BLOG: An update on our nurses’ commuting project

In this blog, Dr Michelle Jamieson provides a brief update on the project investigating commuting patterns among nurses and midwives in England and Wales, and how the team is now extending this work using Scottish microcensus data.

Looking at the journey to work

Before nurses and midwives arrive at work, they have already made another journey: the journey from home to the ward, clinic, care home, community setting, or other workplace.

This journey is not usually central to workforce planning. We often focus on how many nurses and midwives there are, where they work, and whether they remain in the workforce. However, how far people travel to work, and how they get there, may also matter for staff wellbeing, retention, transport planning and the environmental impact of health and care work.

In our earlier ADR Scotland Data Insight (Sept 2025), we used the Census 2021 Individual Microdata Sample for England and Wales to examine commuting patterns among nurses and midwives. We compared nurses and midwives with other workers in similar occupational groups, looking at both distance travelled to work and main mode of transport.

What did we find?

The descriptive analysis showed that nurses and midwives tended to live slightly closer to work than comparable workers. They were more likely to live within two kilometres of their workplace, and less likely to commute very long distances.

Nurses and midwives were also more likely to walk or travel by bus than comparable workers. However, car travel remained the most common mode of commuting. This is important because it suggests that living relatively close to work does not automatically mean that people are able to use lower-carbon or more active forms of travel.

We have now developed this work into a full academic paper, which has been submitted for publication. In the paper, we go beyond descriptive comparisons and model commuting distance while taking account of demographic, household, employment and regional characteristics.

The model showed that nurses and midwives still had slightly shorter commutes than comparable workers after adjustment. The difference was modest, but it remained present even when we accounted for other factors.

Why does this matter?

At first glance, a slightly shorter commute may not seem very important. However, for a large essential workforce, even small differences can tell us something about how work, housing, caring responsibilities and local labour markets fit together.

The model also showed that commuting was not explained by occupation alone. Region, transport mode, sex, working hours, children in the household, housing tenure and unpaid caring responsibilities all helped explain commuting distance.

This means that a commute is not just a line between home and work. It is shaped by where jobs are located, where people can afford to live, whether public transport is available, whether someone works shifts, and what responsibilities they have outside paid work.

For nurses and midwives, this is particularly relevant. Many work long shifts, nights or weekends. Some also have unpaid caring responsibilities or children at home. A long, expensive or unreliable commute may therefore add pressure to already demanding work.

What can the data tell us?

The Census 2021 microdata allow us to look at commuting patterns across a large population sample. This is a major strength because it means we can compare nurses and midwives with other workers, and examine how commuting varies by household, employment and regional characteristics.

However, the data do not tell us whether someone’s commute was easy or difficult. They do not tell us whether public transport fitted around shift times, whether someone felt safe walking or cycling, or whether they would have preferred to live closer to work.

For example, a short commute by car could mean several different things. It might reflect convenience, lack of public transport, caring responsibilities, parking availability, or the need to travel at unsocial hours. Similarly, a longer commute may be manageable for one person but difficult for another, depending on cost, time, reliability and household circumstances.

For this reason, we interpret the findings as evidence about commuting patterns, rather than direct evidence about commuting burden.

Next steps for the project

We are now applying the same analysis to the Scottish microcensus. This will allow us to explore whether similar patterns are found in Scotland, where geography, rurality, settlement patterns and transport infrastructure differ from England and Wales.

This comparison is important. A commute in a large city, a small town, an island community or a rural health board area may mean very different things. By extending the analysis to Scotland, we can begin to ask whether nurses’ commuting patterns are mainly shaped by occupation, or whether they are shaped by local geography and infrastructure.

By looking at the journey before and after the shift, this project broadens how we think about health workforce sustainability. It shows how census and administrative data can help us understand not only how many nurses and midwives there are, but also how their everyday journeys connect health work to housing, transport, place and climate policy.

Author: Dr Michelle Jamieson