Nurses and Task Shifting

Task shifting is high on the EU political agenda as the Commission Expert group believes our EU healthcare systems need to adopt a value-driven approach, and as such both concepts are linked in the political discussions. Aiming to come up with an innovative approach to task shifting, the European Commission has given a mandate to the “Expert Panel on Effective Ways of Investing in Health” (EXPH) to work on the topic and drafted an opinion on “Task shifting in healthcare systems”.  In their opinion a series of evidence-based recommendations for European health systems could underpin the EU policy debate embracing flexibility in professional roles, facilitating change and maximising health outcomes. They consider task shifting as essential to keep pace with the profound changes that our healthcare systems are undergoing – the increasing number of patients living with co-morbidities, digitalisation, patient empowerment, etc. Their set of recommendations are:

1. In all cases, the objective being pursued with task shifting is clearly specified.
2. There is an investment in research on task shifting.
3. Those responsible for training health workers ensure that they convey positive attitudes towards interprofessional and team working.
4. Those responsible for implementing task shifting engage in dialogue with those affected by it.
5. Those responsible for health services evaluate, and where necessary, intervene to improve the organisational culture.
6. Legislative and regulatory authorities review their existing rules to asses to which extent they place unjustifiable barriers to task shifting.
7. Task shifting to patients and their carers recognises the goals, expectations and capacities of those adopting new roles.
8. Decisions to engage in task shifting are planned carefully.

While the EFN welcomes these recommendations, it reminds all EU Health stakeholders, and the Commission, that task shifting has traditionally been used to overload the nursing workforce schedule, and to promote the hiring of lower-qualified and cheaper healthcare workers, not complying with Directive 2013/55/EU. To avoid these, and in line with the EXPH’s recommendations, the EFN members call for the adoption of the Workforce Matrix 3+1.

The EFN, as a strong advocate in this field, has also published policy statements on task shifting in nursing, recruitment and retention of nurses, and on moving care to the community.