European Hospital & Healthcare Employers’ Association

Adoption of the implementation report of the multi-sectoral guidelines to tackle work-related third-party violence

At the the Sectoral Social Dialogue Committee for the Hospital Sector Plenary Meeting of 11 December 2013, HOSPEEM and EPSU members adopted the report on the use and implementation of the Multi-sectoral guidelines to tackle third-party violence and harassment related to work including recommendations. 

The joint evaluation and implementation report contains examples on how the multi-sectoral guidelines have been promoted and implemented by the member organisations of the signatory parties in the framework of projects and campaigns.

The report also contains recommendations for further steps and summarise the main challenges, whereof the main highlights are the following:

• A social partner agreement on preventing third-party violence could be a further step to a more stringent implementation of the guidelines if there is consensus between the social partners to start any negotiations.
• Further projects, conferences, and training for the social partners’ affiliates at local, regional and national level should be considered to implement the guidelines, with financial support of the European Commission.
• National projects could receive financial support from the European Social Fund.
• The implementation of the multi-sectoral guidelines should become an integral part of the Sectoral Social Dialogue Work programmes of the respective social dialogue committees who signed the guidelines. A follow-up report should be conducted by 2015 to evaluate progress on the implementation of the guidelines and identify the potential need for further action.

Download the report

EPSU-HOSPEEM Guidelines and examples of good practice to address the challenges of an ageing workforce in the healthcare sector

Brussels, 11 December 2013: Signature of the EPSU-HOSPEEM guidelines and examples of good practice to address the challenges of an ageing workforce in the healthcare sector.

In the context of the Plenary Meeting 2013 of the Sectoral Social Dialogue Committee for the Hospital Sector, the Secretary General of HOSPEEM, Tjitte Alkema, and the Chair of EPSU’s Standing Committee “Health and Social Services”, Liza di Paolo Sandberg, signed the joint guidelines and examples of good practice to address the challenges of an ageing workforce in the healthcare sector. The document had been agreed upon in October 2013, following nearly two years of negotiations.

The aim of the document is to provide guidance to support social partners as well as decision makers, managers, workers and other stakeholders at national, regional and local and level, addressing different aspects related to age management policies such as flexible working arrangements, talent management and training, health and safety at work, workforce planning and retirement planning. It is for the social partners at all levels to work in partnership and to consider how this guidance can complement their own systems, initiatives and measures.

Read and download the press release

EPSU-HOSPEEM Guidelines to address the challenges of an ageing workforce in the healthcare sector:

 Download in ENG  Download in FR  Download in DE








Background: HOSPEEM-EPSU work on ageing workforce 2006-2013

HOSPEEM-EPSU Study (2006) “Promoting realistic active ageing policies in the hospital sector” : Download in EN  Download in FR

Technical Seminar HOSPEEM-EPSU “Managing the ageing workforce: Challenges, opportunities and experiences” (Brussels, 27 April 2012)  Download the programme

Documents provided by HOSPEEM members and EPSU affiliates


Finnish Institute of Occupational Health (FIOH): Working time + Occupational health – EN
Finnish Institute of Occupational Health (FIOH): Shift planning + Ergonomics – EN
Public Works Department: Helsinki case study in good health age programme – EN


Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege (BGW): Älter werden im Pflegeberuf – DE
Initiative Neue Qualität der Arbeit (INQA)-Ratgeber Demographie: Angebote für Unternehmen im demographischen Wandel – DE
Federal Institute for Occupational Safety and Health: Securing the Future with Prevention: Strategies for a World of Work aligned to Demographic Change – EN

The Netherlands
StAZ: Memo “Active Ageing + Dutch Ageing Workforce Policies” – EN

United Kingdom of Great Britain and Nothern Ireland
DWP: Health Sector: Tackling Ageing Workforce Issues: Resource Pack – EN
DWP/NHS: Managing Ageing Workforce Health & Social Care – EN
Agewell Initiative – Sandwell Primary Care Trust (NHS) – EN
Guide Employers Performance & Retirement Practices (UK) – EN
RCN: Protecting employment for older nurses – EN
RCN: Nurses later stage careers – EN

