National Reporting Instrument 2021
Background
[iBG]
Adopted in 2010 at the 63rd World Health Assembly (WHA Res 63.16), the WHO Global Code of Practice on the International Recruitment of Health Personnel (“the Code”) seeks to strengthen the understanding and ethical management of international health personnel recruitment through improved data, information, and international cooperation.
Article 7 of the Code encourages WHO Member States to exchange information on the international recruitment and migration of health personnel. The WHO Director General is additionally mandated to report to the World Health Assembly every 3 years.
WHO Member States completed the 3rd round of national reporting in March 2019. The WHO Director General reported progress on implementation to the 72nd World Health Assembly in May 2019 (A 72/23). The 3rd Round of National Reporting additionally informed the Member-State led Review of the Code’s relevance and effectiveness, as presented to the 73rd WHA in 2020 (A 73/9).
The Review highlights that Code implementation, through targeted support and safeguards, is necessary to ensure that Health Emergency and Universal Health Coverage-related progress in Member States serves to reinforce rather than compromise similar achievement in others. In light of the considerations in the Report and decision WHA 73(30), the WHO Secretariat has additionally prepared the Health Workforce Support and Safeguards List, 2020.
The National Reporting Instrument (NRI) is a country-based, self-assessment tool for information exchange and Code monitoring. The NRI enables WHO to collect and share current evidence and information on the international recruitment and migration of health personnel. The findings from the 4th Round of National Reporting are to be presented at the 75th World Health Assembly in May 2022. Given the ongoing COVID-19 pandemic, the NRI (2021) has been adapted to additionally capture information related to health personnel recruitment and migration in the context of the pandemic.
The deadline for submitting reports is 31 January 2022.
Should technical difficulties prevent national authorities from filling in the online questionnaire, it is also possible to download the NRI via the link: https://www.who.int/teams/health-workforce/migration/code-nri. Please complete the NRI and submit it, electronically or in hard copy, to the following address:
Health Workforce Department
Universal Health Coverage and Health Systems
World Health Organization
20 Avenue Appia, 1211 Geneva 27
Switzerland
hrhinfo@who.int
Disclaimer: The data and information collected through the National Reporting Instrument will be made publicly available via the WHO web-site following the proceedings of the 75th WHA in 2022. The quantitative data collected will be updated on and available through the National Health Workforce Accounts online platform. (http://www.who.int/hrh/statistics/nhwa/en/).
Article 7 of the Code encourages WHO Member States to exchange information on the international recruitment and migration of health personnel. The WHO Director General is additionally mandated to report to the World Health Assembly every 3 years.
WHO Member States completed the 3rd round of national reporting in March 2019. The WHO Director General reported progress on implementation to the 72nd World Health Assembly in May 2019 (A 72/23). The 3rd Round of National Reporting additionally informed the Member-State led Review of the Code’s relevance and effectiveness, as presented to the 73rd WHA in 2020 (A 73/9).
The Review highlights that Code implementation, through targeted support and safeguards, is necessary to ensure that Health Emergency and Universal Health Coverage-related progress in Member States serves to reinforce rather than compromise similar achievement in others. In light of the considerations in the Report and decision WHA 73(30), the WHO Secretariat has additionally prepared the Health Workforce Support and Safeguards List, 2020.
The National Reporting Instrument (NRI) is a country-based, self-assessment tool for information exchange and Code monitoring. The NRI enables WHO to collect and share current evidence and information on the international recruitment and migration of health personnel. The findings from the 4th Round of National Reporting are to be presented at the 75th World Health Assembly in May 2022. Given the ongoing COVID-19 pandemic, the NRI (2021) has been adapted to additionally capture information related to health personnel recruitment and migration in the context of the pandemic.
The deadline for submitting reports is 31 January 2022.
