HOSPEEM-EPSU Joint Project on Tackling Staff Shortages and Ensuring Future-Proofing Skills in Health

Start Date: 01 April 2025

Duration: 24 Months

Description of the project:

Tackling Staff Shortages and Ensuring Future-Proofing Skills in Health (TaSSEFSH) is a joint project between the European Federation of Public Service Unions (EPSU) and the European Hospital and Healthcare Employers’ Association (HOSPEEM), representing at European level national employers’ organisations in the hospital and healthcare sector.

The aim is to collect and exchange good practices from social partners across Europe that address the massive challenges posed by increasing staff shortages that most health providers face. They are finding it difficult to recruit new staff and to retain skilled and experienced workers. The demographic trends in most countries are driving increased demand at the same time as large cohort of health workers come up for retirement.  Understanding the different dynamics and consequences of labour shortages and future-proofing skills in the hospital and healthcare sector at play matters across Europe to deliver quality care, now and in the next decennia.  The evolving landscape of the healthcare sector requires support for skills, training and education.

Through a series of six meetings involving trade unions and employers from across Europe the project will explore the various factors behind labour and skills shortages and exchange good practices. An external consultant will be contracted to follow the project, report on all the meetings and draft a final briefing that will summarise the key debates and focus on the potential solutions.

The discussions and debates will cover:

  • Ageing of the healthcare workforce: In 11 countries of the European region, a significant demographic shift is imminent as at least 40% of doctors are aged over 55 and are expected to retire in the coming decade. The European Commission Ageing Report 2021 highlights Italy as having the highest participation rate among older population in 2019 with one of the highest percentages of health workers aged 50 and above at 42%, compared to the European average of 36%. The meeting will debate how to attract and retain experienced healthcare workforce while fostering the recruitment of young healthcare professionals. It will include case studies provided by EPSU and HOSPEEM member organisations.
  • Intra-EU mobility and migration: The free movement of labour stands as an achievement of the European Union, aligning with the principles of the European Pillar of Social Rights promoting labour mobility across borders. While some countries experience a negative impact from labour migration, others benefit from the enhanced workforce mobility and cross-border collaboration. Factors such as social benefits, level of pay, working conditions, skills development can play pivotal roles in shaping the healthcare workforce landscape. Additionally, language proficiency serves as a compelling incentive, as evidenced by countries like Ireland leveraging language requirements to attract healthcare professionals. Despite investing in training their health workforce, some countries, especially in Eastern and Central Europe experience staff shortages due to healthcare workers deciding to move to another country. EPSU and HOSPEEM agreed on guidelines for ethical cross-border recruitment in 2008 and this project will contribute to the renewal of the commitment of social partners to promote, guarantee and defend decent recruitment and working conditions for workers from and outside the EU. The workshop will explore what can be done to inspire workers to stay in their country of origin and to support migrant workers and intra- EU mobile workers in receiving countries.
  • Temporary work agencies: In order to deal with staff shortages EU policymakers need to consider the role of a diverse workforce, including private employment agencies that have placed 12.4 million people in labour markets in Europe (11.2 million participated through temporary agency work which had implications for the labour market). Many EU Member States find themselves compelled to use the services of temporary work agencies and thus often compensate for the staff shortages in hospitals. Although temporary work agencies can improve the situation with limited work capacity of healthcare professionals, some countries are experiencing a situation in which companies are exploiting the scarcity of healthcare profiles to establish profitable businesses. For instance, temporary staffing companies actively recruit nurses who are currently employed on permanent contracts, offering them additional benefits on top of their current salary, and allowing them to demand more regarding their schedules. This leads to unequal salary and working conditions between permanent and temporary staff in the workplace. The workshop will consider how the health care sector can become more resilient and make relations with the temporary work agencies more balanced again and what alternatives can be provided by the health sector.
  • Digitalisation: During the pandemic digitalisation helped reduce exposure to the virus and ease administrative burdens. The Social Partners underline that digitalisation will never replace human care delivery. Instead, it can lighten the workload, which can create more time for effective and quality care. The workshop will focus on how digitalisation and AI can softenstaff shortages and support health staff in doing their job while ensuring the protection of workers and patients.
  • Future-proofing skills and career pathways: Future-proofing skills and career pathways for the healthcare workforce is crucial in order to navigate in evolving landscape of the sector. The EU action plan on Labour and Skills shortages includes support for skills, training and education as one of the key policy areas to tackle staff shortages. Emphasising continuous learning and developing soft skills can improve patient-centred care and create a pool of well-trained and motivated healthcare workforce. The corresponding Joint Declaration on Continuous Professional Development and Life-long Learning signed by HOSPEEM and EPSU in 2016 acknowledges the connection between investments in LLL and CPD and improving the quality of training, which in turn improves the attractiveness of the sector.
  • Practical solutions in collective bargaining: Collective bargaining addresses the multifaceted challenges facing the healthcare workforce. Practical solutions can be identified and implemented to improve working conditions and enhance job satisfaction. The workshop will consider how social partners can design innovative solution to address staff shortages through collective agreements.
  • Work-life balance: The updated Framework of Action on Recruitment and Retention agreed between EPSU and HOSPEEM called for Member States to develop supporting infrastructures to facilitate work- life balance in a 24/7 service delivery context. It also said that to facilitate the full participation of men and women in the labour market, healthcare employers and social partners should take measures and develop policies that will improve workers’ work-life balance. The workshop will discuss the measures that social partners and governments have introduced to increase retention of personnel.
  • Mental health: The pandemic put more stress on health workers, with many of them reporting burnouts or considering leaving the sector. The sector is not resilient with a health workforce reporting stress overload. This workshop will exchange on good examples on mental health support for healthcare workforce and what impact it has on staff retention.