Background documents collected by HOSPEEM and EPSU Secretariats 

DG EMPL: Integration Ageing Workforce (2001) – EN
CEEP: Valuing Age (2003) – EN
EFILWC: Working conditions ageing workforce (2008) – EN
EFILWC: Search engine for good practices in ageing management of Eurofound
OSHA: Thematic Webpage “Ageing Workers – Safety and Health”
OSHA: Thematic Webpage “Ageing Workers – Safety and Health”
EU Trio Presidency: Assessing Future Health Workforce Needs (2010) – EN
HOPE: Ageing Workforce and Ageing Patients (2010)
ETUI: Occupations and Ageing@Work (2010): Download in EN Download in FR
Eurofound: Sustainable Work and the Ageing Workforce – Report on the basis of the 5th European Working Conditions Survey (2012)
DG EMPL: EEO Review – Employment Policies to Promote Active Ageing 2012 (2012): Download in EN, Download in FR and Download in DE
Andrea Winkelmann-Gleed: Demographic change and implications for workforce ageing in Europe: Raising awareness and improving practice (WLRI Working Paper 5)

Research Papers and Presentations at Technical Review Seminar “Employment policies to promote active ageing” in the framework of the Mutual Learning Programme under the European Employment Strategy, 11 June 2012, Brussels 

Paper “Globalization and the Labour Market Situation of Older Workers: Exploring Trends, Challenges and Strategies for Adaptation”, Dirk Hofäcker, MZES, Mannheim (Germany)
Paper “Living Longer – Working Better”, Donald Storie, European Foundation for the Improvement of Living and Working Conditions (EUROFOUND), Dublin
Presentation “Elaborating guidance and good practice in relation to various challenges of an ageing health care workforce: Flashlights on work in progress between EPSU and HOSPEEM”, Mathias Maucher, EPSU
Presentation “The role of measures to encourage older workers to stay longer in the labour process”, Jan Schugk, Confederation of Finnish Industries

Liaison Forum Social Dialogue, 27 May 2013, Brussels

Presentation “Managing the Ageing Workforce:-A joint priority of HOSPEEM and EPSU, the European Social Partners in the hospital sector: Guidelines and examples of good practice to address the challenges of an agein workforce”, Elisa Benedetti, HOSPEEM


Promotion and support of the implementation of Directive 2010/32/EU on the prevention of sharps injuries in the hospital and health care sector

The project “Promotion and support of the implementation of Directive 2010/32/EU on the prevention of sharps injuries in the hospital and health care sector” builds on the Sectoral Social Partner’s Framework agreement on the prevention of sharps injuries in the hospital and health care sector of 17 July 2009 incorporated in Directive 2010/32/EU.

The deadline for the transposition into national legislation was 11 May 2013.

The project allowed HOSPEEM and EPSU to obtain first hand information on the realities on the ground and on the role of social partners in the transposition of the directive. It also identified guidance to help with the implementation at the workplace level (e.g. as regards risk assessment, training or reporting), and gave inspiration

to those managing and working in the hospital and healthcare sector to have measures in place to reduce risks of workplace exposure to medical sharps injuries, in line with Directive 2010/32/EU.

In the framework of this project, HOSPEEM and EPSU have organized three regional seminars in Dublin (January 2013), in Rome (March 2013) and Vienna (April 2013), and a final conference in Barcelona (June 2013). These events aimed at providing space for mutual exchange on the experiences related to the implementation of the Directive, including the challenges and the problems that might have occurred. The results of a survey addressed to EPSU affiliates and HOSPEEM members were also discussed.The findings gathered during the events, together with the results on the implementation progress in the EU Members States, have been included in the final report from the project that were presented to the European Commission and disseminated.

EPSU member Royal Colleague of Nursing (RCN) on 23 January 2012 issued a press release reacting the PM David Cameron’s speech regarding the European Union where they point to Directive 2010/32/EU as one good example for the benefits and effectiveness of EU employment legislation to protect the health and safety of healthcare staff: “This directive provides much improved protection for nurses and other healthcare workers exposed to the risk of bloodborne viruses such as Hepatitis C from needlestick and other sharps injuries. It was also a directive that was supported by both trade unions and HOSPEEM – the European hospital and healthcare employers’ association”.

