Call for universities to respond to shortages of health professionals

Europe’s youth workforce declined by 11% between 2000 and 2010, while the health and social work sector experienced a 3% increase in its workforce, creating more than 770,000 jobs at the same time as there was a five-million decline in job openings elsewhere. Changing workforce and skills needs have important implications for higher education.

The health sector is projected to grow by 5% between 2010 and 2020, meaning that more than a million new jobs will be created, in addition to the job openings that will occur because of replacement needs, estimated at seven million, which will require increased numbers of highly qualified people.

Most member states in Europe are facing critical workforce shortages: in 2009, about 30% of all doctors were over 55 years of age and by 2020, an estimated 60,000 doctors or 3.2% of all European doctors, are expected to retire each year. Important 'shortage countries' such as the US, Australia and Canada also create added competition for scarce human resources.

Projections show that not enough young recruits are coming through the education system to replace those who leave, with several countries already experiencing a shortage of doctors and nurses. At the same time, surveys show that many nurses are leaving the profession, ranging from 19% in The Netherlands to 49% in Finland and Greece.

Last month, the European Commission’s Director of Health Systems Dr Andrzej Rys wrote in the Health-EU newsletter that the economic crisis had put health systems under pressure to make fundamental reforms in the way they delivered health care.

New forms of care delivery and new technologies coupled with organisational changes would depend on a highly qualified health workforce equipped with the right skills, Rys said.

Health professional migration

Meanwhile, the number of medical specialists in Europe is increasing more rapidly than general practitioners, with significant differences in cross-border movements showing a clear east-west asymmetry for doctors, nurses and dentists, according to a new report.

The report says western and northern member states are experiencing migration while simultaneously receiving health professionals from other countries.

It identifies common trends that are changing the way health professionals work across Europe, such as the development of new, integrated care delivery models and the growth of new technologies, medical appliances and diagnostic techniques.

Member states should adjust their education and training curricula as a reaction to the changes in healthcare and to adapt their workforce planning to factor in an analysis of the work environment, the report says.

This includes reviewing wage levels and the participation of nurses in decision-making, as this can influence recruitment, retention, mobility, performance, health outputs and quality of care.

To help member states tackle the health workforce challenges, the European Commission has committed to:

• • Launching a three-year joint action on forecasting health workforce needs before the end of 2012.
  
• • Working with partners to develop guidance on utilising training capacities to help respond to recent European Court of Justice cases on the mobility of medical students.
  
• • Carrying out a study, in cooperation with the OECD, on the structure and training capacity in the European Union (EU).

Planning and forecasting mechanisms

A project undertaken by Matrix Insight in collaboration with the Centre for Workforce Intelligence between August 2011 and April 2012 reviewed planning and forecasting mechanisms used in 34 countries.

The investigation involved 12 case studies and a focus discussion with an expert panel that resulted in a report, A Feasibility Study on EU Level Collaboration on Forecasting Health Workforce Needs, Workforce Planning and Health Workforce Trends.

The report was one of the basic reference documents for designing the Joint Action on European Health Workforce Planning and Forecasting, known as JA-HWF and financed by the EU’s second health programme with €3 million (US$3.9 million).

The joint action committee will have its first meeting in Brussels next Thursday, with the general objective of coordinating EU member states in their planning processes for the health workforce and to create a platform for collection of data and exchange of practices between them.

The project has collaborative partners in seven countries – Croatia, Cyprus, Denmark, Ireland, Latvia, Norway, and Sweden – and associated partners in another 18, as well as seven stakeholders’ associations, with the OECD and World Health Organization (WHO) Europe as collaborative partners.

The project will run through to 2015, with the aim of estimating future needs in terms of skills and competence of health workers, and to find out how donor and receiving countries can cooperate on training and the circular mobility of health workers.

The JA-HWF will address these issues by focusing on sharing best practices, developing forecasting methodologies on health workforce needs, improving data gathering in EU countries, and exchanging experiences on education and training capacities in health professions.

It will also launch a new study, next year, of medicine and nursing schools to create a European council of nursing skills and care workers, and will pilot a sector skills alliance to coordinate lifelong learning through review and mapping of national systems and practices.

Another project scheduled is a mapping of healthcare assistants, establishing a database, exploring innovative and effective recruitment and retention strategies of health personnel, and supporting member states’ implementation of the WHO Global Code of Practice for the international recruitment of health professions.