Pre-conference: Skill-mix challenges in the current and future health workforce  

Wednesday 20 November, 09:00 - 17:00, Room Endoume 6

Organised by:

European Observatory on Health Systems and Policies and EUPHA Section Health workforce research (HWR) in collaboration with The Health Foundation and WHO Regional Office for Europe 


Many countries are facing challenges with the skill mix of the health workforce. Optimizing the skill-mix is a key strategy to strengthen the health workforce and improving health system performance. But identifying really innovative skill-mix models and implementing them is rather challenging. Any effective response to this challenge will need to rest on robust comparative research to identify and assess the ‘what’ and ‘how’ of skill-mix innovations. To this end it is of utmost importance to provide a platform for the health workforce research community to develop a common understanding of the health workforce challenges patients, practitioners, policy makers, health systems and researchers are facing. The HWR section of EUPHA provides for this purpose a unique opportunity. We continue with the successful health HWR section pre-conferences and its predecessor in previous years like in Ljubljana, Stockholm and Vienna. This year, we will include both policy and research by inviting policy makers and issue a call for HWF-papers.  

Organisation and aims of the pre-conference
The overarching aim of this pre-conference is to bring together the scientific community and foster collaboration on current and future health workforce skill-mix related issues. To this end the workshop will pursue the following concrete objectives:

  • Reviewing current skill-mix challenges in countries from a policy makers perspective
  • Presenting findings on the effectiveness of skill-mix innovations in primary and chronic care following a call for papers
  • Looking over the horizon for new key health workforce challenges and potential solutions. 

Policy relevance
The health workforce is a key contributor - if not the most important one - to the performance and sustainability of health systems. Policy makers in Europe are therefore eager to learn about developing the composition and skills of the health workforce. Identifying innovations, assessing their effectiveness and transferability are therefore highly important. 

The preconference starts with a brief introduction followed by four thematic sessions and a brief wrap up. The first session focusses on policy makers’ perspective towards skill-mix innovations in primary and chronic care. To allow concrete in-depth discussion we will invite from the host country in France the Caisse Nationale de l’Assurance Maladie (CNAM), which has a pivotal role in developing the health workforce, This will serve as an entry point for discussion. In the second and third session we will review the findings of scientific papers responding to the call of papers. Session 2 will include papers on sectorial perspectives (prevention and health promotion; acute care, chronic care etc.) while session 3 will focus on specific topics (skill-mix and ehealth; coordination; teamwork etc.). The last session will focus on upcoming challenges both for health systems, policy makers and the scientific community. This is followed by a short wrap up.


9.00  Welcome

In this brief welcome session we will explain the aims and objectives of the pre-conference and the contents and formats of the individual sessions.

  • Introduction - Matthias Wismar, European Observatory on Health Systems and Policies and Ellen Kuhlmann, EUPHA (HWR) 

9.00-10.30  Session I: Skill-mix reforms in France – in the context of international evidence

This session aims to set the scene in terms of the challenge that policy makers are facing. In order to allow for sufficient depth, we will focus on France, the host country of this year’s conference. We will review the health workforce challenges and some of the responses including the newly introduced nurses in advanced roles, the medical assistant function under development but also experiences with the ASALEE programme for rural and underserved areas. We will discuss the French experience in the light of international evidence.

  • Introduction and facilitation (tbn)
  • Keynote, CNAM (tbn)
  • Moderated stakeholder panel
  • Discussants and question from the floor

11.00-12.30  Session II: Skill-mix innovations in various segments of primary and chronic care

Primary care compromises a large number of different settings and models of care. Adapting a concept developed by OCED we have invited papers focussing on skill-mix innovations with regards to health promotion and prevention, acute care/transitional care, chronic care (keeping people independent), palliative care and access to care (underserved rural/ deprived urban).

  • Introduction - Claudia B Maier, Technische Universität Berlin, Germany
  • Presentation of five papers from the call and discussion
  • Final discussion

13.30-15.00  Session III: Skill-mix innovations for specific roles and tasks

Often, the health workforce needs to adapt to changes introduced by new technologies or new models of care. This includes e.g. digital health, roles in coordination of patients, informal carers, professionals, services and sectors, or the building of effective teams just to name a few. We will discuss 5 abstracts/draft papers selected from a call of papers:

  • Introduction and facilitation - Anita Charlesworth, The Health Foundation and Jim Buchan, The Health Foundation and Editor-in-Chief Human Resources for Health
  • Presentation of five papers from the call and discussion
  • Final discussion 

15.30-16.30  Session IV: Health workforce challenges now and in the future

In recent years the scientific community has contributed significantly to the better understanding of policy responses arising from health professional mobility, recruitment and retention, health workforce planning and many other issues. The field however remains dynamic and often the resolution of one problem is the source of another one. This session therefore shall serve to discuss upcoming health workforce challenges for policy makers, health systems and researcher.

  • Introduction and facilitation - Marieke Kroezen, Erasmus Medical Center, Rotterdam, The Netherlands and Ronald Batenburg, NIVEL, The Netherlands
  • Keynote
  • Discussants 

16.30-17.00  Closing comments          

Gabrielle Jacob, WHO Regional Office for Europe, and all session chairs together with the workshop participants draw conclusions from the day including further perspectives for collaboration. Building on the previous sessions we should further discuss perspectives for collaboration and next year’s conference. 

The full programme is downloadable here.

Registration fee

The registration fee is € 140 which includes networking lunch and refreshments.