Public Services International sounded the alarm in June 2015, and the European Trade Union Federation of Public Services (EPSU) organized a first meeting on the subject in Berlin in November 2016. This meeting enabled trade unions from different countries to exchange views on staffing issues from an international perspective. The fact remains that most health staffing systems are used primarily to cut costs.

In a context of austerity policies and budget cuts, hospital administrations are increasingly under pressure to significantly reduce staff costs. As a result of this, health professionals’ ability to provide safe and reliable health services have become severely constrained. Staff-to-patient ratios are below safety thresholds, and this is exposing patients to significant risks and contributing to burnout among the staff.

Experience shows that poor staffing generates a high staff turnover, absenteeism and bad working conditions. On-the-job staff try to compensate for extra work to the detriment of their breaks and meal times, or work overtime (sometimes unpaid), contributing to the general malaise of not being able to do their job properly.

Effective and safe staffing must take into account the size of the workforce, but also the combination of skills and cadres that reflect local variations in health needs. The system must be simple to implement, obligatory and must be monitored. In the face of a chronic recruitment and retention problem, Australia and New Zealand have established specific criteria for assessing workload per service. Most hospitals in Finland use a tool that gives information on staff needs per patient every 24 hours. Safe and effective staffing is an opportunity to redefine work organization to ensure decent work conditions.

Staffing:

• is closely linked to the quality of services in health care facilities
• lies at the heart of advocacy for better working conditions for professionals
• can play a leading role in accreditation systems.

To obtain adequate safe staffing, "count us in real time"
Inspired by a survey carried out for several years by UNISON (UK), the Federation CFDT Health-Social (France) will this year launch a survey of health staff to know about their working conditions in a 24-hour period. Both at national and European level, we need to continue to share our experiences on staffing in order to build a strong trade union negotiating position.