The Human Rights Ombudsman has been warning for several years about the need for nursing homes – for people who cannot live independently after completing treatment. They currently remain in hospitals, where they occupy beds, or are taken in by (often inexperienced) relatives. The Ministry of Health and the Slovenian Health Insurance Institute are aware of the problem, but face a lack of staff and space. Non-acute treatment programmes are limited, and many patients therefore needlessly remain in acute treatment wards. A pilot project to establish health and nursing units (33 beds) will attempt to connect healthcare and social care between 2025 and 2028. The Ombudsman welcomes the efforts, but warns that the question remains whether it will be possible to recruit and retain staff in healthcare.

The Human Rights Ombudsman of the Republic of Slovenia (Ombudsman) has been dealing with the issue of establishing so-called nursing hospitals for several years. This concerns the accommodation of persons who have completed hospital treatment, but whose health condition still does not allow them to live independently. Relatives of these persons often find themselves in need and turn to the Ombudsman. Nursing homes cannot accept them due to overcrowding or lack of professional support. As a result, many remain in hospitals, waiting for a vacant place, an improvement in their health condition, or are taken in by relatives – mostly without the knowledge necessary for demanding medical and nursing care. Relatives often find themselves in the role of "impromptu paramedics", without training and support.

As a result, the problems start to snowball. When people who no longer need acute treatment occupy hospital beds, there is no room for patients who urgently need treatment. Thus, patients remain in A&E corridors and wait to be admitted. A vicious circle of waiting is established, which brings dissatisfaction to patients, their relatives, and healthcare workers.

From July 2024 to 2025, the Ombudsman communicated intensively with the Ministry of Health (MZ) and also included the Health Insurance Institute of Slovenia (ZZZS). Answers were sought to the following questions: How can hospital overcrowding be reduced? How can relief be provided to relatives who would like to take care of their loved ones but lack the knowledge, competence, or appropriate space? The Ombudsman was also interested in assessments of needs for non-acute treatment, extended hospital care, and palliative care in Slovenia.

After reviewing the data, the MZ warned that it is not possible to prepare a realistic assessment of needs. The reason is that hospitals have not fully implemented the majority of non-acute treatment programmes. The main obstacles are the lack of staff and space. The scope of services in non-acute wards is limited: it is not possible to perform diagnostic tests there, perform intravenous or antibiotic therapy, or care for more complex cases (tracheostomies, parenteral nutrition, pain pumps). Therefore, palliative care in these wards remains limited to individuals with very mild symptoms. Many patients are therefore still placed in acute treatment wards, where they do not belong, but there is no space for them elsewhere. The ZZZS emphasises that nursing hospitals are not intended for long-term stays (but for stays of a maximum of three months), but for the transition from hospital to home care. At the same time, it warns of the lack of personnel which nursing homes for the elderly are not receiving despite numerous calls for tenders. The Ombudsman doubts that a three-month period is sufficient for rehabilitation, especially for the elderly who live alone and without loved ones.

In its latest letter (September 2025), the MZ informed the Ombudsman of the activities it had carried out: it is establishing a new specialisation in the field of nursing, which would expand the competencies of graduate nurses and enable them to acquire specific knowledge necessary for high-quality patient treatment; to encourage young people to pursue a career in healthcare, it has launched the "Health Team" campaign, which raises awareness of the importance of healthcare workers through workshops: it organises information days and cooperates with schools; the "Nurse-Caregiver" pilot project provides training for staff in primary care and support in healthcare; legislation has been updated to simplify the recognition of professional qualifications, and mandatory monitoring of staff workload and a new salary framework have been introduced, eliminating salary disparities and introducing performance-based pay; scholarships for healthcare activities have also been introduced to encourage young people to train in professions facing a shortage of candidates. In addition, four major investments in nursing wards or hospitals are under way and a European-funded tender for the establishment of health and nursing units in social care institutions is under way. The pilot project will run from 1 October 2025 to 31 December 2028. Three units with a total of 33 beds are planned. The MZ wants to create a bridge between healthcare and social care – an area in which people's expectations are particularly high.

The Ombudsman welcomes the efforts of the MZ, but is aware that the results of the aforementioned efforts will not be seen for some time. However, doubts remain: will we be able to retain the acquired staff in the healthcare sector? Many are leaving the healthcare profession and moving to better-paid and, given the working conditions, schedules and workload, less demanding industries.9.4-31/2025