Harnessing Talent Platform Working Groups in-person meeting

On 11 October 2024, the European Commission’s DG REGIO hosted partners of the Harnessing Talent Platform, a knowledge-building and experience-sharing initiative aimed at fostering dialogue among relevant stakeholders at the European, national, and regional levels. Since the establishment of four working groups in autumn 2023, focusing on Digital, Health, Research & Innovation, and Territorial issues, eleven issue papers have been published. These papers identify the scope of the challenges and propose actionable outputs.

This meeting brought together representatives from all working groups to discuss key issues, short- and long-term outcomes, and potential synergies within the platform and with other EU initiatives, such as the Pact for Skills, the European Cluster Collaboration Platform, and the Rural Revitalisation Platform.

In his opening remarks, François Gallaga (DG REGIO) emphasised that the competitiveness of the European economy depends on its ability to address current and future skills gaps. Following parallel meetings of the working groups, participants identified cross-cutting issues, reflected on external synergies, and discussed the next steps to deliver outputs in line with the work plan.

HOSPEEM is part of the Health Working Group, which focuses on the subtopic of improving service models and working conditions.

Learn more

HOSPEEM participates in the panel discussion during European Week of Regions

On 10 October 2024, Olena Horlach represented HOSPEEM at a panel discussion organized by the European Committee of the Regions’ Interregional Group on Health and Well-being, the European CoR’s Commission for Natural Resources (NAT), and EUREGHA – the reference network for European Regional and Local Health Authorities on the topic of “Strengthening Europe’s Healthcare Workforce: Attracting and retaining talent in a regional context” as part of the European Week of Regions.

Staff shortages, working conditions, and skills mismatches are having a significant impact on access to care and performance of healthcare system. Attracting and retaining talent across Europe’s regions is a key strategy to address this issue. This interactive session explored the difficulties and potential solutions for strengthening Europe’s healthcare workforce and increasing the sector’s attractiveness, in line with existing EU initiatives such as the Harnessing Talent Platform and the Pact for Skills.

HOSPEEM acknowledged that the main challenges include ageing population, work migration and working conditions amongst others. The EPSU-HOSPEEM Updated Framework of Action on Recruitment and Retention examines various remedies to these issues, while considering the 24/7 operational nature of the healthcare sector. Meanwhile, the EPSU-HOSPEEM Code of Conduct on Ethical Recruitment and Retention enables social partners in the hospital and healthcare sector address inequalities and promote ethical recruitment practices at European, national, regional and local level.

10 October 2024, 1143: Strengthening Europe’s Healthcare Workforce: Attracting and retaining talent in a regional context
Belgium – Brussels – October 2024
© European Union / John Thys

John Delamere speaks at online seminar of the cross-sectoral social partners on working time

HOSPEEM Vice-Secretary General John Delamere participated in a seminar of the cross-sectoral social partners on the topic “Shaping working time: role of collective bargaining” which explored the perspectives of social partners and addressed key priorities, including sector-specific needs related to working time, as well as the challenges and opportunities associated with working time organisation. The goal of the meeting was to promote mutual learning on policy initiatives and practical actions taken by social partners in this area.

During the seminar, John Delamere emphasised the challenges of hospital and healthcare employers in relation to the Working Time Directive and the organisation of working time in Europe, given the healthcare sector’s continuous operational nature, which often cannot align with rigid working time limits. Alongside other representatives of public service employers, John Delamere highlighted the difficulties in offering working time reductions in sectors experiencing labour shortages and an ageing workforce. The continuity of care and the need for timely emergency responses require a re-evaluation of rest periods and shift patterns, while also considering workers’ well-being and avoiding staff overburdening.

