complexity of the problem have changed. COVID-19 didn’t cause the crisis, but it exposed and deepened long-standing structural weaknesses in the health workforce. Many hospitals now face a compounding problem, experienced staff are leaving faster than they can be replaced, while new recruits hesitate to join a sector perceived as overworked and under-supported.

This workforce pressure has far-reaching consequences not just for individual health professionals, but for patient safety, clinical outcomes, and the financial health of hospitals. Understanding the causes behind these shortages, and developing proactive rather than reactive responses, is now an urgent priority.

The Roles in Shortest Supply  and Why

Nurses and Midwives: The Frontline Disappearing Fast

Nurses and midwives are essential to safe, effective hospital care, yet this workforce is under unprecedented pressure. In Australia, data from the AIHW shows the number of registered nurses grew by just 1.3% in 2022, while demand increased by more than 5%¹. This imbalance is worse in emergency care, aged care, and regional hospitals.

Why the shortage?

• Burnout and attrition: Years of  fatigue, increased patient loads, and emotional toll have led to mass departures, especially among experienced nurses.
• Pipeline problems: Nursing student enrolments have dropped in some states, while clinical placement opportunities are limited, affecting graduation numbers.
• Ageing workforce: Over 20% of nurses are aged 55 or older¹, and a large wave of retirements is expected over the next decade.

Implication: Without targeted retention efforts and support for new graduates, hospitals risk a vacuum of experience that cannot be filled with incentives alone.

Allied Health Professionals: Critical, Yet Often Overlooked

Allied health professionals including physiotherapists, psychologists, speech pathologists and dietitians are vital to recovery, rehabilitation and chronic disease management. Yet recruitment into these roles is particularly difficult in regional and rural hospitals.

Why the shortage?

• Geographic inequity: City graduates often avoid regional placements due to isolation, housing shortages, and limited career advancement.
• Casualisation and contract work: Many new allied health workers face insecure employment, reducing retention.

Solution in practice:
For example, Victoria’s Goulburn Valley Health addressed this by offering final-year university placements with guaranteed full-time roles upon graduation. This pipeline approach reduced their unfilled allied health positions by 25% within a year².

Medical Specialists: When Geography Collides With Workforce Planning

Specialists such as anaesthetists, psychiatrists, radiologists and emergency physicians are in short supply across Australia, especially in smaller or remote hospitals. This is not simply a matter of headcount, it reflects systemic issues in training distribution and workforce planning.

Why the shortage?

The shortage of healthcare professionals is driven by a combination of long-standing issues within hospital staffing and broader healthcare workforce dynamics. One of the primary causes is the aging workforce, particularly in nursing and allied health professions, with a significant portion of staff approaching retirement age. Meanwhile, the pipeline of new healthcare workers is insufficient to meet the demand. Enrolment in healthcare training programs has declined in recent years, while barriers to entering the workforce, such as high tuition costs and limited clinical placements, further exacerbate the issue.

Additionally, the COVID-19 pandemic significantly intensified the healthcare recruitment challenge exacerbating existing challenges by overwhelming hospitals as many healthcare workers experienced burnout and left the profession, leading to a higher turnover rate. Economic factors, including the rising cost of living pressures, also deter professionals from relocating to under-served areas outside major metropolitan centres, especially in rural and regional hospitals.

Healthcare Systems
These factors, combined with a lack of strategic workforce planning and underinvestment in the exacerbated existing challenges by overwhelming hospitals  over several decades, have led to a perfect storm of staffing shortages. As a result, hospitals are struggling not only to fill open roles but to retain the skilled professionals already on staff, making this a multifaceted challenge that requires urgent, comprehensive solutions, creating a barrier to maintaining  high-quality patient care.

• Training bottlenecks: Highly competitive training positions and limited placements outside metro areas mean rural hospitals rarely produce or retain their own specialists.
• Inflexible rosters: Specialist work patterns are often incompatible with family life or dual-career needs in regional areas.

Case study:
In Western Australia, the WA Country Health Service implemented a fly-in/fly-out model for anaesthetists and obstetricians to ensure coverage. However, this model is expensive, unsustainable, and undermines continuity of care³.

