1.Q. Round table: Primary healthcare workforce crisis in Europe: global policy discourse and national implementation
Authors:   Organised by: European Observatory on Health Systems and Policies, WHO European Centre for Primary Health Care, WHO Collaborating Centre for Health Workforce Policies and Planning, EUPHA-HCW,   Chair persons: Michelle Falkenbach (Germany), Ellen Kuhlmann (EUPHA-HCW)
Published: October 2024

Abstract

Background
Primary healthcare (PHC) has emerged as a powerful global concept, but little attention has been directed towards the pivotal role of the healthcare workforce and the diverse institutional setting in which they work. Recent WHO efforts have underscored the challenges in aligning the global PHC-oriented model with national health systems, highlighting the need for tailored approaches to fulfil diverse needs and contexts. Although significant progress has been made in advancing PHC, some gaps persist, particularly surrounding the integration of PHC and healthcare workforce debates and its prioritisation within national health agendas. These gaps lead to disconnects between PHC policy implementation and workforce considerations, exasperating the existing workforce crisis and obstructing effective service delivery.

Objectives
This workshop bridges the gap between PHC workforce policy and the ongoing healthcare workforce crisis, focusing on the European region and different types of health systems, socio-economic conditions, health labour markets and workforce compositions. We apply a health system and multi-level governance approach, arguing the need for greater attention to the implementation of global policy concepts and the diverse national and regional conditions, interests, and needs. The workshop begins with an overview of the PHC workforce situation, presenting novel results drawn from European comparative research and nine selected country case studies, followed by a panel discussion. The panellists provide in-depth evidence on various PHC workforce challenges and introduce illustrative examples of policy interventions and good-practice models coming from the case countries. Insights from the WHO Centre for Primary Health Care advance the debate by highlighting strategies and capacity for transformative PHC workforce policies, and the need for further investigation to critically align global and national approaches. The policy recommendations emerging from the panel will be critically reflected in a plenary discussion. The workshop will stimulate debate and improve knowledge exchange across countries, in particular in the WHO European region, as well as between research, policy and practice. It will strengthen both the PHC model and the healthcare workforce, and finally advance the building of resilient health systems.

Key messages
• Shift the primary healthcare debate from idealistic attributes to actionable implementation strategies, emphasising policy dynamics, political contexts, and diverse stakeholder interests.
• Understand the various PHC-oriented models and their dynamics to determine the necessary quantity, competencies, and composition of HCWs and how they can be governed effectively to implement PHC.