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 
; 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 
. Levels of risk and complexity increase when handling old-age patients 
, 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 
; 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 
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
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 .
“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) 
Organisational changes, induced by decreasing budgets and the need to maintain quality of care with minimal resource expense 
, 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) 
. 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 
. Other health professionals are likely to work across care delivery boundaries, in a variety of settings, with a growing emphasis on community care 
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’ 
. 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.