Mapping and assessment of developments for one of the sectoral professions under Directive 2005/36/EC : nurse responsible for general care : executive summary.
Date: 2020-05-27
Institutions: Directorate-General for Internal Market, Industry, Entrepreneurship and SMEs
Subjects: EFTA, European Union, United Kingdom, directive (EU), educational system, environmental risk prevention, health care, nursing staff, professional qualifications, teaching

MAPPING AND ASSESSMENT OF 
DEVELOPMENTS FOR ONE OF 
THE SECTORAL PROFESSIONS 
UNDER DIRECTIVE 2005/36/EC 
– NURSE RESPONSIBLE FOR 
GENERAL CARE 
(No 711/PP/GRO/IMA/ 
18/1131/11026) 

Executive summary 

Written by Spark Legal Network 
April – 2020 

 
 
 
 
 
 
 
 
 
 
 
 
This  study  was  carried  out  for  the  European  Commission  by  

Spark Legal Network. 

Spark Legal Network 

Patricia Ypma 

María Domínguez Gaitán 

Dr. Alexandra Ongono Pomme  

Célia Drevon 

Dr. Irena Papadopoulos 

Network of national experts 

DISCLAIMER 

The information and views set out in this study are those of the author(s) and 

do  not  necessarily  reflect 

the  official  opinion  of 

the  Commission.  

The Commission does not guarantee the accuracy of the data included in this 

study.  Neither  the  Commission  nor  any  person  acting  on  the  Commission’s 

behalf  may  be  held  responsible  for  the  use  which  may  be  made  of  the 
information contained therein. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
EUROPEAN COMMISSION 

Directorate-General for Internal Market, Industry, Entrepreneurship and SMEs 

Directorate E — Services in the Single Market and Digitalisation 

E.5 — Regulation of Professions 

European Commission 

B-1049 Brussels 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
EUROPEAN COMMISSION 

MAPPING AND ASSESSMENT OF 
DEVELOPMENTS FOR ONE OF 
THE SECTORAL PROFESSIONS 
UNDER DIRECTIVE 2005/36/EC 
– NURSE RESPONSIBLE FOR 
GENERAL CARE 
(No 711/PP/GRO/IMA/ 
18/1131/11026) 

Executive summary 

Directorate-General for Internal Market, Industry, Entrepreneurship and SMEs 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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Luxembourg: Publications Office of the European Union, 2020 

ISBN 978-92-79-99643-6 

Doi 10.2873/449326 

© European Union, 2020 

Reproduction is authorised provided the source is acknowledged. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Mapping and assessment of developments for one of the sectoral professions 
under Directive 2005/36/EC – Nurse responsible for general care 

Executive summary 

INTRODUCTION AND CONTEXT 

This document constitutes the Final Report for the study ‘Mapping and assessment of 
developments for one of the sectoral professions under Directive 2005/36/EC – nurse 
responsible for general care (No 711/PP/GRO/IMA/18/1131/11026)’ (also referred to 
as: the ‘Study’) carried out by Spark Legal Network for the Commission’s Directorate-
General Internal Market, Industry, Entrepreneurship and SMEs.  

Article  31  in  combination  with  Annex  V  of  Directive  2005/36/EC,  as  amended  by 
Directive  2013/55/EU  (also  referred  to  as:  the  ‘Directive’)  sets  out  the  minimum 
training  requirements  for  nurses  responsible  for  general  care.  Only  the  minimum 
training  requirements  related  to  knowledge  and  skills  (Article  31(6))  and  training 
subjects  (point  5.2.1.  of  Annex V)  are  subject  to  the  delegated  power  that  the 
Commission was granted in order to be able to introduce possible updates, to take 
account of (generally acknowledged) scientific and technical progress and reflect the 
evolution of Union law affecting nurses responsible for general care. Thus, only the 
minimum requirements that are related to these two areas are covered by the present 
study.   