Should technical difficulties prevent national authorities from filling in the online questionnaire, it is also possible to download the NRI via the link: https://www.who.int/teams/health-workforce/migration/code-nri. Please complete the NRI and submit it, electronically or in hard copy, to the following address:
Health Workforce Department
Universal Health Coverage and Health Systems
World Health Organization
20 Avenue Appia, 1211 Geneva 27
Switzerland
hrhinfo@who.int
Disclaimer: The data and information collected through the National Reporting Instrument will be made publicly available via the WHO web-site following the proceedings of the 75th WHA in 2022. The quantitative data collected will be updated on and available through the National Health Workforce Accounts online platform. (http://www.who.int/hrh/statistics/nhwa/en/).
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Please describe
Disclaimer
[disclaim]
For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
I have read and understood the WHO policy on the use and sharing of data collected by WHO in Member States outside the context of public health emergencies
Designated National Authority Contact Details
[q01b]
Contact information:
Country
Poland
Full name of institution:
Małgorzata
Name of designated national authority:
Małgorzata Zadorożna
Title of designated national authority:
Director
Telephone number: (E.g. +41227911530 .)
+48226349858
Email: (Please enter one email address only.)
m.zadorozna@mz.gov.pl,hrhinfo@who.int
Implementation of the Code
[q1]
1. Has your country taken steps to implement the Code?
No
Partnerships, Technical Collaboration and Financial Support 1/2
[q2x1]
2.1. Has your country provided technical or financial assistance to one or more WHO Member States, particularly developing countries, or other stakeholders to support the implementation of the Code?
2.1.1 Specific support for implementation of the Code
2.1.2 Support for health system strengthening
2.1.3 Support for health personnel development
2.1.4 No support provided
2.1.5 Other areas of support:
[q2x2]
2.2. Has your country received technical or financial assistance from one or more WHO Member States, the WHO secretariat, or other stakeholders to support the implementation of the Code?
2.2.1 Specific support for implementation of the Code
2.2.2 Support for health system strengthening
2.2.3 Support for health personnel development
2.2.4 No support received
2.2.5 Other areas of support:
Partnerships, Technical Collaboration and Financial Support 2/2
[q3]
3. Has your country or its sub-national governments entered into bilateral, multilateral, or regional agreements and/or arrangements with respect to the international recruitment and migration of health personnel?
No
[q3xUploadx1]
[q3xUploadx2]
[q3xUploadx3]
Health Workforce Development and Health System Sustainability
[q4]
4. Does your country strive to meet its health personnel needs with its domestically trained health personnel, including measures to educate, retain and sustain a health workforce that is appropriate for the specific conditions of your country, including areas of greatest need?
Yes
[q4x1x]
4.1 Measures taken to educate the health workforce
Yes
[q4x1]
4.1.1 Manage production
4.1.2 Improve quality of education
4.1.3 Strengthen regulation
nurses and and midwives: The activities carried out in recent years in the Ministry of Health for nurses and midwives have brought visible results in the form of increased interest in first degree studies in nursing. That was due to i.a. actions aimed at encouraging young people to take up education in nursing or midwifery, undertaken within the framework of the Operational Programme Knowledge Education Development, i.e. support for pre-graduate education of nurses and midwives from the European Union funds under development programmes ( e.g. scholarships for students, medical simulation centers) and a media campaign promoting nursing and midwifery professions #Stawiam na przyszłość carried out in 2020. In addition, it should be noted that as part of the support for postgraduate education of nurses and and midwives, the Minister of Health annually subsidizes specialization training for these professional groups, within the financial resources allocated for this purpose in the state budget.
