Assessing future health workforce needs
Policy SummaryDraft for consultation
Gilles Dussault, James Buchan, Walter Sermeus, Žilvinas Padaiga
Leuven April 2010
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Policy Summary
• The challenges of future HW needs/ requirements assessment
• Approaches, strategies and tools• Country experiences• Lessons• Policy questions for the EC• Key messages
Questions?
• Do we need future HW needs assessment? YES
• Is it difficult? YES, very• How to get started?
– What are your service objectives?– What is the HW present situation?– What are trends which will affect HW needs?– What do stakeholders say?
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The relationship between needs and objectives
HEALTH OBJECTIVESHEALTH NEEDS
SERVICES NEEDS
RESOURCES NEEDS
SERVICES OBJECTIVES
RESOURCES OBJECTIVES
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A simple model of the dynamics of the supply of health workers
Education pipeline
Immigration
Contracting
Stock of health
workers
Retirement
Attrition
Emigration
Returners
Facilitators & Obstacles
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The challenges of HW needs assessment
• Estimating future needs and demand• How will supply and labour market evolve?• Methodological issues: databases,
definitions, sector vs occupation approach• Policy/political : vision, stakeholders,
continuity
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4 approaches
• Health worker to population ratio • Service-target • Utilization and demand approach. • Health and service needs
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Country experiences
• England, Finland, Germany, Lithuania, Slovenia, Spain , Australia and Canada
• + Belgium, Ireland• Most countries do not have an
explicit HW development strategy
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Lessons
• Assessing HW needs helps prevent/mitigate imbalances
• Focuses the debate on data and facts
• Important that policymakers declare their values, principles and policies
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Lessons
• Future needs are not only numbers; skills-mix, competencies, working conditions, productivity and quality
• Quantitative models and tools are needed, but no substitute to judgments
• Importance of information base
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Lessons
• Need to look at the HW as a whole• Importance of engaging
stakeholders • Forecasting future needs is difficult
when decentralized• No agreement on planning horizon
lengths
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Lessons
• Implement strategies in a flexible manner, based on careful monitoring
• Not doing anything or reacting only when problems become sensitive has high costs
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Policy questions (some...)
• Should there be EU standardized definitions of health occupational categories and of health labour market indicators?
• • Should EU propose (require) the utilization of
standardized data collection tools and reporting formats?
• What is the role of EU in that respect, relative to that of technical agencies like WHO?
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Policy questions (some...)
• Would it be opportune to create a EU Observatory?– to support countries in developing their HW database,
in analyzing data, in developing HW policies– to consolidate country information and produce
regional analysis– to monitor, analyze and disseminate country
experiences
• Should EU encourage and technically support inter-country HW development, for instance between countries which already experience important cross-border movements?
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