Audit finds staff shortages, overwork in Polish emergency medical system

Poland's Supreme Audit Office (NIK) has found widespread staff shortages and excessive workloads in hospital emergency departments and ambulance services following a nationwide audit.

Photo:

PAP/Darek Delmanowicz

One of the most extreme cases involved a doctor at an emergency medical service (EMS) station in Radom, about 100 kilometers south of Warsaw, who worked a continuous 144-hour shift—the equivalent of six days—the audit found.

The audit covered the period from January 1, 2023, to September 1, 2025.

NIK found that doctors at nine hospitals worked shifts exceeding 24 consecutive hours. The longest shift—144 hours—was recorded at a hospital in the western town of Sulęcin. In seven other cases, doctors worked 120-hour shifts.

Auditors also identified 58 cases in the first quarters of 2024 and 2025 in which doctors at a single hospital worked more than 24 hours without a break. One paramedic worked four shifts lasting between 36 and 48 hours.

Paramedics also logged exceptionally long hours. At the provincial EMS station in Szczecin, northwestern Poland, one paramedic worked 456 hours in a single month, averaging more than 15 hours a day.

The audit found a shortage of doctors assigned to ambulance teams, with paramedics in some cases operating without a physician.

Auditors also reviewed the schedules of doctors, nurses and paramedics employed under civil-law contracts. At every emergency dispatch center inspected, staff members were found to have worked more than 24 consecutive hours.

The report also cited cases in the cities of Bydgoszcz and Lublin in which the same employee finished a shift at one EMS unit and began work the same day at another facility located far away. At the Radom EMS station, three doctors moved between units after only brief breaks.

NIK said the long shifts were made possible by the widespread use of civil-law contracts, which are not subject to the same working-time restrictions as standard employment contracts.

Managers at the audited facilities argued that emergency personnel could rest between calls and that some employees preferred longer shifts because they lived far from their workplaces and wanted to reduce commuting.

The audit also found that hospital emergency departments were heavily burdened by patients whose conditions were not urgent.

Nearly half of those admitted did not require emergency care, while more than 60 percent of patients transported by ambulance did not need hospitalization. Only 6.2 percent were classified as the most urgent cases.

Most patients arrived during weekday daytime hours, suggesting that many were using emergency departments instead of waiting for appointments at outpatient clinics, NIK said.

The report comes as Poland's government seeks to improve the efficiency of the country's healthcare system and hospital services amid growing public criticism.

(pu/gs)

Source: IAR, PAP