OBJECTIVES AND METHODOLOGY 

The overall objective of the Study is to support the Commission in its assessment of 
whether  to  propose  an  adaptation  of  the  minimum  knowledge,  skills  and  training 
subjects  for  the  profession  of  nurse  responsible  for  general  care  in  order  to  take 
account  of  (generally  acknowledged)  scientific  and  technical  progress.  This  was 
pursued  through  four  main  tasks:  1) Collection  and  presentation  of  data; 
2) Comparative  assessment  of  data;  3) Presentation  of  preliminary  results  and 
discussion  with  relevant  stakeholders;  and  4)  Drafting  of  the final  study.  The  Study 
therefore  maps  the  current  national  requirements  in  all  EU  Member  States,  EFTA 
States and the UK with regard to the effective theoretical and clinical training of nurses 
responsible for general care, the training subjects included in the national curricula, 
and  the  knowledge  and  skills  that  students  should  acquire  by  such  training. 
Additionally, the Study assesses whether it would be appropriate for the EU to update 
the minimum knowledge, skills and training subjects. Furthermore, the Study provides 
suggestions  on  possible  updates  to  the  Directive,  on  the  basis  of  the  research, 
assessment and interaction with relevant stakeholders. 

6 

 
 
 
 
Mapping and assessment of developments for one of the sectoral professions 
under Directive 2005/36/EC – Nurse responsible for general care 

Data collection 

In  order  to  meet  the  above-mentioned  objectives,  data  was  collected  through 
literature  review,  desk  research  and  stakeholder  consultation.  Through  a  literature 
review relevant information was gathered in relation to the national health systems, 
the effective theoretical and practical training, and the definitions and terminology 
associated with scientific and technical progress. Desk research was conducted by a 
team  of  national  experts.  They  completed  detailed  research  questionnaires, 
identifying and mapping current national requirements in their countries with regard 
to the effective theoretical and clinical training of nurses responsible for general care 
and the knowledge and skills that they should acquire by such training. The results 
were verified and complemented by the competent registration authorities. 

Additionally,  data  was  collected  through  stakeholder  consultation.  This  included: 
1) Stakeholder  questionnaires  completed  by  EU/EFTA-level  stakeholders, 1 national 
regulatory bodies, national associations and training institutions; 2) A workshop which 
brought  together  stakeholders  from  across  Europe; 2  and  3) A presentation  to 
members of the Group of Coordinators for Directive 2005/36/EU. 

Definitions and categorisation elaborated for the purpose of the Study 

In order to assess whether there may be grounds for the Commission to adapt the 
required  knowledge,  skills  and  training  subjects  under  the  Directive,  it  is  crucial  to 
ascertain whether generally acknowledged scientific and technical progress requires 
such  adaptation.  However,  neither  Directive  2005/36/EC  nor  Directive  2013/55/EU 
provides  a  definition  of  ‘generally  acknowledged  scientific  and  technical  progress’. 
Therefore, and for the purpose of the Study, the Study Team developed a broad and 
harmonised definition of ‘generally acknowledged scientific and technical progress’ in 
the framework of training of nurses responsible for general care that could be applied 
to  the  analysis  of  knowledge  and  skills,  and  training  subjects  identified  during  the 
Study, as follows: 

Scientific  and  technical  advancements  are  considered  to  be 
‘generally 
acknowledged’ when these advancements have had an impact on the practice, 
laws,  teaching  standards,  administrative  rules  and/or  curricula  in  a  majority  of 
countries. Taking into account that the present Study covers 32 countries (27 EU 

1  European  Federation  of  Nurses  Associations,  European  Nursing  Student  Association,  EU  Network  of  Nurse 
Regulators, European Federation of Educators in Nursing Sciences, European Specialist Nurses, European Nursing 
Council and European Nurse Directors Association. 
2 National registration authorities, regulatory bodies, national associations, training institutions and representatives 
from EU/EFTA-level stakeholders. 

7 

 
 
 
                                                      
Mapping and assessment of developments for one of the sectoral professions 
under Directive 2005/36/EC – Nurse responsible for general care 

Member States, 4 EFTA States and the UK), and taking into account the specific 
situation of Liechtenstein, a majority is considered to be obtained when relevant 
advancements have been noted in at least 16 countries. 

