Summary

Health professionals fulfil a variety of highly-skilled roles relevant to medical or veterinary areas.

Key facts:

  • Health professionals fulfil a variety of highly-skilled roles relevant to medical or veterinary areas.
  • The five key skills required for these workers are problem solving, communication, learning, teamwork and planning.
  • Demand for health professionals is particularly high across EU as all but three Member States report their shortage. Surpluses of health professionals are rare as they only affect two EU countries.
  • Employment grew by 12% during the 2005-2015 period. Over the next 10 years, about 5% more health professionals are expected to be employed.
  • Around three million job openings are expected, about 90% of which will be driven by replacement demand that reflects ageing health workforces across Europe.
  • Increasing demand for healthcare services, driven by demographic shifts and changing lifestyles throughout Europe is likely to maintain the number of jobs in the traditional health sector , over the next decade.

Who are they?

Health professionals [1] fulfil a variety of highly-skilled roles relevant to medical or veterinary areas. They may conduct research and obtain scientific knowledge regarding human or animal disorders, and how to treat them; apply, or advice on, curative and preventative treatments to patients, and promote good health; or prepare scientific, medical reports. This professional group is made up of a wide range of sub-occupations, including general medical doctors, nursing and midwifery professionals, audiologists, physiotherapists, veterinarians and other specialists responsible for consulting on and providing, diagnostic, and treatment services.

What skills do they need?

According to Cedefop’s European skills and jobs survey (ESJS), the key 5 skills for these workers are problem solving, communication, learning, teamwork and planning. These skills could support employees in this occupation to also tackle anticipated future skill challenges (see drivers of change below).

Figure 1: Most important skills required for health professionals

Cedefop has mapped the countries in which occupations are in surplus or shortage. For more information please see here

Where are they mostly in demand?

The labour market dynamics for this occupation differ across EU Member States:

Figure 2: Shortages and surpluses for health professionals across the EU

According to Cedefop, demand for health professionals is particularly high across EU member states, with most countries suffering from skills shortages. Within this occupation, medical doctors as well as nursing and midwifery professionals are singled out as highly needed occupation in Austria, Belgium, Bulgaria, Czech Republic, Denmark, Germany, Ireland, Cyprus, Luxembourg, Hungary and Slovakia. However, a shortage of medical doctors has been documented in Spain, France, Croatia, Italy, Latvia, Lithuania, Portugal and Romania while shortage for nursing and midwifery professionals is found in Estonia and the United Kingdom. On the other hand, health professionals are reported to be in surplus in the Netherlands while a surplus of veterinarians is registered in Belgium.

Employment grew by 12% during the 2005-2015 period. Over the next 10 years, about 5% more health professionals are expected to be employed. Around 3 million job openings are expected, about 90% of which will be driven by replacement demand [3] that reflects ageing health workforces across Europe [4].

It comes as no surprise that over 85% of these professionals are traditionally and will continue to be highly qualified. National and EU regulations require professionals within this occupational group to train for a minimum of four or five years to receive their license to practice. In some Member States, health professionals must also demonstrate that they are expanding their skillset, and provide clear evidence that they are engaging in continuing professional development activities, to receive their licenses [5].

Increasing demand for healthcare services, driven by demographic shifts and changing lifestyles throughout Europe is likely to maintain the number of jobs in the traditional health sector [6], over the next decade. It can also be said that the development of emerging techniques and technologies will play a part in the increased number of health professionals working in the teaching sector by 2025 (13%). Other sectors experiencing growth in the number of health professionals employed include the public administration and defence sector, which will increase by 6%, as well as the number of professionals working in the retail and wholesale sector, which will see a 23% increase in employment by 2025.

Which drivers of change will affect their skills?

Despite there being very different skills profiles for individual roles within the health sector, this diversity of specialisms can be affected by common drivers of change. Drivers can be identified in relation to shifting demographic patterns, new forms of healthcare provision, and the development and integration of technology into practice.

