During the economic turbulence of recent years, nurses have been hit very hard: cuts in jobs (do more with less) and salary (see EFN Report). As a consequence, many national policies have made nurses redundant, along with an even more worrying phenomenon for which some governments are attempting to bypass Directive 2013/55/EU by creating a cheaper nurse, preferably at a lower cost, who does not benefit from Mutual Recognition of Professional Qualifications.
However, DG Sante keeps on benchmarking health progress in the EU, apparently to learn from each other. We have already learned a lot since 2008, with clear results of a worsened situation for nurses. As politicians often say: let’s use the crisis as an opportunity to change.
Looking at the Expert Panel on Effective Ways of Investing in Health Draft Opinion on Primary Care, it is possible to find some open windows of opportunities, but how willing are Health Ministers to strengthen the nurse as case manager, coordinating the continuity of care? Stating that “nurses are important” is no longer enough.
Furthermore, a concerning message for nurses has been recently released by the Expert Panel on Effective Ways of Investing in Health Opinion on “Benchmarking Access to Healthcare in the EU”. The text speculates on proposing a series of quantitative and qualitative benchmarks for assessing progress in reducing unmet needs for healthcare. In particular, the Opinion considers it necessary to improving current scales for measuring outcomes and developing new ones. In this sense, the Expert Panel on Effective Ways of Investing in Health aims at making proposals for investment in additional data sources – next to the current primary source of comparative data on unmet need for health care, the European Union Survey of Income and Living Conditions (EU-SILC) – that can inform policy and practice in the future. According to the text, the process of benchmarking should be viewed as a systematic process of searching for best practices, innovative ideas, and effective operating procedures that lead to improved performance.
Although the measuring as such is not negative, the EFN believes that a problem arises in the extent to which nurses are pulled away from the patient care towards only collecting data, even the one doctors need (DRGs). In this context, how will data collection impact on the nursing care process and the outcomes achieved?
The EFN fully agrees with the statement of the Expert Panel’s Opinion that “it is not enough to collect information for the sake of it, especially as this requires considerable effort and investment in resources. This investment can only be justified if it leads to improvements.” But such improvements need to be carefully assessed in terms of patients and care benefit. If nurses are pulled away from the bedside to take care of data collection, how much time will still be left for the direct patient care? What will be the improvement in the patient’s experience?
As such, to measure outcomes and adopt informed political decision to reform the health sector, it is crucial to bring frontline personnel, including nurses, doctors and pharmacists, closer to the direct frontline care to enable them to meet patients/citizens needs. This is one of the most important conditions to achieve high quality and safe care.
Investing in health does not require to spend resources on measuring and comparing parameters, while the care cannot be longer delivered in time. Instead, it means investing in Direct Patient Care and Citizens Needs!