Assessing future health workforce needs

Policy SummaryDraft for consultation

Gilles Dussault, James Buchan, Walter Sermeus, Žilvinas Padaiga

Leuven April 2010

2

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?

3

4

The relationship between needs and objectives

HEALTH OBJECTIVESHEALTH NEEDS

SERVICES NEEDS

RESOURCES NEEDS

SERVICES OBJECTIVES

RESOURCES OBJECTIVES

5

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

6

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

7

4 approaches

• Health worker to population ratio • Service-target • Utilization and demand approach. • Health and service needs

8

Country experiences

• England, Finland, Germany, Lithuania, Slovenia, Spain , Australia and Canada

• + Belgium, Ireland• Most countries do not have an

explicit HW development strategy

9

Lessons

• Assessing HW needs helps prevent/mitigate imbalances

• Focuses the debate on data and facts

• Important that policymakers declare their values, principles and policies

10

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

11

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

12

Lessons

• Implement strategies in a flexible manner, based on careful monitoring

• Not doing anything or reacting only when problems become sensitive has high costs

13

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?

14

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?