Event summary, /

The third meeting of the European Commission’s Health Policy Platform Thematic Network on “Profiling and training the health care workers of the future” took place on Monday 22 June 2020 via webinar. The event was organised by Health First Europe and EHMA, as coordinators of the EUHPP Thematic Network dedicated to “Profiling and training the health care workers of the future”. The meeting aimed at discussing the issue of training and core competencies for nurses, the importance of which has been highlighted by the current COVID-19 pandemic. The ways in which healthcare systems and policymakers can support nurses’ education and training to develop their core skills for delivering care was a key theme of the webinar. Speakers presented case studies on core skills and policy actions to enhance nurses’ indispensable role in ensuring continuity of care as well as in identify and implementing best practice models and innovative solutions to improve patient care.

Nursing staff’s education and training are essential to developing skills and competences for the provision of integrated care, especially for those patients coping with chronic conditions and various comorbidities. Digital solutions have a great role to play in ensuring continuity of care, provided that health care professionals are trained for their use as well as involved in identifying the most effective digital tools. Investing in digital skills and in healthcare workers’ education and specialisation is key for building resilient healthcare systems characterised by high patient safety standards. A robust approach to the training and specialisation of nursing staff would be essential not only for dealing with emergencies but for addressing the needs of an increasingly aging population.

Opening the discussion, Mr. Reinhard Waldhör from the Health Trade Union and Public Services Union of Austria, presented a 2019 scoping review on acceptance, effectiveness and efficiency (AEE) studies of informal and formal care technologies authored by Krick et al. The main aim of the review was to examine the existence, usage and benefits of digital technologies in nursing care as well as their potential for offering solutions to problems such as the shortage of skilled workers and the increasing demand for long-term care. Summarising the approach and findings of the scoping review, Mr. Waldhör highlighted the importance of applied AEE evaluation methods as well as on the issue of efficiency of digital technologies deployed in nursing care specifically. He also stressed that sufficient funding should be made available to enable large-scale, long-term evaluations of technologies in the practice of care, filling the research gaps for technologies, target settings and target groups identified in the review.

Departing from those recommendations, Dr. Viorel Rotila, Professor of Social Sciences and President of Health Care Trade Union of Romania (FSSDR), introduced the case study of Romania. Departing from the experience of the Romanian health system, Dr. Rotila discussed the impact of new technologies on nurses as well as the challenges faced by nursing staff when adapting to new professional and technological requirements. In this context, he highlighted the shortage of nursing staff as one of the key problems observed in Romania and one which has been exasperated by the current COVID-19 pandemic. He further pointed at the increased bureaucratisation of the nursing profession which has led to the increase of professional requirements and necessitated continuous re-training thus reducing opportunities for developing meaningful nurse-patient relations. In this context, Dr. Rotila reflected on the impact of new technologies on nurses stressing both the potential for reducing workload as well as the need for appropriate training and skills for the effective utilisation of such technologies.  Professional bodies and institutions were said to often be unable to deal with those new challenges and to provide sufficient support for nursing staff including through the provision of appropriate training and information.

Dr. Rotila highlighted the need for developing robust training programmes and a clear path towards career progression in order to tackle those issues. He cautioned against simplifying training as a means to address nursing shortages in the short term. He suggested that instead alternative strategies such as the creation of new professional categories requiring less training and able to take on some of the nursing tasks could be more effective. Finally, Dr. Rotila called for the modernisation of training practices and the adoption of a new approach to training favouring continuous renewal and development of existing competencies as well as new skills.

Acknowledging the need for revamping of existing training practices in the nursing profession, Dr Eszter Kovacs from the Health Services Management Training Center at Semmelweis University and a Coordinator of SEPEN Tender (“European Support for the Health Workforce Planning and Forecasting Expert Network”), discussed the issue of healthcare planning and its role in strengthening the position of nurses and midwives in the healthcare sector. Dr Kovacs also highlighted the wide-spread shortages of nursing staff but stressed the importance of prioritising quality of staff over quantity. In this context, she discussed the need for developing a common educational framework in Europe in order to remedy the mismatch in training that exists currently. She noted the positive impact that the current COVID-19 pandemic has had in exposing the need for robust data on health workforce across jurisdictions. Dr Kovacs also pointed at the acceleration of the digital transformation of healthcare systems which has been necessitated by the pandemic. In order to ensure that the workforce adapts effectively to this transition, she stressed the need for an EU-level dialogue on nursing education and upscaling.

