Background Well-being in the healthcare sector is of substantial policy relevance, given persistent labour shortages and the central role of subjective well-being in worker productivity and retention. Objective We investigate changes in healthcare workers’ life satisfaction since the onset of the pandemic relative to workers in other essential and non-essential sectors, and examine the role of pandemic severity and subsequent policy responses in explaining these differences. Methods We use thirteen waves of quarterly panel data from the COME-HERE dataset, which collects information on respondents in five European countries from April 2020 to August 2024, and estimate linear regressions via OLS. Results The life satisfaction of healthcare workers is always higher than that of other essential workers and non-essential workers. During the pandemic, the pandemic death rate had a negative effect on life satisfaction that was three times larger for healthcare workers. At the same time, lockdown stringency reduced the life satisfaction of workers in every sector other than healthcare. Conclusions As pandemic death rates and lockdown stringency mostly moved hand-in-hand, the higher life satisfaction of healthcare workers persisted throughout and after the pandemic possibly reflecting the meaningful nature of their jobs. At the same time, the negative impact of pandemic severity on workers’ well-being is especially pronounced among healthcare workers, highlighting the importance of supporting their well-being during public health crises to sustain healthcare system performance.
Background Staffing levels are increasingly used to help address workforce shortages, safeguard quality and support health system performance. However, comparative evidence on why countries define staffing levels and how these policies are designed and governed remains limited. Objective By comparing approaches across countries, the study provides new evidence on the governance and implementation of staffing levels and supports policy learning on designing staffing policies that are both responsive to changing population and workforce needs and aligned with broader health system goals. Methods This article draws on a report developed with the European Commission’s Expert Group on Health Systems Performance Assessment which conducted a comparative analysis of staffing-level policies across European Union Member States and Norway, using a structured questionnaire, complemented by a policy workshop and Policy Focus Group. Results Countries employ fixed, flexible and hybrid staffing approaches across health system sectors in pursuit of different policy objectives. These choices reflect differences in service organisation, workforce capacity and governance arrangements. Staffing policies are governed through varying combinations of national regulation, decentralised decision-making, professional standards and provider-level implementation, and are unevenly integrated with workforce planning, financing and education. Conclusions There is no universally applicable staffing model. Effective staffing policy requires context-sensitive design, clear governance and stronger integration with wider health workforce and health system policies. Comparative monitoring can support policy learning without imposing uniform staffing benchmarks across Europe.
Background Climate change places increasing pressure on health systems. They must both reduce their negative impact on the environment and strengthen resilience to climate-related risks. Objective To synthesize and map the evidence from systematic reviews on the scope and effectiveness of climate change mitigation and adaptation actions in health systems. Methods An umbrella review of systematic reviews examining health system responses to climate change was conducted. The review followed the Joanna Briggs Institute methodological guidelines and adhered to the PRISMA checklist. The included systematic reviews had to meet two overarching criteria: at least two databases were searched, and a predefined instrument was used to assess the quality or risk of bias of the included studies. Results Forty-six systematic reviews published between 2020 and 2026 were included, covering 1,175 individual studies. Most reviews (41/46) focused exclusively on mitigation strategies, with evidence concentrated around major greenhouse gas emission hotspots: surgical procedures; radiology; pharmaceuticals; solid waste; and transportation of patients and staff. Across these areas, some mitigation strategies were associated with environmental and economic co-benefits, although the underlying evidence was heterogeneous and often of low to moderate quality. In contrast, only a small number of reviews addressed climate adaptation and health system resilience. Conclusions Existing evidence provides practical guidance on effective climate mitigation actions. The limited number of systematic reviews on climate adaptation highlights a gap in the evidence base. Translating mitigation evidence into clinical guidelines and policies and strengthening research on adaptation could support more systematic climate action in health systems.
Background Growing hybrid and military threats are converging with health and care workforce poly-crises, placing increasing pressure on health system resilience. Objectives This study examines how European Union (EU) member states protect and prepare the workforce for health security threats and how these measures impact resilience. Methods A qualitative comparative assessment of EU health security policy and seven country cases was performed, including Czechia, Finland, Germany, Netherlands, Poland, Portugal and Romania. A structured topic guide informed data collection in April 2026, drawing on expert input and secondary sources. Results Since COVID-19, health security institutions and defence-related preparedness have expanded substantially across countries. Three broad patterns emerge within a new health security and resilience architecture shaped by health systems, defence strategies and workforce conditions, but also important common trends: workforce stability and resilience remain marginal within these emerging architectures and critical gaps in protection and preparedness, and priority of military-centred approaches threaten health system resilience. Discussion Investment in military-centred defence remains inefficient if not aligned with workforce resilience, including preparedness, physical and mental health protection, equity and gender equality. Key challenges for policymakers are to shift from military- and infrastructure-focused preparedness toward integrated strategies with the workforce as foundational pillar of critical security infrastructure and an operational indicator of resilience, and to build capacity for the implementation of new security policies. Conclusions The EU needs a coordinated workforce-centred strategy with a sustainable budget that strengthens preparedness, protection, governance capacity, research and implementation to improve resilience under crisis and defence conditions.