4.4 Others
[q4x2x]
4.2 Measures taken to ensure the sustainability* of the health workforce
Yes
[q4x2]
4.2.1 Workforce planning/forecasting
4.2.2 Increasing domestic production and education opportunities
4.2.3 Increasing employment opportunities
4.2.4 Manage recruitment of international health personnel
Minister of Health, in order to meet current demands and health needs, and anticipate future health needs as well as to produce so called health maps including elements as follow: disease and death reasons, regional distribution of entities, equipment, services and health workforce. Following that, Minister of Health issues regulation concering priorities in the field of medical disciplines. Referring to the ones on the list, there are certain activities undertaken, for example more residential seats are granted. Doctors: Based on two acts related to the COVID-19 pandemic (http://isap.sejm.gov.pl/isap.nsf/download.xsp/WDU20200002112/U/D20202112Lj.pdf and https://isap.sejm.gov.pl/isap.nsf/download.xsp/WDU20200002401/U/D20202401Lj.pdf) provisions were introduced for people who obtained qualifications of a physician, dentist, nurse, midwife, paramedic, outside the European Union (for citizens of EU Member States and foreigners from outside the EU) enabling: 1) obtaining the above-mentioned persons with the license to practice a given medical profession for a specific scope of professional activities, time and place of employment (in an entity performing medical activities for a period of up to 5 years, provided that certain requirements specified by law are met); 2) obtaining the above-mentioned persons, during an epidemic emergency or epidemic, the conditional license to practice a given medical profession. As part of the so-called “simplified mode”, two types of solutions have been introduced into the Polish legal system: 1) permanent solution, which is also valid after the end of the epidemic, and which is related to the stricter conditions of limited admission to the Polish labor market (the license to practice a profession for a specific scope of professional activities, time and place of employment); 2) a conditionall solution, in force during the announcement of an epidemic threat or state of an epidemic, which is based on maximally simplified rules while maintaining the necessary level of safety in the face of the urgent need to strengthen the existing human resources in entities providing health services to patients suffering from COVID - 19 (conditional license to practice a given medical profession). Moreover, it should be noted that the regulations providing for the introduction to the Polish legal system of the possibility for persons who obtained professional qualifications outside the European Union to apply for the license to practice a medical profession (physician, dentist, nurse, midwife, paramedic) for a specific scope of professional activities, the time and place of employment are based on the regulations and solutions introduced in Germany long before the Covid-19 pandemic. At the same time, it should be noted that persons licensed to practice a given medical profession (physician, dentist, nurse, midwife, paramedic) for a specific scope of professional activities, time and place of employment or having a conditional license to practice in Poland, do not obtain the right to apply for recognition of qualifications in another EU Member State under Directive 2005/36 / EC on the recognition of professional qualifications. nurses and midwives: The Minister of Health undertakes many actions aimed at increasing the number of professionally active nurses and midwives in the health care system: - actions taken to increase the number of students under the Operational Programme Knowledge Education Development, i.e. support for pre-graduate education of nurses and midwives from European Union funds under development programmes e.g. scholarships for students, medical simulation centers) and a media campaign promoting the nursing and midwifery professions #Stawiam na przyszłość carried out in 2020.
Other
[q4x3x]
4.3 Measures taken to address the geographical mal-distribution and retention of health workers*
Yes
[q4x3]
4.3.1 Education (Education institutions in underserved areas; students from under-served areas; relevant topics in education/professional development programmes; others)
not applicable, Minister of Health issues regulation concerns priorities in the field of medicine disciplines. In those on the list, there are certain activities undertaken, for example more residential seats are granted (it applies to the whole of Poland, not only to less populated areas)
4.3.2 Regulation (Mandatory service agreements; scholarships and education subsidies with return of service agreements; enhanced scope of practice; task shifting; skill-mix; others)
4.3.3 Incentives (Financial and non-financial)
: Residential programme available for each of physician in almost all medicine discipline leads to retain in Poland after qualification obtained. Poland has implemented „loyality agreement” dedicated to the physicians who obtain specialization title in the frame of residential programme. It is based on non-obligatory commitment to work in Poland at least for two years after finalizing specialization instead of higher salaries during education period. What’s more, Poland has reserved an increase of salaries for physicians working in public sector, having specialization title. nurses and midwives: The Minister of Health undertakes many actions aimed at increasing the number of professionally active nurses and midwives in the health care system: - actions taken to increase the number of students under the Operational Programme Knowledge Support aimed at nurses and midwives under the Operational Programme Knowledge Education Development , i.e. support for pre-graduate and post-graduate education of nurses and midwives from the European Union funds (e.g., scholarships, medical simulation centers, subsidies for qualification and specialist courses - related to meeting epidemiological and demographic needs) and a media campaign promoting the nursing and midwifery professions #Stawiam na przyszłość carried out in 2020. Additionally, it should be emphasized that as part of the postgraduate education of nurses and and midwives, the Minister of Health annually subsidizes specialization training for these professional groups, within the financial resources allocated for this purpose in the state budget
4.3.4 Support (Decent and safe living and working conditions; career advancement opportunities; social recognition measures; others)
nurses and midwives: Within the framework of post-graduate education of nurses and midwives, the Minister of Health annually subsidizes specialization training in selected areas of nursing for these professional groups, within the limits of financial resources allocated for this purpose in the state budget
[q4x4x]
4.4 Other relevant measures
No
[q5]
5. Are there specific policies and/or laws that guides international recruitment, migration and integration of foreign-trained health personnel in your country?