10-year anniversary of the EPSU-HOSPEEM Code of Conduct on Ethical Cross-Border Recruitment and Retention

MEDIA RELEASE

In their first Working Group meeting of the European Social Dialogue in the Hospital Sector, on 04 April 2018 HOSPEEM and EPSU looked back to the signing of the EPSU-HOSPEEM Code of Conduct on Ethical Cross-Border Recruitment and Retention on 8 April 2008 and renewed their commitment to promote, guarantee and defend decent recruitment and working conditions for migrant workers, from the EU and from outside the EU, in hospitals and healthcare facilities across Europe. 

HOSPEEM and EPSU issued a Joint Media Release on the 10 years anniversary of the Code of Conduct. It represents an important instrument to support the free movement of workers across the European Union while preventing unethical competition between the Member States and employers in terms of cross-country recruitment process, fair and transparent contracting and the induction of migrant workers at the new workplace. This also holds for their equal and non-discriminatory treatment regarding labour law, social protection provisions and the access to training and career progression and the freedom of association.  

The EPSU-HOSPEEM Code of Conduct on Ethical Cross-Border Recruitment and Retention was inspired by social partner-based or/and public policy tools already in use in different European Union Member States. At international level, the World Health Organisation (WHO) on 21 May 2010 adopted and set into practice the WHO Global Code of Practice on the International Recruitment of Health Personnel. The Global Code, non-binding in nature, addresses a number of similar issues already covered with in the EPSU-HOSPEEM Code of Conduct. 

In the meeting on 4 April 2018, HOSPEEM and EPSU members reiterated their commitment to the 12 key principles of their 2008 Code of Conduct and to the promotion of ethical recruitment and retention practices at European, national, regional and local level in the upcoming years, both in their own work and in the broader context of the European Pillar of Social Rights. 

Tjitte Alkema, Secretary General of HOSPEEM reflected on the impact of the Code of Conduct: “10 years ago, our Code of Conduct was an inspiration for the work of the World Health Organisation. Nowadays, given the migration flows to and within the European Member States, it is still very relevant. 

EPSU General Secretary Jan Willem Goudriaan welcomed the constructive dialogue there has been with the European employers since the Code of Conduct. “We sought to ensure decent working conditions for all, to prevent the exploitation of migrant workers and to make sure public health systems are not undermined by unfair recruitment practices. Our Code was and is a significant contribution to achieve sustainable quality care for all.”  

At the meeting on 4 April 2018, several HOSPEEM members and EPSU affiliates commented on the use and positive effects of the EPSU-HOSPEEM Code of Conduct on Ethical Cross-Border Recruitment and Retention. They also referred to different models of how the 12 principles of the Code of Conduct have been incorporated in their national contexts, either into legislation, by means of collective agreements and/or by using enterprise-based agreements. 

Kate Ling, NHS Confederation, United Kingdom, gave an overview on the use by the employers in the NHS and about the effects of the Code of Conduct in the United Kingdom, showcasing some good practice examples: “NHS organisations should only use recruitment agencies that comply with the Code, which includes guarantees to give overseas recruits good induction, training and employment protection. A key tenet of the UK Code is that recruitment of staff from abroad should not damage healthcare systems in developing countries.  Active recruitment from developing countries shouldn’t take place unless there is a government-to-government agreement. For example, the UK and India have a scheme called Earn Learn and Return where staff from India can come to the UK to fill shortages in specialist areas, and in return they get the opportunity to gain specialist expertise and develop skills that they can then take back with them after they leave the UK to improve healthcare in India. So, both countries benefit.” 

Tjitte Alkema wrapped up the Working Group meeting, reflecting on the freedom of movement of persons in the European Union and the respective aim of the Code of Conduct: “We are in the European Union: one of the fundamental rights is the freedom of movement of people within the European Union. Our Code of Conduct is trying to establish a fair system of mobility in which people are not exploited and countries are not suffering from the mobility of workers. The Code of Conduct is however only as strong as the partners that support it. It only works if we also identify incorrect application, put them on the table and make them transparent. The WHO Code and the Code of Conduct of the Social Partners are complementary in the European setting.”

PDF - 304.4 koMedia release

EPSU has also published an article on the event and the 10-year anniversary celebration.

Kick-off of the Joint Action on European Health Workforce Planning and Forecasting

After two years of preparation the Joint Action was officially launched. The inauguration meeting gathered together seven Work Packages’ teams, including collaborative partners, representatives of the European Commission and other stakeholders. The main aims of the project are to improve data collection on mobility at EU level; support the healthcare workforce planning and forecasting; estimate future needs in terms of skills and competences; establish a European network for planning and forecasting. HOSPEEM participated in the meeting as a collaborative partner  in the Work Package 4 on Data for Healthcare Workforce Planning and the Work Package 6 on Horizon Scanning.