NHS European Office

Social dialogue

Shaking hands

The NHS European Office has the mandate to represent NHS employers in the European Social Dialogue. Engagement with the European Social Dialogue offers the NHS a key channel with which to influence EU workforce policy and law at an early stage. This is because the European Commission has a legal duty both to consult European organisations representing employers and trade unions before releasing any proposals relevant to them and, most importantly, to give them the opportunity to negotiate new EU law (in this case the EU law is agreed by the social partners with the EU institutions simply ‘rubber stamping’ the agreement).

The NHS European Office represents the NHS in two social partner organisations, the European Hospital and Healthcare Employers' Association (HOSPEEM) and the European Centre for Employers and Enterprises Providing Public Services (CEEP). We are also members of the UK arm of CEEP, CEEP UK.

Why engage in social dialogue?

There are a number of benefits for the NHS from involvement in social dialogue, including:

  • early sight of European Commission policy developments likely to affect the health sector;
  • the opportunity to influence proposals at an early stage and take an active role in negotiations and discussions on issues important to the health sector across Europe;
  • access to a platform for the exchange of information, good practice and learning experiences 

For more information about Social Dialogue and the NHS European Office's work on EU employment issues more generally, see the European employment policy pages on the NHS Employers website.

'Cross-industry' social dialogue

CEEP, as the representative body for public sector employers, is one of the intersectoral social partner organisations which participate in cross-industry social dialogue (together with representatives of private sector employers, small and medium size enterprises and the trade unions).

Cross-industry social dialogue covers the whole economy and labour market and looks at issues common to all fields of employment and social affairs. The results and standards adopted by the cross-industry social partners apply to businesses and workers across Europe. For example, the EU Directive on parental leave implements an agreement reached by the cross-industry social partners.

Social dialogue in the hospital and healthcare sector

Alongside the cross-industry social dialogue, there are a number of sectoral social dialogue committees, including some for the hospital and healthcare sector, looking at employment-related issues of specific concern or particular importance for their sector. The hospital-sector social partners are HOSPEEM and the European Federation of Public Service Unions (EPSU). 

Social dialogue initiatives involving the NHS European Office 

Working time/work-life balance/workers’ rights

We continue to use our membership of CEEP and HOSPEEM to influence social partner input on:

Occupational health and safety

The European Commission launched a new package of measures to improve health and safety for workers by issuing guidance on health risks such as stress, ergonomic or age related risks, and by setting new exposure limits for carcinogenic chemicals. At the same time they propose to simplify and reduce the administrative burden for employers by starting to remove or update outdated rules. We will in particular input via HOSPEEM to shape the Commission’s proposals about protecting workers from carcinogens, especially healthcare staff who come into contact with cytotoxic drugs.

Continued professional development

Collaboration on promoting continued professional development and lifelong learning for healthcare workers is one of the main activities in HOSPEEM/EPSU’s work programme. Patient safety and service improvement rely on healthcare workers continually updating their knowledge, skills and competences. In addition, in a time of fiscal constraint, opportunities for professional development and progression can be a strong driver in recruiting and retaining staff.

This area is an important component of Health Education England's (HEE) and NHS Employers’ work. The NHS European Office is  actively involved in joint employer/trade union activities on promoting CPD and lifelong learning across the health sector, and we have contributed significantly to the recently concluded HOSPEEM and EPSU framework agreement on CPD and lifelong learning. 

Review of minimum qualifications for healthcare professions

The European Commission has commissioned a consultancy to map Member State minimum training requirements for knowledge and skills, to see where these may be disproportionate and/or need updating in the light of professional, scientific and technical developments. The first profession to be reviewed in this way will be the nursing profession – see the project description here. The consultants will hold one or more stakeholder workshops later in 2019. The NHS European Office intends to participate in these through our membership of HOSPEEM.


Directive EU/2018/958 on a proportionality test before the adoption of new regulation of professions attempts to curb “disproportionate” regulation by Member States which restricts the freedom of professionals to provide services across borders. As this Directive was passed in 2018 and must be implemented in national law by summer 2020, it will still apply in the UK after Brexit at least for any transitional period. 

The NHS European Office used our influence through HOSPEEM, CEEP and HOPE to amend this legislation, as we were (and remain) concerned about how it may affect the ability of the UK to regulate “new” professions such as nurse associates in future, or to tighten up requirements e.g. for CPD. The NHS EU Office will continue to engage in this way with this process after Brexit.

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