Presentation by Timo Sinervo, Laura Hietapakka, Vuokko Niiranen, Sanna Laulainen, Joakim Zitting and Salla Lehtoaro.

1. Future work and skills in health
and social care sector
Timo Sinervo, Laura Hietapakka, Vuokko Niiranen,
Sanna Laulainen, Joakim Zitting, Salla Lehtoaro
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2. Introduction
• Finnish health and social care under large reform
– New legislation (proposal coming) and organisational changes
– Despite legislation changes have taken place already
• Key changes:
– larger areas (counties) in responsibility of services (now
municipalities),
– care integration, social and health, primary and secondary
– service production from municipalities to multiple providers
(counties, private firms, third sector)
– freedom of choice for patients, more competition between
providers
– Digitalization, division of duties
– Aim to develop actual service patient-driven not only organization
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3. Study question
• What are the major changes (already happened, planned and
supposed to happen in future) in health and social service?
– In which sectors and occupations would this mostly effect
– How do the changes differ in the three study organizations
• What is the impact of the changes on future competence
needs?
– Education of future professionals
– Needs for training of employees at work today
– Developing the work and services at work places (training or
something else?)
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4. In focus: Changes needed in working life and
competence
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Project manager: research professor
Ilmo Keskimäki. THL
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5. Data and methods
• Subproject: Changing work and new competence needs in
future health and social care
– Timo Sinervo (PI) and Ilmo Keskimäki, THL; Vuokko Niiranen,
Sanna Laulainen, UEF; Sari Kujala, AU; Piia Silvennoinen,
Laurea (in THL Laura Hietapakka, Salla Lehtoaro, Anu
Kaihlanen)
• Participators: Federations of Municipalities: Siun sote ,
Eksote, Hyvinkää hospital District and City of Hyvinkää
• In this paper:
– 25 theme interviews of top and middle management, later 30
frontline supervisors, and 35 employees, surveys (N=2000-3000)
• The project financed by Strategic Research Council
2016–March 2019
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6. Changes in organizations or in progress 1/2
• Integration of care processes
– Organizational changes
• from municipal to county (joint authorities of municipalities)
• possibility to plan services in larger areas, and to standardize services
(quality, quantity, processes), changing the entire service chain
• adults’ psychosocial services or children’s services under same
management, including health and social services, hospital units
– Co-operation (care processes over organizational structures)
• Combined health and well-being centers, where employees from
different organizational units work together (health centers, social
work, mental health services.. )
• Small acute home care unit (with emergency, inpatient and home care
• Home rehabilitation (physiotherapists working together with home care
– Care coordination (care coordinators in elderly care and health
centers)
• Planning the care of clients with complex and many needs
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7. Changes 2/2
• From institutional care to home-based care
– Several inpatient units closed down (home rehabilitation)
– Development of home care: goal-oriented home care for a period,
evaluation
– Home hospital
• Planning the service network in whole are, standardising
services
• Transportable services to sparsely populated areas
• Easier to invest in new things
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8. Skills (or attitudes) needed in future
• Customer service, service orientation (satisfaction of clients in
competitive environment)
• Understanding and analyzing clients’ needs in a more holistic
way, client centeredness, listening and not giving answers to
problems client does not see
• Multiprofessional co-operation
• Care coordination in complex care processes
• Service planning and understanding of whole service system
(social and health), understanding other parts
• Goal orientation (rehabilitative thinking)
• Active orientation, development of own work, positive attitude
• Strategic and economic thinking of middle managers
• Digitalization and its possibilities and gaps
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9. Challenges in development
• Patient choice, marketization
– Risk of fragmentation, integration difficult
– Difficulties in planning holistic processes
– Planning of service network -> ineffectiveness
– Need for more understanding on what patients need and want
– Interaction with patients
• Skills and development
– Managers can not make difference between skills, attitudes of
needs for development, work orientation
– In changes tailored training
– In vocational education schools make changes
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10. Conclusion
• Studied organizations have made a large variety of changes
in their organization after moving to area-based, larger
entities
• Standardizing and planning services in whole area and over
organizational structures has made it easier to plan client-
centered services
• Integration has been developed using new organizational
structures following clients’ needs, by co-operation and care
coordination
• In the future several generalized competences are needed:
– Client-orientation, customer service, multiprofessional work,
evaluation clients’ needs and planning services more holistic,
• In development, changing attitudes or work cultures is an
important question
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11. More information
• Timo Sinervo firstname.lastname@thl.fi
• www.stncope.fi
• Twitter: @stncope
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