Community homes without doctors and nurses, how regions try to avoid a flop

Community Centres (CdCs) across Italy are currently facing a critical staffing shortage that threatens to undermine their intended role in healthcare delivery. While the National Recovery and Resilience Plan (PNRR) initially aimed for 1,350 facilities, a 2023 revision adjusted that target to 1,038, though programming has since expanded to 1,715 sites. With the June 30, 2026, deadline approaching, an Agenas survey reveals that while 781 centres have at least one active service, only a small fraction possess the required medical and nursing presence. The core challenge remains that these facilities risk functioning as empty shells, lacking the personnel necessary to provide effective diagnostic, preventive, and primary care services.

Why the Staffing Gap Matters

The success of the CdC initiative hinges on human resources rather than mere infrastructure. According to the latest Agenas data, only 204 centres currently meet the medical presence requirements of DM 77/2022, and only 216 satisfy the nursing requirements. This leaves an estimated deficit of more than 2,500 doctors and nearly 7,000 full-time nurses. The significance of this gap is organizational and clinical: without professionals to staff the single access points, handle home care, or provide specialist consultations, the centres cannot offer the stable connection to the territory that they were designed to facilitate.

Did You Know? The total number of planned Community Centres has evolved significantly from the initial PNRR provision of 1,350 facilities to a current programming target of 1,715, with the additional quota intended to be covered by Law 67/1988 funds, cohesion funds, and regional resources.

Regional Strategies and Operational Hurdles

Regions are attempting to address the personnel crisis through various, often experimental, models. Veneto has proposed allowing doctors already employed by the National Health Service to perform hourly activities at CdCs, a move intended to foster better integration between hospitals and the territory. However, this proposal has faced resistance from hospital unions concerned about contractual constraints and the potential to further deplete hospital staffing levels.

Other regions are leveraging existing local traditions to bridge the gap. Emilia-Romagna utilizes a deeply rooted network of GPs, paediatricians, and specialists, while Tuscany integrates family nurses and functional territorial aggregations (AFT). Meanwhile, Piedmont is experimenting with shared medical teams across multiple districts to maximize efficiency, and Trento has reported meeting its PNRR targets by focusing on the advanced skills of nurses in managing chronic conditions.

Expert Insight: The current situation reflects a classic structural mismatch: the rapid expansion of physical sites is outpacing the availability of the professional workforce. The shift from “site-centric” planning to “personnel-centric” solutions suggests that the ultimate success of the network will rely on how effectively regions can distribute existing staff across these new hubs without compromising hospital operations.

What May Happen Next

As the June 2026 deadline looms, the landscape of Italian community healthcare is likely to become increasingly fragmented as regions implement divergent staffing solutions. Analysts expect that if recruitment efforts remain insufficient, more regions may move toward “flexible” models, such as using external professionals or accredited private providers, though this carries the risk of service inconsistency. It is also possible that continued union resistance will force further policy pivots, potentially shifting the focus toward telemedicine and remote specialist consultations as a stopgap measure for areas unable to secure permanent on-site staff.

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Frequently Asked Questions

Are these centres at risk of losing European funding?
Not automatically. Many of these facilities are financed through channels outside the PNRR, such as cohesion funds, the Fund for non-deferrable works, and regional or provincial resources.

What is the main obstacle to the centres becoming operational?
The primary obstacle is a severe shortage of personnel. There is an estimated need for over 2,500 doctors and nearly 7,000 full-time nurses to ensure these centres function according to established standards.

How are regions attempting to solve the doctor shortage?
Regions are testing various approaches, including using hospital-based doctors for hourly sessions in CdCs, employing telemedicine, and utilizing shared teams between different districts to cover multiple locations.

As the race to open these facilities continues, will the focus on flexible staffing models ultimately provide the level of care patients expect from their local community centres?