Yes
[q5x1]
5.1 Please provide further information in the box below:
Law/policy 1
Doctors: the provisions can be found in the Act on the Professions of Doctor and Dentist - Upload docs Ustawa o zawodach lekarza I lekarza dentysty http://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20210000790
Law/policy 2
Law/policy 3
[q6x]
6. Recognizing the role of other government entities, does the Ministry of Health have processes (e.g. policies, mechanisms, unit) to monitor and coordinate across sectors on issues related to the international recruitment and migration of health personnel?
No
[q7x]
7. Has your country established a database or compilation of laws and regulations related to international health personnel recruitment and migration and, as appropriate, information related to their implementation?
Yes
[q7x1x]
7.1.a Please provide further information in the box below.
Doctors: Web-site: https://nil.org.pl/uploaded_files/1631106091_za-sierpien-2021-zestawienie-nr-07.pdf; Doctors: Upload docs Ustawa o zawodach lekarza I lekarza dentysty http://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20210000790
[q7x2x]
7.1.b Please upload any format of documentation that provides such information (e.g. pdf, excel, word)
Upload document:
Responsibilities, Rights and Recruitment Practices
[q8x]
8. Which legal safeguards and/or other mechanisms are in place to ensure that migrant health personnel enjoy the same legal rights and responsibilities as the domestically trained health workforce? Please tick all options that apply from the list below:
8.1 Migrant health personnel are recruited internationally using mechanisms that allow them to assess the benefits and risk associated with employment positions and to make timely and informed decisions regarding them
8.2 Migrant health personnel are hired, promoted and remunerated based on objective criteria such as levels of qualification, years of experience and degrees of professional responsibility on the same basis as the domestically trained health workforce
8.3 Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression
8.4 Other mechanisms, please provide details below if possible:
[q8xoth]
8.4 Please describe at least one mechanism
Mechanism 1
Migrant health workforce have the same rights and responsibilities as the domestically trained health professionals. The right to practice and the conditions are recorded in the local acts for each medical professions, e.g. doctors, dentists, nurses and midwives.
Mechanism 2
Mechanism 3
[q9x]
9. Please submit any other comments or information you wish to provide regarding legal, administrative and other measures that have been taken or are planned in your country to ensure fair recruitment and employment practices of foreign-trained and/or immigrant health personnel.
the possibility of applying for the authorization to practice the profession of a doctor / dentist / nurse / midwife / paramedic was introduced into the Polish legal system for persons who had obtained professional qualifications outside the European Union for a specific scope of professional activity or time and place of employment
[q10x]
10. Regarding domestically trained/ emigrant health personnel (diaspora) working outside your country, please submit any comments or information on measures that have been taken or are planned in your country to ensure their fair recruitment and employment practices, as well as difficulties encountered
Measure 1
not applicable
Measure 2
Measure 3
Data on International Health Personnel Recruitment & Migration
[iq11]
Improving the availability and international comparability of data is essential to understanding and addressing the global dynamic of health worker migration.
[q11]
11. Does your country have any mechanism(s) or entity(ies) to maintain statistical records of foreign-born and foreign-trained health personnel?
