The Ministry of Health has presented a package of ten recommendations to "attract and retain professionals and facilitate their return to Primary Care," in which it proposes, among other measures, "offering stable contracts to those who complete the Residency, linked to a team and a reference list, and moving toward more flexible working hours."
These proposals are integrated into one of the four main lines of the report "Retention and Return of Talent in Primary Care: situation analysis and strategies for the National Health System, within the framework of the Primary and Community Care Action Plan 2025-2027," focused on "improving stability, flexibility, and reconciliation."
The report examines the elements that condition the staying, departure, and return of specialists in Family and Community Nursing and Family and Community Medicine. The data show that between 2013 and 2023 the number of Nursing professionals in Primary Care teams grew by 18.5 percent, compared with 32.4 percent recorded in hospitals and 54.1 percent in Emergency and Emergency Services.
In the case of Medicine, the increase in Primary Care teams was 8.3 percent, while in hospitals it reached 24.8 percent and in Urgency and Emergency Services it arrived at 25.2 percent. Based on these figures, the document concludes that there is "an underutilization of specialization," highlighting that "in 2024, around one in four specialists in Family and Community Nursing worked in Primary Care (24.6%)," and that "in Medicine, one in six specialists in Family and Community Medicine worked in the hospital setting in 2023 (16.4%)."
Adapting training and facilitating the return to Primary Care
After analyzing national and international sources, conducting focus groups, interviews with professionals and representatives, and mapping regional policies that included 25 informants from 12 autonomous communities, the Ministry proposes ensuring that Primary Care has specialists, enabling return itineraries for those who carry out their work at other care levels, recognizing Family and Community Nursing positions, and adjusting the training offering to the future needs of the system.
Likewise, it is considered a priority to reorganize work through teams made up of Medicine, Nursing, and administrative staff; to reduce the bureaucratic burden borne by clinical professionals and to adapt care workloads both to the characteristics of the population and to the functions specific to each professional profile.
The report recalls that several of the initiatives have already been implemented in full or in part in different communities, although "their integration into a coordinated strategy would make it possible to adapt them to the needs of each community and evaluate their results". In this context, Health proposes expanding options for professional development, teaching activity, and research, as well as strengthening leadership and the management capacity of health centers. To this end, the importance of optimizing coordination, monitoring, and funding for talent retention and return policies is emphasized.