Abstract Chapter 14

Chapter 14 investigates the degree of inclusion of under35 administrative personnel in Italian Local Health Units, by describing their background, the professional and contractual arrangements they are subjected to. In literature, this topic is not as debated as that related to healthcare professionals and/or managers, even though the administrative personnel includes 11% of the total Italian NHS workforce. Moreover, multiple norms promulgated in the past ten years, together with interventions on the institutional architecture and governance, have deeply affected the characteristics of the NHS workforce. Data from the Conto Annuale (administrative data from the Italian Ministry of Treasury and Finance) show that in the 2006 – 2016 period, there was a sharp decrease in the total number of NHS’s administrative personnel (from 77.148 to 68.947 people), and a 63,9% reduction of under35 employed in administrative roles in local health authorities. The research consisted of two methodological steps. The first step included a desk analysis of the organizational models that all Italian Local Health Units (LHU) and Independent Hospitals (IH) have adopted for five Administrative Services (“Planning and Control”, “HR management”, “Marketing and Communications”, “ICT”, “Financial and Accounting management”). Secondly, a survey was submitted to all HR Managers of such authorities. The study shows the existence of a generational gap in LHU and IH, and provides evidence for three main suggestions: first, under35 administrative personnel share on total workforce of an authority is always below 10% in the administrative services analysed. Secondly, authorities based in Regions that have never been subject to recovery plans (Piani di Rientro) register a 7.1% share of personnel in the under35 cohort, in sharp contrast to the 2.7% we found in Regions that undertook recovery plans. Last, more than 50% of under35 profiles working in local healthcare authorities have a permanent contract and the use of temporary arrangements seems to be very limited. In the end, the Chapter shows that there is space for improvement in terms of balancing the age mix in non-sanitary services, which should be accompanied by the selection of professional competences that could match the necessity of managing increasingly complex organizations (e.g. through Talent management and Knowledge management approach).