A cross countries in Europe, health policy is seeking to adapt to the post-pandemic 'permacrisis', where high demands on the healthcare workforce and shortages continue and combine with climate change, and war. The success of these efforts depends on the capacities of the healthcare workforce. This study aims to compare health policy responses to strengthen the capacities of the healthcare workforce and to explore the underpinning dynamics between health systems, policy actors and health policies. The study draws on a qualitative, comparative analysis of Austria, the Czech Republic, Denmark, Germany, Italy and the Netherlands. The findings suggest that policy responses at the national level focused on hospitals and absorptive capacities, while policy responses at local/regional levels also included general practice and adaptive capacities. There were only few examples of policies directed at transformative capacities. The underling dynamics were shaped by health systems, where individual parts are closely connected, by embeddedness in specific service delivery and areas, and by power dynamics. In conclusion, sub-national health policy responses emerge as key to effective responses to the post-pandemic permacrisis, where health professions are central policy actors. Sub-national health policy responses build on existing power relations, but also have the potential to transcend these power relations.

Department of Public Health Aarhus University Denmark

Department of Social and Political Sciences University of Milan Milan Italy

Erasmus School of Health Policy and Management Erasmus University Rotterdam Rotterdam The Netherlands

European Observatory on Health Systems and Policies Brussels Belgium; University of Michigan School of Health Management and Policy Ann Arbor MI United States

Institute for Economics Labour and Culture Goethe University Frankfurt Frankfurt am Main Germany; Institute for Epidemiology Social Medicine and Health Systems Research Hannover Medical School Hannover Germany

Institute of Public Health and Medical Law 1st Faculty of Medicine Charles University Czech Republic; Institute of Sociological Studies Faculty of Social Sciences Charles University Czech Republic

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