An ever-expanding population that is living longer and healthier lives, with great expectancies concerning health
and welfare, brings many challenges to the provision of quality healthcare.

This is especially the case in Intensive Care Medicine, where an increasing demand together with changing
perspectives as to what is both achievable and warranted come together. The provision of care in this setting is
extremely dependent on skilled, well-qualified multi-professional staffs that are capable of dealing with an
increasingly busy, more complex and more stressful environment.

The European Society of Intensive Care Medicine (ESICM) represents a large body of clinicians, nurses and
allied health professionals who work in the Intensive Care specialty, mainly within European borders. ESICM is
acutely aware of the issues that its members are faced with on a daily basis.

The European Working Time Directive has resulted in more intense and complex rotations and shift patterns.
This has hindered the ability to train the next generation of healthcare professionals and has had significant
knock on effects in terms of worker satisfaction, provision of care and ultimately patient safety.

The ESICM has developed a number of strategies to document and understand the impact of work patterns and
shift intensity on provision of care and patient outcome. These include the research projects recently published
that originated in the Health Service Research Outcomes section of the society- namely the SAP3 project
looking at hospital demographics, patient outcome and cost-effectiveness of care and the SEE 1 and SEE2
studies looking at the causes and consequences of adverse events and medication errors.

As our population continues to grow and the need for acute medical care expands, these pressures and issues
will become more important to both understand and cope with. The ESICM fully supports any initiative from the
EU that will help us delineate the available workforce and therefore lead to strategies that can overcome the
forthcoming potential shortfall in trained and skilled staff. It is quite clear that there are significant geographic differences in the provision of healthcare within the EU.

The ESICM is of the view that high quality care provided by a motivated, skilled and experienced workforce is
vital, cannot be substituted by any new devices or monitoring techniques, and that this should be planned for
and achieved wherever it is required in the EU.