It is of paramount importance to support the development of relevant and high-quality skills and competences in combination with further strengthen key competences in VET in relation to health care. European healthcare systems show significant gaps in the provision of healthcare (Council of Europe, 2016) and at the same time our health care system is under a considerable budgetary and societal strain (European Commission, 2017). In order to improve our provision of care, we need to devise a more efficient and sustainable healthcare system. Then it is essential to be able to implement change and monitoring the outcomes and at the same time numerous studies show that implementing the proposed changes in a health care setting remains fragmented, inconsistent and not efficient.Hence, there is a substantial need for the development of high quality work-based VET in the healthcare sector that facilitate the process of implementing change in an efficient and structured way as well as being cost-efficient.

The need for ongoing training and development of health care professionals is highlighted in the Directive 2013/55/EU "Member States shall ensure, by encouraging continuous professional development, that health professionals are able to update their knowledge.. to maintain safe and effective practice". A key priority is the need to train healthcare professionals in how to implement change and monitoring the effect at clinical levels. The healthcare partners from Slovenia, Greece, Estonia, Latvia and Romania reports that they do not have the resources or training to enable them to adequately address these issues and they are therefore neglected.

The objectives of this project are to develop, test, implement and disseminate the developed training material for healthcare managers and healthcare professionals as well as students. A further objective is to produce a functional training programme, reflective of the sociocultural diversity across Europe. The project aims to make the training material accessible to a broad range of stakeholders and will do so through multi-mode delivery accessible as open-resource.

The consortium consists of public health experts in change and implementation methodology (SE) and pedagogical experts in vocational training (NO) with a NGO (NL) that will incorporate the patient perspective. The hospitals (LT, EL, RO, SI, EE) will conduct a needs analysis of each partners' healthcare setting.

The methodological approach and activities will generate the following results:

1. A functional and evaluated training material that is based upon research evidence and the needs analysis.

2. The training will quickly have an impact through high quality work-based VET that enhances service provision by addressing the need to create tools on how to implement and evaluate change in a structured way.

3. Health care organisations will have access to continuing education and training (CVET) that will update their health professionals' knowledge in this area in order to maintain safe and effective practice

4. As prioritised by the European Commission, it is paramount to create more sustainable health care system that can address that everyone has access to affordable, preventive and curative health care of good quality. This developed training course provide the tools on how to implement and monitoring these changes for all patient groups, including those that are at risk for social exclusion and poverty.

5. The training will be economically viable to implement and be able to reach a large group of members of health staff or NGO's. This is due to the methodological design of a concrete and focused 1-day training course that emphasis on addressing knowledge and skill deficits in this area.

The long term benefits will be that staff/students in the health care sector and NGOs will receive a training that will directly enhance their skill set and as a consequence will facilitate better health care provision for their intended target groups and in the same way make the health care system more efficient. With better implementation strategies that can ensure that improvement in health care provision will be more successful. This will then result in that patients will receive an improved timely access to affordable, preventive and curative health care of good quality. Individuals that also belong to socially disadvantaged groups will also benefit since the training will address the particularly circumstances that needs to be considered when implementing change in order to avoid unintentional marginalisation.

The project will result in raising a European awareness of these aspects, which adheres to the established priorities of the European commission (European Commission Communication 'European Disability Strategy 2010-2020: A Renewed Commitment to a Barrier-Free Europe', November 2010; European Commission Communication 'The European Platform against Poverty and Social Exclusion', December 2010).