New professionals roles in Europe Antoinette de Bont, Maarten Janssen, Iris Wallenburg Munros Team Erasmus University Rotterdam Panel: Engaging Doctors and Health Professionals What Is It? Does It Matter? 21 st March 2015

Allied Professionals Heart AttackBreast CancerDiabetes Emergency physicianBreast clinicianDiabetes ward physician Outpatient physicianWard physicianOutpatient physician Physician assistantNurse practitionersPractice nurse Emergency nursePhysician AssistantPodiatrist Triage nurseBreast Care NursesFood care technicians Out-patient nurseTechnical radiation assistantNeurophysiopathology technicians PerfustionistMedical assistantDieticians ParamedicWard AssistantNutritionists TechnicianHealth care assistant Resuscitator Documentation assistant Health care assistant

How do physicians, nurses and allied professionals control the work they do? – How do physicians, nurses and allied professionals distributed and reclaim work? – What kind of work do they distributed and/or reclaim?

Integrated care Co-ordination of care delivery to a patient with new general professional roles within a care organization (e.g. expansion of services) and/or between care organizations (e.g. primary and secondary care) Patient-centred care Specialized, integrated care pathway Traditional care delivery with one specialist within a care organization responsible for the care delivery to a patient, supported by general nursing, technical and/or administrative staff Physician-centred care Multiple specialists within a care organization involved in care delivery to a patient, based on the required expertise, supported by specialized nursing, technical and/or administrative staff Expertise-centred care SPECIALIZATION OF CARE  Developments in medical technology and training  Developments in information technology INTEGRATION OF HEALTH SERVICES  Improve quality of care / patient outcomes  Increase share in health services INCREASING SKILL-MIX CHANGE

Allied professionals and organized professionalism Health Care Organizations provide the training for Allied Professionals. Allied professionals claim to fulfill organizational goals patient centered care, productivity and transparency. Their competencies are defined by products and services of the organization Yet, allied professionals are locked in organizations.

High status professionals are not the ones who distribute the work. High status professionals can not reclaim work at any time. The work that is delegated to allied professionals is not only lower status work.

We wish to thank the European Commission for funding this research programme ‘Health Care Reform: The iMpact on practice, oUtcomes and cost of New ROles for health profeSsionals (MUNROS), under the European Community’s Seventh Framework Programme (FP7 HEALTH INNOVATION-1) grant agreement number HEALTH-F EC.