Report 1st Regional Seminar Dublin
31 January 2013

Brussels, 5 February 2013 Joint EPSU-HOSPEEM Project “Promotion and support of the implementation of Directive 2010/32/EU on the prevention of sharps injuries in the hospital and health care sector” Regional Seminar 1 – Dublin, 31 January 2013 Godfrey Perera, Chief Executive, HOSPEEM ; John Delamere, Head of Corporate Employee Relations, HSE ; Louise O’Donnell, Coordinator Healthcare Sector, IMPACT ; Tina Weber, ICF GHK (from left to right) during the opening plenary session The first (…)

Report 2nd Regional Seminar Rome
7 March 2013

Brussels, 10 March 2013 Joint EPSU-HOSPEEM Project “Promotion and support of the implementation of Directive 2010/32/EU on the prevention of sharps injuries in the hospital and health care sector” Regional Seminar 2 – Rome, 7 March 2013 The second regional seminar with about 80 participants from 8 European countries (Belgium, Cyprus, France, Italy, Malta, Norway, Spain and the United Kingdom) invited to attend the event took place on 7 March 2013 in Rome. It was hosted (…)

Report 3rd Regional Seminar Vienna
16 April 2013

Brussels, 25 April 2013 Joint EPSU-HOSPEEM Project “Promotion and support of the implementation of Directive 2010/32/EU on the prevention of sharps injuries in the hospital and health care sector” Regional Seminar 3 – Vienna, 16 April 2013 The third regional seminar with nearly 110 participants from 8 EU Member States (Austria, Bulgaria, the Czech Republic, Germany, Hungary, Poland, Romania, Slovakia) as well as from Belarus, Croatia, Kosovo, Moldova and Russia took place on 16 April 2013 (…)

Report Final Conference Barcelona
20 June 2013

Brussels, 26 June 2013/18 September 2013 Joint EPSU-HOSPEEM Project “Promotion and support of the implementation of Directive 2010/32/EU on the prevention of sharps injuries in the hospital and health care sector” Final Conference – Barcelona, 20 June 2013 The final conference with about 95 participants from 24 out of 28 EU Member States (including Croatia to adhere to the EU as of 1 July 2013) took place on 20 June 2013 in Barcelona. It was hosted by EPSU affiliate Federación de Servicios (…)

(Guidelines, Handbooks, Tool Kits, Films)

Film DG EMPL “From needlesticks to sharps. The added value”

In Europe, it is estimated that there are 1 million needlestick injuries annually. Film produced by the European Commission, DG EMPL, on the genesis and the year-long policy process towards the adoption of directive 2010/32/EU to prevent injuries with medical sharps. Watch the video in English: Watch the video in Spanish: Link to DG EMPL webpage for the video in other (…)

“From needle-sticks to sharps. The added value” Success Stories from the EU sectoral social dialogue

The added value of the framework agreement on the prevention from sharps injuries (Directive 2010/32/EU) (…)

Cross-border recruitment and retention: HOSPEEM-EPSU code of conduct

The European Federation of Public Service Unions (EPSU) and the European Hospital and Healthcare Employers’ Association (HOSPEEM) have jointly signed a code of conduct on ethical cross-border recruitment and retention.

Through the code of conduct the European social partners in the hospital sector want to address inequalities and unnecessary burdens on healthcare caused by unethical recruitment practices. With this agreement they establish in the European hospital sector social dialogue a full commitment to promote ethical recruitment practices at European, national, regional and local level.

The choice of the world health day 2008 as the date for the official signature of the agreement is not casual. The cross-border movement of healthcare professional is indeed an increasingly expanding phenomenon that clearly goes beyond European borders. With that global scope in mind, the European social partners wish that the code becomes a source of inspiration inside and outside Europe’s borders and remind that, in addition to European and national legislation and collective agreements, the already existing ILO-conventions in this field should be taken into account, when looking for an appropriate framework to support ethical recruitment and retention practices.

