Health professionals: skills opportunities and challenges (2019 update)

Summary

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

Key facts:

• Around 5.9 million people were employed as health professionals in 2018.  Employment in the occupation grew by 14.3 per cent between 2006 and 2018.
• Employment is projected to grow by a further 5 per cent over the period 2018 to 2030, an increase of more than 300 thousand new jobs.  This underestimates the true level of employment demand.  In order to replace those workers who will leave the occupation for one reason or another – an estimated 3.6 million between 2018 and 2030 – and meet the projected growth in demand over the same period, almost 4 million job openings will need to be filled. 
• The top 3 workplace tasks of health professionals are gather and evaluate information, service and attend and creativity and resolution.
• 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.

According to Eurofound's Job Monitor, the key 3 tasks of health professionals are gather and evaluate information, service and attend and creativity and resolution.

Figure 1: Importance of tasks of health professionals

What are the trends for the future? [2]

The employment level of health professionals across sectors is expected to increase by 5 per cent between 2018 and 2030, a further expansion following the 14 per cent growth during the 2006-2018 period.

The growth of employment of health professionals is expected in 18 of 28 analysed European countries, while in remaining 10  - especially in Western and Central Europe - are expected to loose some jobs for this occupation.

Figure 2: Future employment growth of health professionals in European countries (2018-2030, in %)

The 5 per cent growth – an increase of more than 300 thousand jobs - in employment understates the growth in demand for people to work as health professionals.  Over the period 2018-2030 an estimated 3.6 million people are projected to leave the occupation for one reason or another such as retirement [3]. This reflects ageing health workforces across Europe [4]. Given the projected increase in employment over the same period, this will result in there being around 4 million job openings that will need to be filled between 2018 and 2030.

Figure 3: Future job openings of health professionals (2018-2030)

It comes as no surprise that over 85% of these professionals are traditionally and will continue to be highly qualified. National and European 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 countries, 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. Employment of health care professionals will increase in this sector into the future.  A substantial number of jobs will also be created in the wholesale and retail sector; a similar trend to that observed for associate health care professionals.

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.

As a part of its Ditigitalization and future of work project, Cedefop estimates the risks of automation for occupations. The most exposed occupations are those with significant share of tasks that can be automated – operation of specialised technical equipment, routine or non-autonomous tasks  – and those with a small reliance on communication, collaboration, critical thinking and customer-serving skills. The risk of automation is further accentuated in those (occupations) in which people report they have little access to professional training that could help them to cope with labour market changes. Health professionals belong to occupations where the automation risk is lower.

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.