Planning for change: developing a policy framework for nursing labour markets.

This article examines key aspects of change in European nursing labour markets, and highlights an integrated policy framework intended to improve nurse recruitment, retention and utilization in European health care. Health care is labour intensive. Staffing costs are often a major focus of the health sector. There is a tendency for staffing to be regarded as part of the 'problem' of cost containment, and staffing costs are often a major focus of health sector reform. This report argues that it is more appropriate to regard staffing in general, and nurses in particular, as part of the solution to improving quality, access and cost of care. The major elements in nurse workforce planning are discussed, and the need for planning to be integrated with service delivery is emphasized. With projected increases in the demand for healthcare, and concern about staff shortages, policy attention across Europe and in other countries must focus on improving the methods of recruiting, retaining and utilizing nursing resources. A policy-based framework for sustained improvement is presented, based on five areas of action: improve 'conventional' recruitment; improve recruitment from 'non-conventional' sources; identify and apply incentives to improve staff retention and motivation; improve staff deployment; and improve utilization/skill mix.