In  addition,  the  Study  Team  elaborated  a  categorisation  of  scientific  and  technical 
progress  in  order  to  classify  and  assess  the  findings.  The  figure  below  shows  this 
categorisation model: 

Scientific progress 

  Nursing theories in general 

  Person-centred care theories 

  Patient safety theories 

 

Inter-/ multidisciplinary theories 

  Health promotion theories 

  Management theories applied to nursing 

  Transcultural nursing theories 

  Evidence-Based Practice 

Technical progress 

 e-Health 

 Healthcare/nursing methods 

 Technology in nursing education 

DATA COLLECTED AT NATIONAL LEVEL VIA DESK RESEARCH 

National educational systems 

The  Study  includes  general  information  on  the  educational  systems  for  nurses 
responsible for general care in each of the countries covered. Specifically, it includes 
information on the admission to training of nurses responsible for general care, the 
level of nursing training and the differences between training institutions within the 
same country (where applicable).  

Knowledge, skills and training subjects 

The  Study  presents  information  in  relation  to  the  knowledge,  skills  and  training 
subjects  required  for  the  training  of  nurses  responsible  for  general  care  in  the 
countries  covered  by  the  Study.  In  relation  to  the  knowledge  and  skills,  the  Study 
identifies  the  knowledge  and  skills  which  appear  to  be  required  in the  countries  in 
order to cater for scientific and technical progress and classifies them following the 
categorisation  model  elaborated  for  the  purpose  of  the  Study.  With  regard  to  the 
training subjects, the Study presents the training subjects which appear to be included 
in the curricula of the countries, in order to cater for scientific and technical progress, 
and classifies them following the categorisation model elaborated for the purpose of 
the Study.  

8 

 
 
 
 
 
 
 
 
 
 
 
 
Mapping and assessment of developments for one of the sectoral professions 
under Directive 2005/36/EC – Nurse responsible for general care 

DATA COLLECTED FROM STAKEHOLDERS 

Scientific and technical advancements 

The Study presents the scientific and technical advancements affecting the profession 
of  nurse  responsible  for  general  care  in  the  last  5-10  years  that  were  reported  by 
stakeholders. The findings are classified following the categorisation elaborated for 
the purpose of the Study and specifying the countries where the findings have been 
noted. 

Knowledge, skills and training subjects 

The  Study  presents  the  knowledge,  skills  and  training  subjects  reported  by 
stakeholders which have been introduced in the training programmes over the last 10 
years as a result of scientific and technical progress. Following the same approach as 
applied  to  the  desk  research  results,  the  knowledge,  skills  and  training  subjects 
identified are classified following the categorisation elaborated for the purpose of the 
Study and specifying the countries where the findings have been noted. 

ANALYSIS OF THE FINDINGS 

In order to assess which of the identified advancements, knowledge, skills and training 
subjects can be considered to reflect generally acknowledged scientific and technical 
progress,  the  Study  classifies  all  the  findings  following  the  above-mentioned 
categorisation and specifies in how many countries the data have been noted. These 
numbers  are  subsequently  used  to  create  a  ranking,  identifying  advancements, 
knowledge,  skills  and  training  subjects  that  can  be  considered  to  reflect  generally 
acknowledged scientific and technical progress (i.e. those identified in at least 16 of 
the 32 countries in relation to which the research was conducted). It should be noted 
that all the information gathered during the Study is considered as complementary 
and therefore presented and assessed as a whole. 

Generally acknowledged scientific and technical advancements 

The classification and ranking developed during the analysis of the findings reveal that 
the following scientific and technical advancements affecting the profession of nurses 
responsible  for  general care  reflect  generally  acknowledged  scientific  and technical 
progress: 

Scientific 

topics/ areas 

Person-centred care theories: 22 countries 

Inter-/multidisciplinary theories: 16 countries 

Advancements 

9 

 
 
 
 
Mapping and assessment of developments for one of the sectoral professions 
under Directive 2005/36/EC – Nurse responsible for general care 

Evidence-Based Practice: 24 countries 

Technical 

e-Health: 26 countries 

topics/ areas 

Healthcare/nursing methods: 21 countries 

Knowledge,  skills  and  training  subjects  reflecting  generally  acknowledged  scientific 
and technical progress 

In addition, the results of the analysis have shown that the following knowledge, skills 
and  training  subjects  have  been  introduced  as  a  result  of  generally  acknowledged 
scientific and technical progress: 

Knowledge and skills 

Training subjects 

Person-centred care theories: 18 countries 

Person-centred 
countries 

care 

theories: 