Why Hospitals Struggle to Recruit

A Friction-Filled Recruitment Process

Many hospital recruitment systems are outdated and user-unfriendly. Candidates are required to create multiple logins, repeat information, or upload credentials that have already been verified elsewhere. In an environment where private employers and locum agencies offer streamlined application processes, this complexity deters even interested applicants.

Evidence:
For example, Aa Deloitte healthcare talent survey found that 42% of clinicians abandoned a job application mid-way due to complexity and time burden⁴.

What is the Impact:
Hospitals may lose highly qualified candidates not only  because of location or salary  but because the process itself acts as a barrier.

Lack of Visibility and Employer Branding

While healthcare professionals value purpose-driven work, they also want to work in environments where their skills are recognised, and their well-being supported.

Yet most hospital job listings present no clear narrative about what makes their team unique.

What’s missing?

• Transparent career pathways
• Information on leadership, mentorship and culture
• Testimonials from existing staff or team profiles

Case in point:
A Brisbane-based hospital redesigned its job ads with team photos, quotes from nurses, and a short video showing workplace culture. Within 3 months, they increased job applications by 30%, and interview-to-acceptance rates improved significantly.

Location-Based Disadvantage

Recruitment is hardest for hospitals in regional and rural areas, not only because of geographic isolation but because their offers often don’t address the full spectrum of needs for relocating professionals.

Key issues:

• No support for partners/spouses seeking employment
• Limited access to schooling or housing
• Fewer flexible rostering options

Without wraparound relocation support, many otherwise suitable candidates will decline offers, regardless of financial incentives.

Workplace Culture and Psychological Safety

Even well-staffed hospitals risk losing staff if their workplace culture is toxic or dismissive. Bullying, burnout, and rigid hierarchies push early- and mid-career professionals away.

A growing body of research shows that workplace culture plays a critical role in both attracting and retaining skilled healthcare professionals. Despite increased attention to recruitment, many hospitals overlook the impact that culture and psychological safety have on long-term workforce stability. A high-pressure environment, unclear communication, or a punitive culture can drive skilled professionals away  regardless of pay or benefits.

In healthcare settings, psychological safety refers to an environment where staff feel respected, heard, and safe to speak up about concerns or mistakes without fear of blame or retribution. This is essential in clinical settings where open communication can directly impact patient safety. However, when staff are afraid to voice concerns or feel unsupported by leadership, the risk of burnout and disengagement rises significantly. This has a direct impact on hospital staffing levels, as staff may seek employment elsewhere or leave the profession entirely.

Studies from the Institute for Healthcare Improvement (IHI) and the British Medical Journal (BMJ) reinforce the importance of cultivating psychologically safe workplaces. For example, a BMJ study found that healthcare teams with high psychological safety were more likely to report errors early, leading to faster improvements in care and stronger team cohesion (6). Similarly, the IHI emphasises that fostering a supportive culture not only improves patient outcomes but also reduces staff turnover, a critical metric in the face of ongoing healthcare workforce shortages.

Some healthcare organisations have begun to adopt frameworks such as Schwartz Rounds or structured peer support programs to enhance psychological safety and resilience. Others have made a point of embedding cultural values into onboarding, leadership training, and ongoing communication strategies. But these approaches are still not widespread, especially in under-resourced hospitals where time and staff are already stretched.

Improving culture requires deliberate leadership effort, ongoing listening to staff needs, and a shift away from top-down mandates toward collaborative problem-solving. For healthcare HR teams, the takeaway is clear: even the best recruitment strategies will struggle if the internal culture pushes good professionals out the door.

Data:
The 2023 Beyond Blue National Health Workforce Survey found that nearly 50% of junior doctors and nurses reported moderate to severe burnout, and 40% had considered leaving the profession⁵.

Retention is as much about relationships, respect, and support as it is about compensation.

What Can Be Done? Strategies for Real Impact

Solving the healthcare staffing crisis requires more than short-term fixes or increased job advertising. It calls for system-level thinking and long-term investment in people, culture, and planning. From workforce pipeline development to better leadership and retention strategies, hospitals and health systems must work together to create sustainable change. Below are several practical and evidence-informed strategies that healthcare organisations can begin implementing now to strengthen their healthcare workforce and address hospital staffing shortages.

