Climate heat disasters fuel the health and care workforce crisis: a comparative assessment of workforce heat-health policy in selected European countries

Abstract Background. A majority of European countries have heat-health action plans in place or under development, yet the health and social sectors are poorly considered despite their high burden and key role for health system resilience and security. Objectives. This research connects workforce policy and heat-health action policy, aiming to assess preparedness, protection and agency of health and care workers and identify gaps and capacities for implementation. Methods. Qualitative comparative methodology and a country case study design were applied and a rapid assessment of eight European countries performed during August/September 2026. A semi-structed topic guide informed data collection, drawing on policy documents and other secondary sources. Results. No country case study established a dedicated workforce-centred heat-health strategy nor do they have routine workforce-specific heat-health surveillance systems in place. Countries recognise health workers primarily as service providers, rather than as a workforce requiring protection. This approach shapes all areas of heat-health action. Preparedness of health workers shows limited strategic action but with some adaptations at the provider and individual level and in the education sector. Protection remains poorly addressed and equality, gender equality and migrant health workers are largely absent. Professional stakeholders and bottom-up emerging adaptations create capacities but agency is limited. Four interrelated priorities for advancing workforce heat-health policy can be identified: alignment of heat-health policy and occupational health law; workforce-specific surveillance and monitoring; stakeholder involvement and transsectoral governance; and a European Union strategy. Conclusions. Workforce resilience and climate-health resilience must be addressed together to ensure health security.