The Secretary General of EPSU, Carola Fischbach-Pyttel, added that, “Healthcare services are an essential part of the European Social model, therefore all relevant actors must be committed to their fair and effective functioning. The contribution of health care workers to good quality healthcare is essential. Social Partners therefore need to address the various challenges different countries are experiencing in terms of health workers shortages and the reasons why healthcare workers decide to migrate. Strategies which promote adequate workforce supply in all countries should be supported. EPSU and HOSPEEM want to encourage, and as far as possible contribute to, the development and implementation of policies at local, national and European level with the purpose to enhance work force retention”.

The Secretary General of HOSPEEM, Godfrey Perera stated that, “The promotion of ethical recruitment practices all over Europe clearly calls for a multifaceted strategy, including not only social partners but also governments, regulatory and professional bodies and other relevant stakeholders at local, regional national and European level. However, with the present agreement European social partners also want to firmly commit to their own responsibilities. For instance, when using the services of external agencies only those with demonstrated ethical recruitment practices should be used for cross-border recruitment. In case exploitative practices occur, these agencies should be removed from agreed lists”.

The code of conduct is based upon 12 key principles and commitments:

  1. High quality health care, accessible for all people in the EU
  2. Registration and data collection
  3. Workforce planning
  4. Equal access to training and career development
  5. Open and transparent information about hospital vacancies across the EU
  6. Fair and transparent contracting
  7. Registration, permits and recognition of qualifications
  8. Proper Induction, Housing and standards of living
  9. Equal rights and non-discrimination
  10. Promoting ethical recruitment practices
  11. Freedom of association
  12. Implementation, Monitoring and Follow-up


The launch of the European Social Dialogue in the Hospital Sector in September 2006 was a crucial step in the development of industrial relations in Europe, as it gave the recognized social partners EPSU and HOSPEEM the possibility to take joint actions in the field of human resources, employment and social policies by using the social dialogue instruments. It also gave employers and workers both jointly and individually the possibility to give direct formal input on EU polices affecting the hospital sector and its workers. As employers’ and workers’ representatives we (the social partners) also want to take up our responsibilities as European social partners according to the provisions of article 138 of the European Treaty. Policy initiatives on the field of cross-border health care have many social aspects and will affect management and labour. FULL TEXT: HOSPEEM-EPSU Code of conduct – EN

The document will be soon available in 13 languages  :
HOSPEEM-EPSU Code of conduct – FR
HOSPEEM-EPSU Code of conduct – DE
HOSPEEM-EPSU Code of conduct – BG
HOSPEEM-EPSU Code of conduct – CZ
HOSPEEM-EPSU Code of conduct – ES
HOSPEEM-EPSU Code of conduct – FIN
HOSPEEM-EPSU Code of conduct – HU
HOSPEEM-EPSU Code of conduct – NL
HOSPEEM-EPSU Code of conduct – PL
HOSPEEM-EPSU Code of conduct – ROM
HOSPEEM-EPSU Code of conduct – RU
HOSPEEM-EPSU Code of conduct – SV

Example for the use and implementation of the EPSU-HOSPEEM Code of Conduct on Ethical Cross-border Recruitment and Retention from The Netherlands:

This table has been elaborated by NVZ (employers), ABVAKABO FNV, NU 91, CNV Publieke Zaak and FBZ (employees) to promote the implementation in The Netherlands : Table Dutch State of Play – EN , Table Dutch State of Play – NL

This presentation by Dutch social partners in the hospital sector describes the transposition of EPSU-HOSPEEM Code of Conduct on Ethical Cross-border Recruitment and Retention (2008) in The Netherlands: Slides by Elise Merlijn, ABVAKABO FNV, Rolf de Wilde, NU’91 and Tjitte Alkema, NVZ, 1 July 2011 – EN

Report on use and implementation of the EPSU-HOSPEEM Code of Conduct on Ethical Cross-border Recruitment and Retention (2008)

The document was adopted in the meeting of the Sectoral Social Dialogue Committee for the Hospital Sector working group 3/2012 on 5 September 2012 by EPSU and HOSPEEM. Final Report Use and Implementation – EN

Other related documents – WHO Code of Practice on the International Recruitment of Health Personnel:

The World Health Organisation Code of Practice was unanimously adopted by the 63rd World Health Assembly in May 2010: WHO Code of Practice (2010) and User’s Guide (2011)

Documents on the implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel :