Views on task shifting implementation in Norwegian health policy and among health service managers – a mixed methods study

A mixed-methods study reported broad support for task shifting in Norwegian health policy and among health service managers, while finding differences in which workers and organizations they considered should participate. The available abstract indicates that the government’s guidance emphasized developing competencies among skilled workers, whereas most managers surveyed focused on using existing competencies higher in the workforce, including shifting tasks from physicians to nurses. Managers were generally positive about implementation despite reporting organizational challenges.

Researchers combined content analysis of task-shifting guidance in three Norwegian health policy documents with a cross-sectional survey of health service managers in Western Norway. The documents, issued between 2023 and 2024, comprised a white paper, an Official Norwegian Report and operational guidance concerning reductions in hospital waiting times. The survey was conducted in September 2024 and included 139 managers. Policy documents were examined through content analysis, while the survey results were summarized with descriptive statistics and correlation analysis, according to the abstract.

The policy documents endorsed task shifting while assigning three areas of responsibility to managers: strategic competency planning, patient safety and leading staff. The government’s recommended approach focused on building competencies at lower levels of the workforce, primarily among skilled workers. It also recognized that task shifting could involve technology, patients and non-governmental organizations. Among the surveyed managers, however, the strongest emphasis was on using competencies at higher levels of the workforce. Their reported practices included shifting tasks from physicians to nurses, which differed from the broader range of actors described in the policy guidance.

Manager responses also varied in how prominently they described their responsibilities. Strategic competency planning was reported as an annual activity, leading staff was considered important, and patient safety was less salient. The abstract states that the early stage of implementation may help explain why some managerial responsibilities appeared less prominent in managers’ responses. Overall, managers supported involving a wider range of actors than was occurring at the time.

The study offers a policy and management perspective rather than evidence that task shifting improves access, efficiency, safety or clinical outcomes. Its survey component was cross-sectional, was limited to one region and included 139 managers, so it did not track changes over time or establish the effects of implementation. The supplied evidence is an abstract of a peer-reviewed, accepted manuscript and does not provide detailed sampling information, statistical estimates or results for the correlation analyses. The findings therefore describe views and reported practices among the documents and managers studied, rather than the effectiveness of task shifting in Norwegian health services.

Subject of Research: Norwegian policy and manager perspectives on implementing task shifting in health services

Article Title: Views on task shifting implementation in Norwegian health policy and among health service managers – a mixed methods study

Article References: Oksavik, J. D., & Kirchhoff, R. (2026). Views on task shifting implementation in Norwegian health policy and among health service managers – a mixed methods study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15740-3

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15740-3

Keywords: task shifting, Norwegian health policy, health service managers, workforce competencies, patient safety, mixed-methods study, Western Norway, implementation, Views, task, shifting, Norwegian