Post-covid policy responses to health workforce capacities: comparing health system resilience

BACKGROUND: Post-Covid health policies seek to adapt to the ‘new normal'. Their success depends on the capacities of healthcare workforce (HCWF). Policies need to tackle rapidly growing shortages, high levels of stress and increases in violence against the HCWF. We lack more systematic comparisons of how countries respond, also across different sectors. Our study analyses policy responses in six European countries in relation to hospitals and ambulatory care, to provide in-depth insights into on how health system resilience is created, maintained and transformed. METHODS: We used a framework which considers the relationships between health system prerequisites, health workforce capacities, and health system resilience as flexible. We selected Austria, the Czech Republic, Denmark, Germany, Italy, and the Netherlands for our comparative analysis. We collected data in 2022 and prepared descriptive country cases, based on expert information and written secondary and primary research. RESULTS: Across our countries, the focus of national policy responses tends to be on hospitals and governments are often limited in developing HWCF capacity in ambulatory care. There are also variations in how fast national governments are moving to post-pandemic policy responses. Policy responses at sub-national levels have a broader focus on HWCF capacity, reflecting decentralisation as well as greater proximity to the consequences of increasing demands and greater shortages in the HWCF. At all levels, medical interests continue to be more influential compared to those of other health workers. Only few countries have adopted major transformative policy responses and capitalised on the possibilities offered by the EU Next Generation programmme. CONCLUSIONS: Considering the scale of the post-Covid challenges, policy responses remain fragmented and often patchy. Securing health system resilience requires more concerted policies directed at the capacities of the entire HCWF. KEY MESSAGES: • Success of post-Covid health policies depends on the capacities of the HCWF and needs to tackle growing shortages, high levels of stress and increases in violence against health workers. • Our comparison analysis shows that policy responses remain patchy and are fragmented across national and local levels, hospitals and ambulatory care, as well as different groups of the HCWF.