Headcount and FTE data in the European health workforce monitoring and planning process

Background: Health workforce (HWF) planning and monitoring processes face challenges regarding data and appropriate indicators. One such area fraught with difficulties is labour activity and, more specifically, defining headcount and full-time equivalent (FTE). This study aims to review national practices in FTE calculation formulas for selected EU Member States (MS). Methods: The research was conducted as a part of the Joint Action on European Health Workforce Planning and Forecasting. Definitions, categories and terms concerning the five sectoral professions were examined in 14 MS by conducting a survey. To gain a deeper understanding of the international data-reporting processes (Joint Questionnaire on Non-Monetary Health Care Statistics-JQ), six international expert interviews were conducted by using a semi-structured interview guide. Results: Of the 14 investigated countries, four MS indicated that they report FTE to the JQ and that they also calculate FTE data for national planning purposes. The other countries do not use FTE data for national purposes, but most of them do use special calculations and/or estimation methods for converting headcount to FTE. The findings revealed significant differences between national calculation methods when reporting FTE data to the JQ. This diversity in terms of calculations and estimations can lead to biases with respect to international comparisons. This finding was reinforced by the expert interviews, since the experts agreed that the activities of healthcare professionals are a fundamental factor in HWF monitoring and planning. Experts underscored that activity should also be measured by FTE, and not only by headcount. Conclusions: FTE and headcount are significant factors in HWF planning and monitoring therefore, national data collections should place emphasis on collecting data and calculating the appropriate indicators. National FTE could serve as a call to action for HWF planners due to the lack of matching international FTE data. At the international level, it is beneficial to monitor the trends and numbers regarding human resources and working time. For the moment, the exchange of information and mutual assistance for developing the capacity to apply common methodology could be a first step towards the standardisation of data collections. © 2016 The Author(s)

Return Schemes from European Countries: Assessing the Challenges

International audienceDrawing on a review of the academic literature on return migration and return migration policies, as well as on reports and project documentation, this article provides a general assessment of return schemes from European countries, with a focus on those targeting failed asylum‐seekers and irregular migrants. The article first highlights the contrasted understanding of return and reintegration by migration policy‐makers and migration scholars respectively. It then provides an overview of the main challenges, focusing on seven key issues: preparedness to return, the imbalance of represented interests, legal mobility, conditions in the countries of origin, the reintegration package, integration in Europe, and the specific obstacles to return faced by failed asylum‐seekers. The article highlights the need to reassess return policies and frame more realistic schemes

Making the economic case for prevention – a view from Wales

<p>Abstract</p> <p>Background</p> <p>It is widely acknowledged that adverse lifestyle behaviours in the population now will place an unsustainable burden on health service resources in the future. It has been estimated that the combined cost to the NHS in Wales of overweight and obesity, alcohol and tobacco is in excess of £540 million.</p> <p>In the current climate of financial austerity, there can be a tendency for the case for prevention efforts to be judged on the basis of their scope for cost savings. This paper was prompted by discussion in Wales about the evidence for the cost savings from prevention and early intervention and a resulting concern that these programmes were thus being evaluated in policy terms using an incorrect metric. Following a review of the literature, this paper contributes to the discussion of the potential role that economics can play in informing decisions in this area.</p> <p>Discussion</p> <p>This paper argues that whilst studies of the economic burden of diseases provide information about the magnitude of the problem faced, they should not be used as a means of priority setting. Similarly, studies discussing the likelihood of savings as a result of prevention programmes may be distorting the arguments for public health.</p> <p>Prevention spend needs to be considered purposefully, resulting in a strategic commitment to spending. The role of economics in this process is to provide evidence demonstrating that information and support can be provided cost effectively to individuals to change their lifestyles thus avoiding lifestyle related morbidity and mortality. There is growing evidence that prevention programmes represent value for money using the currently accepted techniques and decision making metrics such as those advocated by NICE.</p> <p>Summary</p> <p>The issue here is not one of arguing that the economic evaluation of prevention and early intervention should be treated differently, although in some instances that may be appropriate, rather it is about making the case for these interventions to be treated and evaluated to the same standard. The difficulty arises when a higher standard of cost saving may be expected from prevention and public health programmes.</p> <p>The paper concludes that it is of vital importance that during times of budget constraints, as currently faced, the public health budgets are not eroded to fund secondary care budget shortfalls, which are more easily identifiable. To do so would diminish any possibility of reducing the future burden faced by the NHS of lifestyle-related illnesses.</p

From social instrument to migration management tool: assisted voluntary return programmes : the case of Belgium

The return of migrants to their country of origin and the development of efficient return measures have become more prominent on the political agenda of many Western European countries. Since policymakers prefer ‘voluntary’ return, governmental programmes to support the return of migrants – Assisted Voluntary Return (AVR) programmes – were developed as far back as the 1970s and have played an increasingly important role in migration policy over the last three decades. At the same time, general migration policy and welfare systems have undergone profound change, including in the meanings and connotations attached to social welfare, return support and return policy. This raises questions about the implications of these broader societal and policy changes for the widely implemented AVR programmes. In this article, we discuss the interpretation and evolution of AVR programmes by analyzing how one particular European country, Belgium, has developed its AVR programme over time. We explore the evolution of the programme’s content, target group and institutional positioning, which shed light on its changing goals and are closely linked to a broader shift towards a ‘managerial’ approach to migration policy and the welfare state. We argue that return support may become decontextualized when it adopts ‘conditional entitlement’ as a central principle. This leads to strong differentiation, based on personal responsibility, between ‘deserving’ and ‘undeserving’ migrants, the levelling down of the support given to returnees, and a more coercive voluntary return policy in which social support is linked to deportation