Heroes Community of Practice

Mobility and retention of Health Workforce

10th HEROES Community of Practice Meeting
5 December 2025
Hosted by: Health Workforce Monitoring and Planning Unit of the Central Administration of the Health System ACSS, I.P.

Speakers:

• Tiago Correia – IHMT-UNL / Department of Global Public Health; Head of WHO Collaborating Center
• Pedro Lopes Ferreira – Centre for Health Studies and Research / Centre for Innovative Biomedicine and Biotechnology from University of Coimbra.
• Ana Rita Santos – Health Economics; NOVA National School of Public Health

Over the past several years, many EU Member States have experienced a steady intensification of workforce constraints driven by well-documented structural factors. While the pandemic prompted rapid, short-term responses that helped address immediate needs, it also exposed the limitations of existing workforce planning models and underscored the need for more robust, forward-looking approaches to health workforce planning. Today, health systems face a shortage of skilled professionals, making retention a critical priority. Heightened competition between public and private providers, combined with increased international mobility of health workers, reinforces the importance of adopting a systematic and evidence-based focus on professional satisfaction as a key determinant of workforce sustainability.

The most pressing priority is to prevent further loss of health professionals from the Portuguese NHS by acting decisively on retention drivers, particularly working conditions, organizational climate and burnout. The evidence shows that while overall professional satisfaction is moderate, there are clear structural stressors – excessive workload, insufficient staffing, limited work life balance, limited career progression and weak organizational support – that directly affect professionals’ intention to stay. Hospital settings and younger professionals are especially vulnerable, as are those working under multi-employment arrangements. Immediate action is required to stabilise teams, reduce burnout and restore trust, as continued inaction risks accelerating exits to the private sector or abroad, undermining service continuity and system resilience.

Looking ahead, the major challenges are structural, demographic and systemic. Portugal faces an ageing health workforce alongside increasing population health needs, while competing in a global labour market where mobility is high and private-sector opportunities are expanding. Persistent regional imbalances, chronic understaffing in certain specialties, and reliance on temporary or fragmented work arrangements threaten long-term sustainability. Another key challenge is governance: translating data and evidence into coherent, long-term workforce strategies that survive political cycles. Without integrated planning between health and other sectors such as education, labour and finance, policies risk remaining reactive and short-term.

The most significant insight is the clear demonstration that professional satisfaction and retention are multidimensional phenomena, shaped more by organisational, relational and psychosocial factors than by pay alone. Leadership quality, team cohesion, autonomy, recognition, work–life balance and alignment between professional values and system goals emerge as decisive factors influencing whether professionals remain in the NHS. This finding is particularly important because it shifts the policy focus from isolated financial measures to systemic organisational reform, offering actionable entry points for change. Within the Joint Action HEROES framework, this might create strong potential for cross-country learning, shared tools and scalable solutions that strengthen workforce sustainability across health systems.

With this session we hope to have shared our expertise regarding health workforce policies, better understanding how job satisfaction influences retention and mobility as well as exchange different contexts and experiences.