ROUTE-HWF aims to reduce inequalities in access to healthcare among countries and regions in Europe by supporting EU Member States in designing and implementing their policies related to regional medical deserts. It will do so by: (1) providing a definition and taxonomy of the concept of medical deserts, (2) developing guidelines on how EU Member States can monitor and measure medical deserts (as defined and categorized in the developed taxonomy) at national and subnational levels, (3) providing in-depth insights on factors driving “desertification” and of HWF policy responses and approaches to medical deserts, (4) providing an optimal mix of HWF policy responses and approaches to medical deserts per category of the taxonomy on medical deserts, and (5) developing a roadmap which will support EU Member States in designing and implementing their health workforce policies, actions and initiatives related to medical deserts.

Divided over 3 horizontal WPs and 5 core WPs, the following methods will be used to achieve these aims: a literature study, a country survey among 33 European countries, a database search, five national workshops (NL, FI, ES, PL, HR) with 10 participants each, six in-depth case studies, and a 1,5 day consensus building workshop with 66 participants from 33 countries.

The elements of the ROUTE-HWF roadmap will be strongly rooted in practice and support public authorities and health professionals at national and subnational levels in (a) better understanding the characteristics of medical deserts in their country or region, (b) better monitoring and measuring medical deserts, including the effects of policy measures, and (c) improving the design and implementation of policies to move out of medical deserts in their country or region, by providing a rationale for a mix of policy measures, taking into account relevant contextual factors (including possible legal and other barriers).

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The expression of medical desert is commonly used in the public and mediatic field referring to several situations or areas where people have difficulties to access care (e.g. waiting time, doctor’s registration difficulties or long distances to hospital).The identification of such areas became a major issue and is exacerbated by the fact that the accessibility itself is complex to address due to its multidimensional nature (spatial, physical, temporal, financial, and cultural).The OASES proposal aims to represent a source of knowledge in European medical deserts, reinforcing the capacity of health authorities of EU Member States to reform their health systems and address all the important aspects to successfully tackle the challenges that the medical desert is posing, with specific regard to actions focusing on skill mix, task shifting, use of e-health and IT systems, recruitment and retention management and policies, in order to guarantee universal coverage also in rural and underserved areas. To achieve this, the proposal presents and supports the application of a stepwise methodology focused on a) definition of a measurement methodology and tool applicable in different contexts (minimal, intermediate, advanced dataset); b) implementation of the measurement methods and tools in selected pilot sites of 7 European countries; c) assessment, policy actions analysis and sustainability in each pilot site, d) impact evaluation in each pilot site and updating the measurement methods and tools according to the pilot results; e) scaling up of the methods and of the policy actions at EU level.
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