OECD and ILO urge flexible training routes to ease Europe's health worker shortages

The OECD and the International Labour Organization published new guidance on Wednesday calling on governments to rethink how people enter and progress in healthcare occupations, arguing that simply adding places on traditional training courses will not close persistent staffing gaps. The guidance note, which focuses on flexible learning pathways into health and social care roles, sets out five priorities for policy makers, from workforce planning to investment in training.

The two bodies said rising demand for care, aging populations, technological innovation and changing models of service delivery mean health systems must widen the pool of people who can join the sector. Their proposed answer is modular courses, recognition of skills already gained, learning on the job and opportunities for workers from other fields to retrain into health roles. Training should also be reachable for people who already hold jobs or have family responsibilities, the document states.

Planning by skill, not just by headcount

The first of the five pillars concerns workforce planning. According to the guidance, authorities should not limit themselves to estimating how many physicians and nurses are missing. They also need to establish which competences are required and to anticipate future needs, taking into account demographic aging, the spread of digital health and new care models.

The document flags persistent gaps in digital skills, teamwork and leadership capabilities, which it describes as increasingly important for integrated, patient-centered care. It also points to forecasting as a core competence for governments, since service models and technology change faster than traditional training cycles.

The guidance cites the case of the Philippines, which trains a large number of health professionals, especially nurses, many of whom emigrate. The result is a paradox noted by the two organizations: despite strong training capacity, national health facilities, particularly in rural areas, continue to report staff shortages.

A warning on standards

The two bodies attached a caution to their recommendations. Greater flexibility, they said, must not translate into second-tier qualifications, lower wages or reduced guarantees for patients. The guidance frames recognition of prior learning and modular routes as ways to bring people into regulated professions without diluting the quality of training or the safety of care.

The publication comes as labor market data point to durable demand. A separate analysis covering 38 countries found that workers in information and communication technology, health and teaching face the largest and most persistent shortages across the OECD, while surpluses are more common in lower-skilled and routine roles. That pattern reflects the effect of digital transformation, automation and artificial intelligence on labor demand, the OECD said.

For working adults and students weighing a move into care work, the guidance signals that entry routes may multiply. Recognition of skills gained elsewhere, part-time and modular study and on-the-job learning could shorten the path into clinical and support roles, while digital and teamwork competences are likely to matter more in hiring. For employers, the emphasis on forecasting suggests recruitment alone will not solve staffing problems.

What to watch next

The test will be whether national governments adopt the five priorities in their own workforce plans and how quickly education providers adapt curricula. The two organizations have positioned the note as guidance rather than binding rules, so implementation will vary by country. Analysts will also watch whether flexible pathways are paired with safeguards on pay and patient safety, and whether countries that train large numbers of health workers can retain more of them at home.