CPME has Published Policies for Optimization of the Healthcare Workforce

The Doctor’s Chamber, as a member of the Standing Committee of European Doctors (CPME), conveys the policies for the Optimization of the Healthcare Workforce that were published on the 31^st of March, 2026, by the CPME.

Recommendations:

•  Key to improving health service performance and efficiency is a well-resourced and motivated workforce. Access to facilities and equipment, adequate staffing levels and safe working conditions and the deployment of user-friendly e-Health solutions can help improve the delivery of quality, safe, efficient, equitable and accessible healthcare.

• The concept of optimisation in terms of redefining teams and skill mix and the use of digital technologies including but not limited to AI must not be driven by cost-containment but by improvement to quality of care and patient outcomes and efficient allocation of resources.

• Reducing unnecessary administrative and bureaucratic workload should be a core optimisation objective, to protect doctors’ well-being and ensure that clinical time is devoted to patient care.

• Task shifting must not replace long-term investment in safe staffing, training, and working conditions. Task shifting is the name now given to a process whereby specific tasks are moved, where appropriate, to health workers with shorter training and fewer qualifications.

• National authorities must work together with the medical profession, regulators and healthcare professional representative bodies to safeguard medical standards and professional responsibilities through retaining physician-led care. Multi-disciplinary teams, coordinated by a physician, should be viewed as the gold standard.

• Ethical principles and a clearly defined safe scope of practice are essential to defining good practice when non-physician healthcare staff take on new tasks.

Policies

• • CPME opposes the replacement of doctors with inadequately trained staff, which endangers the quality, continuity, and safety of the medical care.
• • CPME emphasizes the risks of relying on digital tools and AI to address the workforce shortage and underlines that validated tools can support, but not replace, clinical expertise.
• CPME stands for transparent and inclusive policy-making processes where doctors are fully consulted and involved.

Introduction

Recruitment and retention of doctors is increasingly insufficient to meet growing demand for healthcare. An ageing population and increasingly complex care requirements have outstripped available resources, while the declining attractiveness of the medical profession and its consequent increase in attrition threaten the right to healthcare and the commitment to universal health coverage for all Europeans.

Internationally, this perspective is reflected in the WHO Framework for Action on the Health and Care Workforce1, where among its five pillars, the promotion of workforce optimisation, redefining teams and skill mix and the use of digital solutions with a focus on improving performance and efficiency is increasingly positioned as a core principle of healthcare reform.

Key to optimising healthcare performance is a well-resourced and motivated workforce:

1. Equipment and capacities: Doctors must be provided with the equipment and facilities to deliver safe and effective care. Difficulties in accessing diagnostics, inpatient beds, clinic and operating theatre space cause on-going backlogs to patient care.

2. Safety conditions: Adequate staffing levels and safe working conditions will help reduce risk of burnout, support recruitment and retention and reduce the risk of patient safety incidents.

3. Digitalization: Investment in electronic health care records and other automated systems can help reduce errors and repetition and reduce the administrative burden. Systems must be user friendly and fit for purpose in a busy clinical environment.

The efforts to optimise healthcare services must be guided first and foremost by patients’ rights, effective prevention where possible, clinical benefit, and ethical standards, and the concept of physician-led teams. Without appropriate safeguards, the concept risks being reduced to narrow short-term efficiency measures that may be invalid proxy measures for better health outcomes that undermine medical standards and erode patient trust.

Productivity

CPME cautions against applying narrow industrial concepts of productivity to healthcare. Productivity is a measure of how much output is produced as a measure of input, but fails to consider individual needs, patient preferences and social circumstances, and focuses on a very narrow set of inputs and outputs. Improving efficiency, on the other hand, is about maximising value for money in terms of the resources spent to improve quality of care and population health outcomes.

“Prudent Healthcare” versus “Low Value Care”

CPME emphasises the importance of prioritising prudent healthcare, a concept that better aligns with the principles of clinical appropriateness, quality, and patient safety.

Publications have implied that spending on healthcare provided by highly qualified professionals is wasteful if the care could also be provided by persons with a lower qualification. From this rationale, healthcare services which are considered as not being cost-effective can be referred to as “low value care”. CPME warns against use of this definition as it is misleading and such framings risk being misused to justify unsafe substitution of medical expertise. CPME considers that the concept of “prudent healthcare” more appropriately captures the objectives of clinical appropriateness.

Task Shifting

The term “task shifting” describes a situation that is usually performed by a doctor that has been transferred to a healthcare worker with a lower education level or to a person who has been previously trained fort that particular task only.

• Assignment of tasks: The responsibility remains with the doctor.
• Task shifting: The responsibility has been transferred to the other employee that bears the risk for the quality of the above in case not conducted properly.

Another the concept that exists is “task sharing”, which is the rational redistribution of responsibilities among health workforce teams that should be accompanied by appropriate measures in terms of education, supervision and licensing.

While task shifting has traditionally been associated with low- and middle-income countries this is now increasingly being made in Europe in response to shortage of doctors. CPME cautions that such measures cannot replace comprehensive workforce planning and investment to ensure adequate and equitable supply of doctors across all regions. Transfer of tasks can help optimise resources if safely designed and properly implemented to allow doctors to focus more on patient care and tasks that specifically require their expertise.