Yes
[q11x1]
Please describe
Data and statistics on physicians from another countries are collected by the Polish Chamber of Physicians and Dentists. Data and statistics on nurses from other countries (registered foreign-trained nurses) are collected by theSupreme Chamber of Nurses and Midwives.. Data from the national register of medical students and graduates (universities) are in the possession Polish universities. The register contains information about foreigners
nurses and midwives:The Supreme Chamber of Nurses and Midwives (Naczelna Izba Pielęgniarek i Położnych) keeps the Central Register of Nurses and Midwives, which collects, among others, data on the number of nurses and midwives without Polish citizenship who have the right to practice in Poland.
[iQ12]
12. Data on the active stock of health personnel, disaggregated by country of training and birth
Previous data shared with WHO is available here. Please liaise with your NHWA focal point and update as relevant.
For the latest year available, consistent with the National Health Workforce Accounts (NHWA) Indicators 1-07 and 1-08, please provide information on the total stock of health personnel in your country (preferably the active workforce1), disaggregated by the country of training (foreign-trained) and the country of birth (foreign-born). Please consult with your NHWA focal point, if available, to ensure that data reported below is consistent with NHWA reporting.
Previous data shared with WHO is available here. Please liaise with your NHWA focal point and update as relevant.
For the latest year available, consistent with the National Health Workforce Accounts (NHWA) Indicators 1-07 and 1-08, please provide information on the total stock of health personnel in your country (preferably the active workforce1), disaggregated by the country of training (foreign-trained) and the country of birth (foreign-born). Please consult with your NHWA focal point, if available, to ensure that data reported below is consistent with NHWA reporting.
[q12x0]
12.1 Consolidated stock of active health personnel
This information can be provided by one of the following three options. Please choose your preferred mode of data entry:
This information can be provided by one of the following three options. Please choose your preferred mode of data entry:
Option A: Completion of the table below
[q12x1x1]
Option A: Please complete the table below
Please fill red highlighted cells.
| Total | Domestically Trained | Foreign Trained | Unknown Place of Training | National Born | Foreign Born | Source* | Year | Does the data represent active stock? | Remarks | |
|---|---|---|---|---|---|---|---|---|---|---|
| Medical Doctors | 142 712 | 142 014 | 643 | not applicable | not applicable | not applicable | NIL | 2020 | 1 | Active |
| Nurses | 231 612 | 230 118 | 315 | not applicable | not applicable | not applicable | NPIP | 2020 | 1 | Active |
| Midwives | 28 231 | 28 215 | 17 | not applicable | not applicable | not applicable | NPIP | 2020 | 1 | Active |
| Dentists | 38 882 | 38 664 | 216 | not applicable | not applicable | not applicable | NIL | 2020 | 1 | Active |
| Pharmacists | 36 527 | 36 527 | not applicable | not applicable | not applicable | not applicable | naczelna Izba Aptekarska | 2020 | 1 | Active |
[q12x1x3]
Upload any format of documentation that provides such information (e.g. pdf, excel, word).
[q13x2]
12.2 Top 10 countries of training for foreign-trained health personnel
Please provide data on the top 10 countries of training for foreign-trained health personnel in your country. This information can be provided by one of the following two options:
Please provide data on the top 10 countries of training for foreign-trained health personnel in your country. This information can be provided by one of the following two options:
[q13x2x3]
Upload any format of documentation that provides such information (e.g. pdf, excel, word).
Please upload file
COVID-19 and Health personnel mobility
[q13]
13. Were measures undertaken at national or sub-national level in response to the COVID-19 pandemic with respect to the temporary or permanent mobility of international health personnel?