1. Rethink Recruitment as an Experience

Hospitals need to redesign their hiring processes with user experience in mind. This includes:

• Simplified online application platforms
• Mobile-friendly forms
• Reduced duplication for internal applicants
• Faster screening and interview turnaround

A shorter time-to-hire improves both fill rates and applicant engagement. Every additional day a job is open increases the chance of candidate dropout.

2. Use Purposeful Employer Branding

Hospitals should move beyond generic job ads by highlighting what truly sets their teams and workplaces apart. This approach can help attract candidates who are not just qualified but also aligned with the organisation’s values.

Tactics:

• Feature Staff Stories:
  Share real-life experiences and personal stories of staff on specific job portals and social media, showcasing the unique culture and team dynamics.
• Highlight Team Collaboration and Innovation:
  Showcase examples of successful team collaboration, innovative patient care, and problem-solving in the workplace.
• Leverage Healthcare-Specific Job Boards:
  Use platforms dedicated for healthcare professionals, to post roles that attract candidates who resonate with your hospital’s culture and values

3. Develop Internal Talent Pipelines

Building a sustainable workforce means looking beyond reactive hiring. Health services need to plan proactively by cultivating ongoing relationships with potential candidates, particularly in hard-to-fill roles like senior nursing, rural clinical leadership, and specialised allied health.

Rather than competing for the same limited talent pool, hospitals can create their own. This means

1. Partner with universities and training providers to create clearer pathways into priority roles. These partnerships can include placements, joint research, and mentoring initiatives.

2. Strengthen internal succession planning by identifying and developing emerging leaders early, supported by structured professional development and mentorship to build loyalty.

3. Create centralised, professional-facing platforms where job opportunities are easy to find and reflect the full scope of career possibilities in healthcare.

   One such example is the UBIS Health Jobs Platform, a dedicated central hub that supports hospital recruitment efforts by making it easier to post and promote professional-level roles across the sector. Unlike traditional job boards, the platform enables direct connection between hospitals and qualified candidates, helping to improve visibility of healthcare jobs, reduce friction in the hiring process and support the long term recruitment and retention strategies.

These approaches build long-term retention and reduce reliance on expensive agency staff.

4. Address Culture, Not Just Rosters

Hospitals should invest in professional development, feedback systems, and conflict resolution training for leaders. Leaders set the tone, and poor middle management remains one of the top reasons staff leave.

Initiatives that help:

• Staff advisory panels
• Peer support and mental health check-ins
• Exit interviews that inform real change

5. Use Smarter, Targeted Job Advertising

Generic job boards often attract the wrong audience. Instead, hospitals should:

• Advertise on dedicated healthcare job platforms
• Create longer-duration ads with targeted exposure
• Integrate advertising with employer content that builds familiarity over time

This builds a pipeline, not just one-time applications.

Conclusion: Planning for a Sustainable Workforce

Staffing is not a short-term recruitment task, it is a long-term strategic priority. Addressing the root causes of shortages means rethinking how hospitals attract, support, and retain their workforce. Culture, career pathways, digital systems, and reputation all matter.  For HR teams and health executives, the opportunity now is to lead not just hiring, but workforce transformation.

References

1  Australian Institute of Health and Welfare (AIHW). (2023). Nursing and Midwifery Workforce. https://www.aihw.gov.au/reports/workforce/nursing-and-midwifery-workforce

2  Goulburn Valley Health Annual Report 2022–23. https://www.gvhealth.org.au

3  WA Country Health Service. (2023). Annual Workforce Report. https://www.wacountry.health.wa.gov.au

4  Deloitte (2021). Global Human Capital Trends in Healthcare. https://www2.deloitte.com/global/en/insights/human-capital-trends.html

5  Beyond Blue (2023). National Mental Health Survey – Health Workforce. https://www.beyondblue.org.au

6 Institute for Healthcare Improvement (IHI) & British Medical Journal (BMJ). (2021). Psychological Safety in Healthcare Teams. BMJ Study: BMJ Article on Psychological Safety  IHI Report: IHI Psychological Safety

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