22 

Inter-/multidisciplinary theories: 22 countries 

Management theories applied to nursing: 20 
countries 

Management theories applied to nursing: 
20 countries 

Evidence-Based Practice: 18 countries 

Evidence-Based Practice: 25 countries 

e-Health: 23 countries 

Scientific 

topics / areas  

Technical 

topics / areas  

Healthcare/nursing methods: 16 countries 

ASSESSMENT OF WHETHER TO UPDATE THE DIRECTIVE AND HOW 

Assessment of the findings under the current provisions of the Directive 

Having  identified  the  main  advancements,  knowledge,  skills  and  training  subjects 
reflecting generally acknowledged scientific and technical progress, the next step is to 
assess  whether these  advancements,  knowledge,  skills  and/or training  subjects  are 
already (sufficiently) provided for by the current text of the Directive. In this context, 
the  Study  assesses  each  main  category  under  scientific  and  technical  progress  that 
reached the threshold of at least 16 countries. A close look at the Directive shows that 
Inter-/multidisciplinary  theories  are  already  sufficiently  covered  in  the  Directive. 
Additionally, the assessment reveals that for some topics that are already mentioned 
in  the  Directive  (Person-centred  care  theories,  Management  theories  applied  to 
nursing and Evidence-Based Practice) more emphasis could be given, considering for 
example,  the  apparent  importance  of  these  subjects  across  the  countries.  Finally, 
some of the topics identified in at least 16 countries seem not to be covered in the 
Directive, such as e-Health and Healthcare/nursing methods. 

Suggestion to update the Directive 

Having  identified  the  potential  gaps  in  the  Directive  with  regard  to  generally 
acknowledged advancements across the countries covered by the Study, what follows 

10 

 
 
 
 
 
 
 
Mapping and assessment of developments for one of the sectoral professions 
under Directive 2005/36/EC – Nurse responsible for general care 

is the formulation of potential updates of the Directive. Having in mind the objective 
of adapting the training programme to the evolution of the nursing profession in the 
scientific and technical field, the Study Team recommends updating Article 31(6) on 
knowledge and skills and point 5.2.1 of Annex V as follows: 3 

Knowledge and skills 

Training subjects 

SCIENTIFIC PROGRESS 

Person-centred care theories  

To be added to Article 31(6): 

‘Ability  to  provide  individualised  nursing  care  and  to 
empower  patients,  relatives  and  other  relevant 
persons in relation to self-care and leading a healthy 
lifestyle.’ 

To be  added  to  Annex  V,  V.2.,  5.2.1.,  under  A.  a.,  after 
‘General principles of health and nursing’: 

‘, including person-centred care theories’ 

Indent  to  be  added  to  Annex  V,  V.2.,  5.2.1.,  under  B., 
under the indent ‘Nursing in relation to’: 

‘- Person-centred approach’  

Replacement  under  Annex V, V.2., 5.2.1., under B., last 
indent of ‘home nursing’ with:  

‘- Nursing care in community settings’ 

No update needed 

 No updated needed 

Inter- /multidisciplinary theories  

Management theories applied to nursing  

To be added to Article 31(6): 

To  be  added  to  Annex  V,  V.2.,  5.2.1.,  under  A.  c.,  after 
‘Principles of administration’: 

'- Ability to develop an effective leadership approach; 
decision-making skills.’ 

‘- and management’ 

Evidence-Based Practice  

To be added to Annex V, V.2., 5.2.1., under A. a: 

‘- Evidence-Based Nursing Practice and research’ 

TECHNICAL PROGRESS 

e-Health  

To be added to Annex V, V.2., 5.2.1., under A. (under a 
new category d.) and B. (as a separate indent): “Science 
and Technology”: 

‘ - e-Health’  

Healthcare/nursing methods  

To be added to Article 31(6): 

‘-  Comprehensive  knowledge  of 
technical 
innovations  related  to  healthcare  and  nursing 
methods.’  

the 

3 Furthermore, on the basis of the findings and suggestions for changes, the Study  Team also proposes deleting 
superfluous and / or redundant text in the Directive, by merging and deleting text. 

11 

 
 
 
 
 
 
 
 
                                                      
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doi: 10.2873/449326