Health social partners agree recruitment and retention framework

The EU-level social partners in hospitals and healthcare, HOSPEEM and EPSU agreed, in December 2010, a framework of actions on recruitment and retention of staff. These are key issues in this sector, with demographic ageing and tight budgets compounding the problems of recruiting skilled employees for difficult working conditions on relatively low pay. The social partners’ formal dialogue began only in 2006, but has developed rapidly, leading to several joint texts.


The European-level social partners in the hospitals and healthcare sector are the European Federation of Public Service Unions (EPSU) and the European Hospital and Healthcare Employers’ Association (HOSPEEM). Their formal sectoral dialogue which began in 2006 (EU0610039I) has led to several joint texts, including a 2009 agreement on preventing sharps injuries in hospitals and healthcare (EU0908029I), which was given EU-wide legal force by Council Directive 2010/23/EU) (EU1003059I).

Focus on recruitment and retention

Staff recruitment and retention are key issues in hospitals and healthcare. There are long-standing skills shortages, made worse by demographic ageing and budgetary constraints, and a high demand for skilled employees expected to work in difficult conditions on comparatively low pay (TN1008022S).

These topics have been on the agenda of the sector’s EU-level dialogue since its inception and in 2008 the partners agreed a code of conduct on ethical cross-border recruitment and retention (EU0805039I). Further discussions in a working group led in December 2010 to agreement (2.4Mb PDF) on a framework of actions on recruitment and retention. This document sets out a number of agreed principles and guidelines, as a basis for concrete action by the social partners at European and national levels, aimed at tackling current and future staff shortages and qualification needs. EPSU and HOSPEEM want to encourage and to contribute fully to the development and implementation of policies at all levels with the purpose of enhancing workforce recruitment and retention, and promoting accessible and high-quality healthcare.

The cross-industry EU-level social partners have agreed several frameworks of actions, for example on gender equality (EU0509203F) and lifelong learning (EU0204210F), but this form of joint text is very unusual in European sectoral social dialogue.

Framework of actions

The framework deals with:

  • supporting the recruitment and retention of workers;
  • improving work organisation;
  • developing and implementing workforce-planning mechanisms;
  • encouraging diversity and gender equality in the health workforce;
  • promoting initial training, lifelong learning and continuous professional development;
  • achieving the safest possible working environment.

For each topic, the framework sets out a number of principles and aims – such as the need for healthcare staff to be valued and recognised, or for the workforce to reflect the diversity of the society it cares for – along with actions to be taken by the sectoral social partners. For example, EPSU and HOSPEEM will, through their national member organisations, promote and support initial training, lifelong learning and continuous professional development with a view to ensuring quality of training and up-to-date staff knowledge and competences. The joint text states that the hospitals and healthcare social partners should, for instance:

  • ,develop supporting infrastructures, in cooperation with Member States’ authorities, to facilitate work in a ‘24/7 service delivery context’;
  • cooperate to promote the best way of delivering efficient healthcare, while safeguarding staff and patient health and safety;
  • consider the implementation of innovative workplace designs, such as ‘self-rostering’, actively involving the workforce and their representatives;
  • map the potential for integrating fixed-term and agency workers into the workforce;
  • take measures and develop policies to improve work-life balance;
  • explore and promote policies and practices to encourage the participation of underrepresented groups in the workforce;
  • support programmes that assist workers who have undergone training to find jobs corresponding to their newly acquired competences;
  • support the development of programmes and initiatives that help workers to manage their professional lives and make informed decisions about their future career steps and training.


EPSU and HOSPEEM make a commitment to implementing the framework of actions and will:

  • collate case studies and consider joint model initiatives in line with the framework’s content;
  • consider follow-up action on implementation of the 2008 code of conduct on ethical cross-border recruitment and retention;
  • monitor EU legislation and other policies that may affect recruitment and retention.


Godfrey Perera, the HOSPEEM Secretary General, commented:

Our framework shows that social partners can produce practical results that will improve healthcare delivery in the interest of patients, healthcare providers and workers. To have the right workforce-planning mechanisms in place is key from an employers’ perspective in the health and hospital sector.

EPSU General Secretary Carola Fischbach-Pyttel said:

Our healthcare systems cannot function properly without a well-trained and motivated workforce. Their contribution must be recognised also in their terms and conditions of work … We see it as our task to make the healthcare and hospital sector an attractive workplace for women and men. We therefore need measures for improved work–life balance in the sector.

Mark Carley, Spire Associates

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