Policy responses for Poland - HSRM

Poland


Policy responses for Poland

2.2 Workforce

MEASURES IMPLEMENTED IN 2020

JANUARY-JUNE:

Staffing
Comprehensive legislation on the prevention and eradication of COVID-19, which was passed in the parliament on 29 March, includes several health workforce measures.
 
In order to prevent a shortage of medical personnel, doctors who do not have a specialization in infectious diseases or are not anaesthesiologists may be redeployed or seconded (for up to 3 months) to infectious disease departments or to other facilities where help is needed. In addition, physicians undergoing specialist training may be deployed to fight the epidemic or to carry out designated tasks (in line with their current skills and experience) to free up other doctors’ time. Further, a new platform was created by a private company to allow retired physicians, who are at greater health risk due to COVID-19, to return to work remotely and provide teleconsultations. Final-year students of medicine, pharmacy, medical analytics, nursing and emergency may perform support roles (if they are willing to do so), e.g. conduct epidemiological interviews. They can also perform support roles in hospitals and nursing homes. There are also attempts to boost the number of nurses. For example, a simplified procedure is in place to allow non-practising nurses or midwives (who have had a break of at least a 5-year) to return to work.
 
Soldiers from the Territorial Defence Forces have been recently involved in the COVID-19 response. For example, they conduct evacuation of residents of nursing homes and are involved in provision of testing (see Section 1.5). Further support is available from volunteers who help older people with shopping or computer use.
 
Remuneration
Several legislative provisions address working hours, off- duty time, and payment structures (including overtime and night work) of medical employees in order to optimise working time and provide healthcare services around the clock. Since 29 April healthcare employees who are in contact with COVID-19 patients (or persons with a suspected coronavirus infection) have been prohibited from working in more than one place (for which they are financially compensated; see Section 4.1).
 
Since 29 April, healthcare employees who are in contact with COVID-19 patients (or persons with a suspected coronavirus infection) have been prohibited from working in more than one place. To compensate them for the loss of income due to this restriction, the Minister of Health instructed the NHF to provide them with monthly cash benefits (which will be financed from the Ministry of Health budget). The benefits are capped at PLN 10,000 per month and will be calculated at 80% of the remuneration received at the place of work where, after the introduction of the restriction, the employee no longer works, or, at the minimum, at 50% of remuneration received at the place where the employee chose to work after the restriction have been introduced. The compensation will cover the costs of social security contributions payable by the employer.  Funding for this additional remuneration comes from the state budget.
 
Some hospitals have supplemented the remuneration of their employees with an allowance to compensate them for being exposed to patients infected with the coronavirus. For example, employees of hospitals in Gdańsk receive an additional 20% of their basic salary (as specified in the employment contract) and 20% of the hourly rate (as per contract); and in Wroclaw an additional PLN 30 (gross) per hour of work is offered as compensation. The director of the University Hospital in Krakow also declared to pay supplements to personnel working in the infectious ward and in the Hospital Emergency Department.
 
Other support for health workers
Medical personnel working in hospitals are at higher risk of contracting coronavirus. To protect their families, some hotels provide accommodation to such medical personnel. Voivodeship branches of the National Health Fund provide and secure accommodation for the staff of hospitals fighting SARS-Cov-2.
 
In terms of psychological support for medical staff and other employees who work during the epidemic, the Supreme Medical Chamber has taken the initiative to create a database of mental health specialists who are willing to offer their services to doctors, nurses, paramedics and other medical free of charge, either online or by phone. In addition, the state insurance state company (PZU Life) has set up a helpline (tel. number 22 505 11 77) offering psychological support to healthcare workers. The helpline is open every day from 8am until 8pm. 
 
The staff of the emergency department of the University Hospital in Zielona Góra together with the Polish Radio West prepared a spot as part of the #wspierajmedyka (‘support the medic’) campaign, which aims to draw attention to the problem of discriminatory treatment of medical workers during the coronavirus epidemic (e.g. not allowing them into shops out of fears that they carry coronavirus).
 
Sources:
http://orka.sejm.gov.pl/Druki9ka.nsf/Projekty/9-020-126-2020/$file/9-020-126-2020.pdf [access online: 29.03.2020]
https://zdrowie.wprost.pl/koronawirus/10307840/koronawirus-nowa-platforma-umozliwi-teleprace-lekarzom-na-emeryturze.html. [access online: 10.04.2020]
https://serwisy.gazetaprawna.pl/zdrowie/artykuly/1469866,koronawirus-nakaz-pracy-szpital-kary.html. Access: 17.04.2020.
https://pulsmedycyny.pl/rusza-bezplatna-infolinia-psychologiczna-dla-pracownikow-ochrony-zdrowia-walczacych-z-epidemia-sars-cov-2-987933 [access online: 25.04.2020]
https://nauka.trojmiasto.pl/Studenci-medycyny-pomagaja-w-walce-z-epidemia-n143907.html. [access online: 04.05.2020]
https://pulsmedycyny.pl/koronawirus-sars-cov-2-w-polsce-opublikowano-rozporzadzenie-ws-pracy-czesci-medykow-w-jednym-miejscu-989764
https://gazetawroclawska.pl/nowe-izolatorium-dla-zakazonych-we-wroclawskim-akademiku/ar/c1-14932204. [access online: 04.05.2020]
https://www.nfz.gov.pl/aktualnosci/aktualnosci-centrali/dodatkowe-wynagrodzenie-dla-personelu-medycznego-za-prace-w-jednym-miejscu,7721.html. [access online: 19.05.2020]
 
JULY:

At the end of July, the rules restricting health employees dealing with COVID-19 patients to work in only one hospital were eased. According to the amended regulations, the director of a specialist hospital or facility with an infectious disease ward will decide if health workers dealing with COVID-19 patients may work at more than one institution.
 