  • Most European countries are undergoing demographic shifts, which alter the key areas of demand in national healthcare systems. Population ageing drives demand for specialised skills on how to treat long-term illnesses associated with old age, such as dementia and Alzheimer’s [7]; and other age-related health conditions; for example, dentists will have to acquire skills on geriatric dentistry or gerodontology, midwives will need to consult and provide care to women of increasing age at childbirth [8]. Levels of risk and complexity increase when handling old-age patients [9], so some risk management skills could also be relevant for health professionals.
  • Shifting patterns of healthcare provision (emphasising telemedicine and personalised medicine as well as more preventative actions, such as health coaching, health promotion and patient empowerment) are likely to change the skills needs of healthcare professionals. Staff will be expected to possess soft skills, such as: adaptability in relation to new techniques; taking charge of learning processes; and the ability to communicate complex information with a diverse range of patients [10]; as well as communication and management. The latter are increasingly necessary to coordinate multidisciplinary teams of care service providers, such as nurses, care home staff and psychiatric practitioners.
  • Technological advancements continuously expand the potential of health professionals in clinical decision-making and advance care delivery. Health care delivery is revolutionised by disruptive technologies [not necessarily created for medical purposes (such as mobile devices, the Internet, big data, and analytics)] and eHealth applications (EHRs). The use of ICT can have significant benefits for patients: for example, a medical doctor in a hospital can reach the diagnosis more quickly and with greater accuracy by using an ICT expert system than by traditional methods. The doctor inserts patients’ data in the system, which delivers a diagnosis. The system may be able to draw intelligence from medical books and recent reports/publications to reach the diagnosis and even recommend treatments or additional lab testing [11].
  • These technologies also enrich the government data by digitising, collating, and analysing patients’ records. All this inevitably augment and expand health professionals’ skills palette. Healthcare specialists should possess and continuously develop technical skills and experience using health-relevant emerging techniques and methods[12].

Personalised forms of treatment present an increasingly important trend of delivery of clinical diagnosis and provision of medical advice. Made available through e-tools, it can better serve an increased number of elderly and other patient groups, even in remote areas. Soft skills such as effective communication skills to engage patients in new ways, through telephone communications or via online platforms gain importance. Deeper understanding of other aspects is also important, such as personalised prevention and treatment methods and a greater awareness of other evidence-based best practice [13].

“mHealth (mobile health) is one of the tools that could help EU Member States maintain sustainable healthcare systems as it could support more efficient delivery of care. It should be noted that the work pressure of health care professionals is high. Introducing mHealth services may, in the beginning, require training in order to adapt and develop their digital skills”.

Source: European Commission Green Paper on mHealth.

 
  • In the post-crisis time, national healthcare budgets are still under budgetary constraints in many Member States. Professionals may need to adapt their management skills to ‘get more for less’ (e.g. improving cost-benefit analyses of procedures and prescriptions) and implement structural reforms (e.g. towards community care settings) [14].
  • Organisational changes, induced by decreasing budgets and the need to maintain quality of care with minimal resource expense [15], have led to the blurring of roles between healthcare professionals in different areas and at different levels of seniority. There has also been a renewed push for training nurse practitioners in a number of countries, who will take on some of the roles already carried out by consultants and other medical practitioners. Nurse practitioners, and other health professionals carrying out an expanded role, should be able to demonstrate complex decision-making skills, clinical expertise and high-level qualifications (i.e. master’s level) [16]. A similar change has begun occurring in the UK, where paramedic practitioners have gained an expanding role in providing care in the community, thus reducing the flow of patients visiting accident and emergency departments [17]. Other health professionals are likely to work across care delivery boundaries, in a variety of settings, with a growing emphasis on community care [18].
  • The incorporation of greater ‘consumer’/patient choice in public health systems has led to greater use of data sharing to provide more personalised services and greater accountability for patients- what is known as ‘transparency’ [19]. Data regarding the performance of primary care providers have been made available to patients and competitors to promote consumer choice and increase the quality of care. Healthcare professionals will need to be aware of their service quality, especially in comparison to other healthcare providers, and command updated skills in terms of quality management systems.

How can these skill needs be met?

As their core work regards health, one of the main public goods, supporting and upskilling these professionals is often high in political agendas. The challenge of improving the efficiency of health systems troubles several EU Member States [20]. Coupled with suitable funding and improved accessibility, training health professionals and ensuring good working conditions could be one of the focus health policy areas.

The demand for specialist qualifications in new and emerging technologies opens opportunities for education and training providers, who play a part in healthcare professionals’ initial education as well as in their continued professional development. According to the World Health Organisation, the education of medical students must have a much greater emphasis on providing contextual and integrative competences that can be directly applied to the challenges they are going to face in the profession. Identifying key competencies during initial training represents the first step, outlined by the WHO, which must then be continually built upon throughout each medical professional’s career so as to ensure that they keep pace with evolving practices. A constant awareness of emerging practices and technologies is also important in the case of preventative medicine and health promotion. General practitioners, for example, increasingly need to be trained to act as health coaches as well as provide the traditional services, like administering treatments [21]. Supporting the population’s ability of self-care will therefore, be an important learning area for all health professionals [22].