The above case studies resulted in the following policy recommendations:

  1. Fund research enabling large-scale, long-term evaluation of the efficiency and effectiveness of digital technologies in the practice of care.
  2. Promote digital literacy among nursing staff in order to ensure effective utilisation of digital technologies.
  3. Modernise training practices to make them fit for the digital age.
  4. Develop a common educational framework for nurses in Europe.

Dr Mwidimi Ndosi, Senior Lecturer in Rheumatology Nursing at UWE Bristol in the United Kingdom (representing EULAR, European League Against Rheumatism, nember of the BioMed Alliance) discussed the need for developing harmonised competences and training of specialist nurses in rheumatology. Dr Ndosi agreed with the other speakers’ concerns about the differences in training across Europe. Furthermore, speaking of the situation in the UK, he outlined the lack of sufficient training as well as insufficient succession planning as key concerns in the rheumatology nursing community.  He specifically stressed the need for strengthening training in diagnostics, disease and risk management and health promotion.

Dr Ndosi argued for the development of competence-based training which takes into account the key skills (both generic and specialised) that nurses need to possess. In this context, he presented the Royal College of Nurses Competency Framework which was developed by leading emergency nursing experts in order to support personal and continuous professional development of nurses as well as succession planning. It also represents a benchmarking tool for rheumatology nurses and a tool for establishing nation-wide standards of training. Such frameworks, Dr Ndosi argued, are key in facilitating a clear pathway for career development for nurses by defining specific competencies, qualities and outcomes that are expected from nursing staff. Such competence-based training can be instrumental in facilitating a patient-centred approach to care.

The case study resulted in the following policy recommendations:

  1. Develop robust competence-based training as a means to facilitate a clear pathway to career development for nurses.
  2. Address current mismatch between the training offered across different European countries.
  3. Strengthen specialist training for nursing staff.

In response to the speakers’ input, Alina Timofte from DG SANTE of the European Commission, acknowledged the central importance of workforce training and lifelong learning for achieving resilience of the European healthcare systems. The need for remedying shortcoming in training as well as shortages of healthcare staff have become especially obvious during the current pandemic. While building a sustainable and resilient healthcare workforce remains primarily a national competency, Ms. Timofte stressed the Commission’s willingness to support national authorities in their efforts to address shared challenges. In this context, the Commission has invested in various health-related projects including related to training. Ms. Timofte further noted the key challenge of digitalisation as well as its potential for improving patient safety, boosting quality and reducing inequalities in access to healthcare. To support this process, the Commission is committed to supporting workforce training as well as digital literacy more generally in order to prevent the emergence of a digital divide in access to care.

Sumathi Subramaniam from the Commission’s Directorate General for Education and Culture, elaborated on the Commission’s efforts to harmonise education and training frameworks, which include nurses. She also noted that curriculum development should take into account the lessons learnt from the COVID-19 pandemic. Training and career paths should also seek to address existing gender imbalances in the nursing field in order to ensure a truly diverse workforce.

Building on the discussion, Sara Fasoli from the European Hospital and Healthcare Employers’ Association (HOSPEEM) stressed the key importance of leadership and soft skills (e.g. empathy, communications skills) for nurses. Johan Prevot from the International Patient Organisation for Primary Immunodeficiencies (IPOPI) endorsed observations on the need for more training and better education as well as on the shortage of trained specialised nurses. He stressed that this is a particularly important issue when it comes to rare diseases where significant discrepancies in availability of specialist nursing staff across Member States exists. Reflecting on the challenges of digitalisation specifically, Mr. Prevot highlighted the key role played by nurses in facilitating the digital transition and the uptake of new tools. To allow them to successfully perform this role, however, nurses should be provided appropriate training on data management as well as on the use of specific devices and

Overall, participants agreed that robust and harmonised workforce training is essential for transforming Europe’s healthcare systems and reaping the benefits of the digital revolution. Replacing the current mismatch in training practices with a common European educational framework focused on competencies and specialist skills as the basis for career progression has the potential to make the profession more appealing and remedy nursing shortages. Professional organisations, educational institutions and EU law-makers all have a role to play in facilitating the training of a European nursing workforce fit for the digital age.

The outcome of this debate, as well as of the following webinars, will be included the Thematic Network joint statement, aiming at profiling the healthcare workers of the future and identifying their core competencies and role for promoting data-driven innovation and patient-centred and inter-disciplinary models of care.

 Speakers’ presentations: