Health Ministry adds hospital staffing cost indicators to contract terms

Poland’s Minister Zdrowia has added three staffing-cost quality indicators to the general terms of contracts for publicly funded health services, requiring hospitals to report payroll and civil-contract spending as a share of their revenue from the Narodowy Fundusz Zdrowia. The amendment was signed on 16 October 2026 by acting minister T. Maciejewski and published in the Dziennik Ustaw of 26 October 2026 as Dz.U. 2026 poz. 1409. It takes effect 14 days after publication, on 9 November 2026.

The regulation amends the Minister Zdrowia regulation of 8 September 2015 on the general terms of contracts for the provision of health services (Dz.U. 2026 poz. 712, 863 and 1137), issued under Article 137(2) of the Act of 27 August 2004 on health services financed from public funds (Dz.U. 2025 poz. 1461, as amended). It inserts items 4 to 6 into part C.II of the annex to the annex, the catalogue headed “Quality indicators of health care described by the parameter of the degree of use of the resources at the disposal of the entity”.

All three indicators refer to the calendar year preceding the year in which the indicators are published under Article 5(2) of the Act of 16 June 2023 on quality in health care and patient safety.

Three measures of the payroll mix

• Indicator 4 — the share of total staffing-resource costs in revenue from the performance of contracts for health services. The numerator combines remuneration, social insurance and other benefits, medical contracts and nursing contracts; the denominator is revenue from the Narodowy Fundusz Zdrowia less revenue from medicines and active substances in drug programmes and chemotherapy.
• Indicator 5 — the share of staffing costs from employment contracts in total staffing costs, with remuneration under contracts of mandate and contracts for specific work excluded from the numerator.
• Indicator 6 — the share of staffing costs of people practising a medical profession in total staffing costs.

The definition of the first indicator covers all remuneration costs, including derivatives, for people employed under an employment relationship and all remuneration under civil-law contracts, including contracts for the provision of health services referred to in Article 27 of the Act of 15 April 2011 on medical activity. It covers staff practising a medical profession and staff practising a non-medical profession.

Two separate reporting channels

Indicators 4 and 5 are to be calculated from the MZ-BFA financial statements of medical entities that are hospitals, submitted to the Narodowy Fundusz Zdrowia. The formula draws on positions W40K01 B.V. (remuneration), W47K01 B.VI. (social insurance and other benefits), W32K01 B.III.3.1 (medical contracts) and W33K01 B.III.3.2 (nursing contracts), plus any other civil-law contracts from a separate position in the MZ-BFA statements.

Indicator 6 relies instead on remuneration data submitted to the Agencja Oceny Technologii Medycznych i Taryfikacji by providers. Its numerator is the remuneration of occupational groups 1 to 7, taken from the “Tabela-UoP, dzieło, zlecenie-OKRES” sheet and the “Tabela-podwykonawstwo-okres” sheet, with the same two sheets forming the denominator.

Transitional rule for drug programmes

In the denominator of indicator 4, revenue from medicines and active substances in drug programmes and chemotherapy is deducted. Until 31 December 2027, providers may use the higher of two figures: the value reported in position W05K01 A.I.1.a, or the value of Narodowy Fundusz Zdrowia contracts listed in the contract information system for active substances in chemotherapy and drug programmes and for emergency access to drug technologies, calculated for a full calendar year.

The regulation contains only the amending provisions and the entry-into-force clause; no separate transitional or reporting deadline is set beyond the 31 December 2027 date written into the formula.

The change puts the staffing structure of every hospital provider into the contractual quality framework on a single, comparable basis, distinguishing employment contracts from civil-law arrangements and medical from non-medical staff. Because the indicators are calculated from statements already sent to the Narodowy Fundusz Zdrowia and to the Agencja Oceny Technologii Medycznych i Taryfikacji, hospitals will be measured on data they report rather than on a separate survey.

Source: Dziennik Ustaw, No. 1409 of 26 October 2026, section I (official reference: Dz.U. 2026 poz. 1409).