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Examples of Systemic Solutions for Skill-Mix Issues-An Analysis of International Experiences with a Focus on Rural
Jan Łuczak1, Katarzyna Bochniak1, Wiktoria Kaczmarek1
1Faculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland.
Healthcare (Basel, Switzerland)
|June 12, 2026
Summary
Skill-mix strategies, involving task shifting and new professional roles, improve healthcare access and quality. Successful implementation requires clear regulations and training, especially for rural medical deserts.
Area of Science:
- Healthcare Management
- Health Policy
- Workforce Development
Background:
- Healthcare systems worldwide face staff shortages and unequal access, particularly in rural areas.
- Task shifting, task sharing, and skill-mix strategies are increasingly adopted to address these challenges.
- This review examines how different healthcare systems integrate competencies through new roles and task redistribution.
Purpose of the Study:
- To summarize skill-mix strategies implemented in various healthcare systems.
- To identify potential strategies relevant for the Polish healthcare context.
- To analyze the impact of skill-mix on access to care and professional workload.
Main Methods:
- A narrative literature review was conducted using PubMed and Embase.
- Publications from 2010-2024 in English or Polish were included.
- A thematic synthesis approach was used to analyze relevant publications and policy documents.
Main Results:
- Introduction of new professional roles and expanded scopes of practice (nurses, physiotherapists, pharmacists) improved care access and continuity.
- These strategies helped reduce physician workload and, in some cases, improved treatment outcomes.
- Challenges included unclear role boundaries, training gaps, increased workload, and insufficient organizational support, particularly in rural areas.
Conclusions:
- Skill-mix strategies can enhance healthcare access and quality if supported by clear regulations, adequate training, and health worker acceptance.
- Further research is needed to evaluate the long-term effects and applicability of these strategies in underserved regions ('medical deserts').
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