Source:
https://serwiszoz.pl/aktualnosci-prawne/zlagodzono-przepisy-o-nakazie-pracy-w-jednym-miejscu-5503.html. [access online: 28.08.2020]
October:

OCTOBER:

On the 19th of October, the Ministry of Health announce several support measures for medical staff:
· Relaxation of staff employment standards, with the managers of health facilities having the possibility to decide on employment standards.
· Specializations will end with a written exam and medical residents will be exempt from having to take an oral exam.
· A draft law on "Good Samaritan" foresees measures to ensure adequate  safety and other  conditions for medical personnel. The allowance for medical personnel involved in the COVID-19 response will be increased from 50% to 100% of remuneration.
· All doctors who are referred to quarantine or isolation will receive 100% of their salary. The Minister of Health announced that this solution will be regulated at the statutory level. This solution will also be used for the uniformed services (e.g. military).
· The Minister of Health announced that doctors and nurses will be excluded from criminal liability for inadvertent errors committed while providing services within the COVID-19 response (except for cases of obvious negligence).
· The soldiers of the Polish Army will replace medical personnel at drive thru points allowing for  medical personnel operating the mobile collection points to be relocated to hospitals. The working times of these points would be extended as needed.

Sources:
https://www.gov.pl/web/zdrowie/podwojenie-bazy-lozkowej-i-udogodnienia-dla-personelu-medycznego. [Accessed online: 29.10.2020]
 
NOVEMBER:

Soldiers of the Territorial Defence Forces have been involved in the fight against the pandemic. In the Mazovian voivodeship, they are responsible for the initial patient triage, for taking swabs within drive-thru testing points, and for verifying (in cooperation with the police) whether people follow isolation and quarantine requirements. To that end, soldiers have received extensive training and further courses on Qualified First Aid and collection of biological material are already underway. It is planned that soldiers will provide further support to doctors and nurses by being stationed in temporary hospitals under construction so that the medical personnel can focus on the most needy patients.

Sources:
https://media.terytorialsi.wp.mil.pl/informacje/587337/wspieraja-szpitale-pobieraja-wymazy-dostarczaja-srodki-ochrony-osobistej. [Accessed online: 17.11.2020]
 
DECEMBER:

Due to the Covid-19 pandemic, it was necessary to provide hospital wards with an appropriate number of doctors. With regard to negligence in the human resources policy for decades, the Polish health care system has to deal with a pandemic in a situation of limited resources. The concept of admitting doctors from abroad and facilitating them to recognize diplomas obtained at foreign universities has emerged. Ultimately, however, the Ministry of Health withdrew from this idea.

Source:
https://www.termedia.pl/koronawirus/Tysiac-lekarzy-z-zagranicy-do-walki-z-COVID-19,40174.html. Data access: 10.12.2020.

MEASURES INTRODUCED IN 2021

JANUARY:

The Polish health care system has suffered from staff shortages for many years and these shortages have become particularly acute during the coronavirus pandemic. A special statutory regulation has thus been introduced to facilitate return to work for medical professionals who have not worked for several years or those who were educated in countries outside the EU. The regulation has introduced the following changes:
· Doctors, pharmacists, laboratory diagnosticians, paramedics, physiotherapists, nurses and midwives who have not practiced their profession for over 5 years are exempted from having to undergo training before returning to work. Former health professionals who return to work have to, during the first 3 months, practice under the supervision of another practitioner. This exemption is in place during the period of the state of epidemic threat or the state of epidemic.
· During the state of epidemic threat or the state of epidemic dentists are allowed to provide specific health services.
· Doctors and dentists who obtained their professional qualifications outside of the European Union do not need to have to obtain the right to stay on the territory of the Republic of Poland in order to practice their profession in Poland.
· During the state of epidemic threat or state of epidemic the Minister of Health can grant a conditional right to practice to doctors and dentists.
· During the state of epidemic threat or state of epidemic the Minister of Health can grant the right to practice to paramedics who obtained their qualifications outside of the European Union if they meet the following conditions:  they have full legal capacity; their health condition allows them to perform the profession; they have a diploma that confirms they had obtained the title of a paramedic or documents confirming at least 3 years of professional experience in performing professional tasks of a paramedic.
· It is possible to use the system of equivalent work for medical dispatchers, emergency medical coordinators and members of emergency medical teams. This allows them to perform work continuously for 24 hours.
· During the state of epidemic threat or state of epidemic doctors, dentists, nurses, midwives and paramedics can practice in a medical facility on the basis of an agreement concluded by the healthcare entity running the facility with the employment agency.
· It is possible to fulfil electronic orders for the supply of medical device repair orders that constitute electronic medical documentation, accessible through the Internet Patient Account.
· A module containing patient data on suspected or confirmed infection with SARS-CoV-2 (age, sex, patient number in the main list of admissions and discharge, patient condition according to the modified early warning scale (MEWS scale), and information about received oxygen therapy) and information on the number of hospital beds and their use, have been added to the Healthcare Resources Records System.
· Nurses and midwives who obtained their qualifications outside of the EU can be granted the right to practice within a specific scope of professional activities, during a specific period and at a specific place of employment in an entity performing medical activities.
· A permanent indexation mechanism was introduced for the lowest salaries of employees of healthcare entities.

The COVID-19 vaccination programme carried out since the end of December 2020 prioritizes vaccination of health workers (see section titled “Vaccine services and delivery”).

Source:
https://www.medexpress.pl/ustawa-kadrowa-z-podpisem-prezydenta-mozna-zatrudniac-medykow-spoza-ue-na-specjalnych-warunkach/80160 [Access online: 05.02.2021]