To effectively respond to the social, technological and economic changes, continuing professional development will need to touch upon a wide range of topics, on top of medical/scientific developments. For example, training could focus on patient safety, e-Health and IT systems, new technologies (equipment), intercultural communication and care for the elderly as commonly covered areas [23]. All health professionals will need to have skills pertinent to providing health care and advice on older populations, challenged by disabilities, old-age frailty or chronic diseases [24].

These professionals often attend conferences and symposia, learning from new case presentations, utilising e-learning resources, and completing hands-on clinical courses [25]. The coordination and monitoring of these events, and of health professionals’ development, is predominantly carried out by scientific societies and professional organisations. Accessibility to these services is crucial, and so professionals’ participation should be facilitated.

Continued professional development activities need to evolve in line with emerging practices. On a policy level, this stresses the importance of coordination between policy makers, training and education providers and health professionals’ association.

References

[1] Defined as ILO ISCO 08 group 22 health professionals. ILO, (2012) International Standard Classification of Occupations ISCO-08. More information on this occupational group can be found here.

[3] The need to replace workers leaving a profession for various reasons, such as retirement. More information on replacement demand and how it drives employment across sectors, can be found on the Skills Panorama here.

[4] Fellows, J. and Edwards, M., 2016, Future skills and competences of the health workforce in Europe, Report for the Joint Action Health Workforce Planning and Forecasting www.healthworkforce.eu

[5] European Commission, 2016, Study concerning the review and mapping of continuous professional development and lifelong learning for health professionals in the EU

[7] The King’s Fund, 2014 ,Making our health and care systems fit for an ageing population, viewed 30 May 2016

[8] Fellows, J. and Edwards, M., 2016, Future skills and competences of the health workforce in Europe, Report for the Joint Action Health Workforce Planning and Forecasting www.healthworkforce.eu

[9] The King’s Fund, 2014, Making our health and care systems fit for an ageing population, viewed 30 May 2016

[10] Fellows, J. and Edwards, M., 2016, Future skills and competences of the health workforce in Europe, Report for the Joint Action Health Workforce Planning and Forecasting www.healthworkforce.eu

[11] European Commission 2016, ICT for work: Digital skills in the workplace – SMART 2014/0048, intermediate report

[12] Sweeney, A., 2015, Nanomedicine Concepts in the General Medical Curriculum: Initiating a Discussion, International Journal of Nanomedicine, 10, pp. 7319–7331, viewed 30 May 2016 and European Commission 2015, Personalised Medicine, viewed 01 July 2016.

[13] UK Commission for Employment and Skills, 2015, Sector insights: skills and performance challenges in the health and social care sector, viewed 30 May 2016.

[14] Thomson, S., Figueras, J., Evetovits, T., Jowett, M., Mladovsky, Ph., Maresso, A., Cylus, J., Karanikolos, M. & Kluge, prepared for the World Health Organisation 2015, Economic Crisis, Health Systems and Health in Europe: Impact and Implications for policy, viewed 30 May 2016.

[16] Niezen, G. H. M., Mathijssen, J. P. J., 2014 , ‘Reframing professional boundaries in healthcare: A systematic review of facilitators and barriers to task reallocation from the domain of medicine to the nursing domain’, Health Policy, Vol. 117, no 2, pp.151-169

[17] Morris, D., 2016, ‘The new breed of paramedics charged with keeping people out of hospital’, The guardian, 20 January 2016, viewed 30 May 2016.

[18] Fellows, J and Edwards, M 2016 Future skills and competences of the health workforce in Europe, Report for the Joint Action Health Workforce Planning and Forecasting www.healthworkforce.eu

[19] McKinsey & Company, 2011, Transparency: The most powerful driver in healthcare

[20] European Commission, 2016, 2016 European Commission’s Country Specific Recommendations, viewed June 27 2016.

[21] The Kings Fund, 2010, A Pro-Active Approach. Health Promotion and Ill-health prevention, viewed 29 May 2016.

[22] Fellows, J. and Edwards, M., 2016, Future skills and competences of the health workforce in Europe, Report for the Joint Action Health Workforce Planning and Forecasting www.healthworkforce.eu

[23] European Commission 2016, Study concerning the review and mapping of continuous professional development and lifelong learning for health professionals in the EU.

[24] Fellows, J. and Edwards, M., 2016, Future skills and competences of the health workforce in Europe, Report for the Joint Action Health Workforce Planning and Forecasting www.healthworkforce.eu

[25] European Commission, 2016, Study concerning the review and mapping of continuous professional development and lifelong learning for health professionals in the EU.