13.1 No change in national or sub-national regulation, policy or processes related to the entry or exit of foreign-trained or foreign-born health personnel
doctors: As mentioned in the comment in point 4.2 of the survey; nurses and midwives: It was made possible to employ, in a simplified procedure, nurses and midwives with qualifications obtained outside the territory of the European Union in the Polish health care system, for a defined scope of activities, time and place of employment in an entity performing medical activity and during an epidemic emergency or a state of epidemics, in a medical entity intended to provide health services to patients suffering from COVID-19, after meeting the necessary conditions; paramedics: It was possible to employ, in a simplified manner, in the Polish health care system, paramedics with qualifications obtained outside the territory of the European Union, for a specific scope of activities, time and place of employment in an entity performing medical activities, after meeting the relevant conditions. This decision is the basis for practicing the profession of a paramedic for a period of 5 years from the date of its issuance. A person who has received the consent of the minister competent for health matters performs professional activities under the supervision of a paramedic or a doctor appointed by the head of the medical entity.
13.2 National and/or sub-national regulation, policy or processes enacted to ease entry and integration of foreign-trained or foreign-born health personnel
13.3 National and/or sub-national regulation, policy or processes enacted to limit the exit of health personnel from country
13.4 Others
[q14]
14. Did you have a mechanism to monitor the inflow and outflow of health personnel to/from your country during the COVID-19 pandemic?
Inflow
Outflow
No
[q14x1]
14.1 How many foreign-trained or foreign-born health personnel were newly (inflow) active (temporarily and/or permanently) in your country in 2019 and 2020?
| Doctors | Nurses | Midwives | Dentists | Pharmacists | Comments | |
|---|---|---|---|---|---|---|
|
Data Source (e.g. Regulatory authority, immigration records, work permits, etc.) Please ensure data source consistency for each category of personnel for the two years |
data from the central register of doctors and dentists NIL | data from Central Register of Nurses and Midwives NIPiP | data from Central Register of Nurses and Midwives NIPiP | data from the central register of doctors and dentists NIL | ||
| 2020 | 590 | 57 | 2 | 216 | ||
| 2019 | 473 | 52 | 2 | 185 |
[q14x2]
14.2 How many domestically-trained health personnel left (outflow) your country in 2019 and 2020 (for temporary or permanent migration)?
| Doctors | Nurses | Midwives | Dentists | Pharmacists | Comments | |
|---|---|---|---|---|---|---|
|
Data Source (e.g. letters of good standing, emigration records, G-G agreements etc.) Please ensure data source consistency for each category of personnel for the two years |
Number of certificates issued for the recognition of professional qualifications NIL | Number of certificates issued for the recognition of professional qualifications NIPIP | Number of certificates issued for the recognition of professional qualifications NIPIP | Number of certificates issued for the recognition of professional qualifications NIL | ||
| 2020 | 784 | 306 | 24 | 167 | ||
| 2019 | 969 | 371 | 42 | 185 |
[q15]
15. Please list any challenges related to ethical international recruitment of health personnel during the COVID-19 pandemic
Please describe (e.g. active recruitment of ICU personnel)
Please describe (e.g. active recruitment of ICU personnel)
1st Challenge
not applicable, rules set out in Polish legislation
2nd Challenge
3rd Challenge
Constraints, Solutions, and Complementary Comments
[q16]
16. Please list in priority order, the three main constraints to the ethical management of international migration in your country and propose possible solutions
| Main constraints | Possible solution /Recommendation | |
|---|---|---|
| not applicable, rules set out in Polish legislation | not applicable, rules set out in Polish legislation | |
[q17]
17. Is there any specific support your country requires to strengthen implementation of the Code?
17.1 Support to strengthen data and information
17.2 Support for policy dialogue and development
17.3 Support for the development of bilateral/multi-lateral agreements
17.4 Other areas of support:
not applicable, rules set out in Polish legislation
[q17x]
Other areas of support:
Support Area 1
Support Area 2
Support Area 3
[q18]
18. Submit any other complementary comments or material you may wish to provide regarding the international recruitment and migration of health personnel, as related to implementation of the Code.
not applicable
[q18x1]
Please upload any supporting files
Thank You
[iThank]
You have reached the end of the National Reporting Instrument - 2021. You may go back to any question to update your answers or confirm your entry by clicking ‘Submit’.