Dedicare is one of the Nordic region’s largest staffing companies in healthcare and social work and operates in Sweden, Norway, Finland and Denmark.
The staffing market’s contribution to health care and social work has become increasingly significant in recent years. In our sector, there are up to 100 companies, of which some 40 are authorized staffing companies that apply the industry’s collective agreement.
According to the Swedish Municipalities and Counties (SKL), the Regions (formerly the County Council) staffed healthcare personnel for just over SEK 5.4 billion in 2018, which is an increase of 4% compared to 2017. The rate of increase has slowed in recent years. SKL has developed the action program “Independent of hired staff in health care”, which comes into force on January 1, 2019. The goal is to reduce the cost share of hired staff in relation to own staff from 3.8 percent to 2 percent.
When working with Dedicare, health care personnel will work within private and public care providers. Social workers will mainly work with public care providers.
Of the total market, Dedicare estimates that approximately 55% of the market’s turnover is attributable to physician staffing, about 25% to nurses, about 15% to social workers, and about 5% to other occupational categories. During 2018, the market for nurse staffing increased, physician staffing has remained the same and social worker staffing has decreased compared to previous years.
Compared to other segments of the staffing market as a whole, the healthcare market has performed relatively well through the recession. The use of staffing varies across the country and between regions. In absolute terms, the Stockholm region is the largest market, but measured in per capita sales, northern Sweden is at the top. One reason for the regional differences is that the northern regions have had a harder time recruiting staff than the metropolitan regions.
Dedicare is the largest company in the industry when it comes to staffing social workers as well as one of the largest in staffing doctors and nurses. Dedicare’s assessment is that the market share is just under 10%.
Total turnover for healthcare staffing in 2018 is estimated to have amounted to approximately SEK 1.6 billion and in 2018 had a decline of approximately 5%. Between 2013 and 2017, the market saw annual growth of about 2%. Thus, 2018 was the lowest turnover in the industry since 2012.
There are no statistics on how the Norwegian staffing market is divided into occupational categories. Dedicare’s estimate is that about 25% of sales are attributable to physician staffing, about 60% to nurses, and about 15% to other occupational categories.
The market in Norway is divided into two parts:
- All Norwegian hospitals have gathered under a joint framework agreement procured by the purchasing organization Sykehusinnkjøp. The framework agreement on nurses was renegotiated in 2015 and Dedicare has been covered by a new framework agreement with Hospital Purchasing since October 1, 2015. Dedicare has framework agreements in all specialist areas and all regions. During 2019, the agreements with Hospital Purchasing will be re-procured.
- Outside of the large framework agreement with Norwegian hospitals, the municipalities are the other major player. This market is characterized by many large and small framework agreements. In the municipal market, Dedicare has had strong growth since 2009.
Dedicare’s share of the Norwegian staffing market was estimated in 2018 at just over 16%. The market share has increased compared to last year as Dedicare has grown significantly more than the market. Competition is different within the framework agreement with Hospital Purchasing and in the agreements with the municipalities.
There is everything from specialist companies that only staff specialist nurses as well as companies who only staff doctors. Dedicare is the largest player in Norway, which has operations in all of the Healthcarestaffing sectors.
Market forces for staffing
A common driving force for markets in the Nordic countries is that demographic trends indicate that the proportion of older people (65 years and older) will increase in the future. The number of residents older than 79 years will increase sharply, mainly during the period 2019-2030. Approximately half of the total number of care units in the healthcare sector are currently occupied by persons over 65 years of age. As a result, local health care is expected to be expanded in order to avoid hospitalization in the care and treatment of the elderly. In addition to increased pressure on care places, demand for specialist doctors and specialist nurses is also expected to increase. This is considered to require more staff, which is a need that can partly be met by staffing.
Another factor that indicates continued positive market growth is the generation born in the 40’s who have retired. The care needs of this group are expected to lead to a shortage of staff in both general medicine and specialist areas, such as psychiatry and geriatrics. Large retirement pension among physicians and nurses are also expected in the coming ten-year period.
Increased demands for cost efficiency and flexibility
Demographic developments in combination with medical technology advances and increased demands from patients and caregivers are expected to lead to increased costs for healthcare in society as a whole. In 2017, healthcare costs in Sweden accounted for 11.0 per cent of GDP, compared with 8.2 per cent in 1990.
This development may put pressure on public healthcare providers to run the business in the most cost-effective way possible. Dedicare believes that the possibility of more flexible staffing solutions can be an important instrument for running a cost-effective business. The increased need for health care and care in general is also expected to increase, in the long term, the private companies’ share of the market (primarily in public financing, but also in private financing of care and care).
At the same time, as pressure is increasing on existing care sites, Sweden’s municipalities and county councils plan for a largely unchanged number of employees in healthcare and care in general. There is a shortage of nurses and doctors in both Sweden and Norway and the shortage is expected to remain for the next few years. The need for staff is evident from the Employment Service’s so-called shortage index, which shows that the demand for staff for these occupational categories is high.