Without immediate action, health and care workforce gaps in the European Region could spell disaster

All countries of the WHO European Region – which includes 53 member states across Europe and Central Asia – currently face serious challenges related to their health and care workforce, according to a new report released by WHO/Europe today. An aging workforce is the most important among them. The analysis found that 13 of the 44 countries that reported data on this issue have a workforce in which 40% of physicians are 55 or older.

The healthcare and healthcare workforce was a serious problem before the COVID-19 pandemic, but it’s even more worrisome now, with severe fatigue and demographic factors contributing to an ever-shrinking workforce. Properly replacing retired doctors and other health and care workers will be a major policy concern for governments and health authorities in the coming years. WHO/Europe is urging countries to act now to train, hire and retain the next generation of health and care workers.

Another major finding of the report is the poor mental health of this workforce in the Region. Long working hours, inadequate professional support, serious staffing shortages, and high rates of COVID-19 infection and death among frontline workers — especially during the early stages of the pandemic — have left their mark.

Absenteeism of health workers in the Region increased by 62% amid the first wave of the pandemic in March 2020, and mental health problems were reported in almost all countries of the Region. In some countries, more than 80% of nurses have reported some form of pandemic-induced psychological distress. WHO/Europe has received reports that as many as 9 out of 10 nurses have announced their intention to leave their jobs.

“My personal journey through this pandemic has been choppy,” said British nurse Ms Sarah Gazzard. I held a phone next to a dying woman’s ear while her daughter was finally saying goodbye. It was very difficult for me, so I asked for some support to help me cope.”

Mixed picture across the region

While 53 countries in the Region have, on average, the highest availability of physicians, nurses and midwives compared to other WHO regions, countries in Europe and Central Asia still face significant shortages and gaps, with significant differences in the subregion.

Availability of health workers varies 5 times between countries. The overall density of doctors, nurses, and midwives ranges from 54.3 per 10,000 people in Turkey to more than 200 per 10,000 people in Iceland, Monaco, Norway and Switzerland. At the subregional level, the countries of Central and Western Asia have the lowest density, while the countries of Northern and Western Europe have the highest density.

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These problems are exacerbated by insufficient data and limited analytical capacity, poor management and administration, lack of strategic planning, and insufficient investment in workforce development. Furthermore, the World Health Organization estimates that as many as 50,000 health and care workers may have died from COVID-19 in Europe alone.”

Dr. Kluge warned, “All of these threats are a ticking time bomb which, if not addressed, has the potential to lead to poor health outcomes across the board, long waiting times for treatment, many preventable deaths, and possibly a collapse of the health system. It is time to address the workforce shortage in health and care. Moreover, countries are responding to challenges at a time of acute economic crisis, which requires effective, innovative and smart approaches.”

Ms. Annika Schröder is a midwife from Germany who works in a hospital where about 950 births are carried out every year. There, the challenges mirror those seen across the region. “I often work in shifts without even being able to go to the toilet, without breaks or time to eat,” she told WHO/Europe.

“Doorbells and phones ring as we rush from room to room. On average, I take care of two women in labor at once. That’s not how I envisioned my day-to-day career or work life. I often feel overwhelmed and tired. The shortage of midwives makes Childbirth is unsafe. Since the pandemic, things have gotten worse. This affects the physical and mental health of midwives, mothers, women in labor and infants, Ms. Schroeder explained.

Based on the most recent data available for 2022, the region has on average:

  • 80 nurses per 10,000 people
  • 37 doctors per 10,000 people
  • 8 physiotherapists per 10,000 people
  • 6.9 pharmacists per 10,000 people
  • 6.7 dentists per 10,000 people
  • 4.1 midwives per 10,000 people.

In the WHO Global Strategy on Human Resources for Health 2016, the overall density threshold for health workers was set at 44.5 doctors, nurses and midwives per 10,000 people. Thus, all countries in the region are currently above the threshold, but this does not mean that they can tolerate complacency. There are serious health and care workforce gaps and shortages, which will only get worse over time without policies and practices to address them.

Rising to the Challenge: Examples from Countries

“Countries will need to rethink how they support and manage their health workforce. They will need to design strategies that reflect their contexts and needs, because there is no one-size-fits-all approach,” said Dr. Natasha Azopardi-Muscat, Director of Country Health Policies and Systems at WHO/Europe. everybody”.

“The Region is at a critical juncture: strategic planning and smart investment are critical next steps to making sure that our health workers have the tools and support they need to care for themselves and their patients. Society will pay a heavy price if we fail to meet this challenge. This new report presents the data it includes on each One of our member states, we have solutions and opportunities that we should not miss.”

Many countries across the region have already begun to take bold and innovative steps. In Ireland, where there will be more people aged over 65 than under 14 by 2028, the government has introduced the Enhanced Community Care Program to help seniors maintain their independence. The program relieves pressure on the hospital system by providing enhanced community care services for seniors in cities and villages across the country.

In Kyrgyzstan, the government has introduced a pay-for-performance system in primary health care. The goal is to attract more doctors by increasing the salaries of those who perform their duties well. The system also includes an offer for specialists to retrain as family physicians, as 30% of family physicians were of retirement age in 2020.

In the UK, the government has been hiring overseas-trained nurses and midwives to replace those who retire or leave the profession. Currently, nearly 114,000 foreign trained nurses are registered there – an increase of 66% since 2017/2018. Conversely, the number of trained nurses in the European Union (EU) / European Economic Area (EEA) decreased by about 18% over the same period. This is likely driven by the UK’s decision to leave the EU, and reflects a significant shift from hiring nurses from the EU/EEA to hiring from other regions and countries, particularly India, Nigeria and the Philippines.

Despite progressive steps in many places, more investment, innovation and partnership are needed to avoid further health and care workforce shortages in the future. WHO/Europe urges all Member States – even those with above-average labor densities – not to waste time by taking the following: 10 actions To strengthen the health and care workforce:

  1. alignment Education with the needs of the population and the requirements of the health service
  2. strengthen – strengthen Professional development to provide the workforce with new knowledge and competencies
  3. sought Use digital tools that support your workforce
  4. Develop Strategies that hire and retain health workers in rural and remote areas
  5. Create Working conditions that promote a healthy work-life balance
  6. Protect Mental health and wellness for the workforce
  7. Builds Leadership capacity for workforce governance and planning
  8. to improve Health information systems to improve data collection and analysis
  9. a plus Public investment in workforce education, development, and protection
  10. to improve Use of funds for innovative workforce policies.

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