Frequently asked questions about the operating models and division of duties of healthcare and social welfare personnel

In healthcare and social welfare units, medicines are generally administered by qualified healthcare and social welfare professionals who have been trained for the task. Each unit has a pharmacotherapy plan which defines the role and responsibility of professionals in administering medicines to clients and patients. In all units where medication is provided, management bears overall responsibility for ensuring safe medication practices and the conditions for them in their units. Nurses, public health nurses, midwives and paramedics receive extensive training in medication as part of their professional education. For this reason, they can administer a wide range of medicines without a separate medication permit. However, they need additional training and a specific written medication permit for demanding tasks such as intravenous (i.v.) drug and fluid therapy. The permit must clearly specify which person and which medication tasks it covers. A doctor grants the written permit. Legislation and guidelines make no distinction between nurses working in hospitals and those in home care.

In all units where medication is provided, management bears overall responsibility for ensuring safe medication practices and the conditions for them. In healthcare and social welfare units where medication is part of daily work, medicines are mainly given by healthcare and social welfare professionals. They have been trained for the task and follow the unit’s pharmacotherapy plan. If the employer considers it essential for a care assistant to participate in medication, the assistant must be trained for the task, their competence verified and a written medication permit issued. A care assistant may give pre-dispensed medicines only by natural routes. They cannot independently take responsibility for a client’s medication.

A licensed optician is a healthcare professional authorised by the competent supervisory authority to practise in Finland. Since 1 August 2025, opticians have been allowed to prescribe glasses more broadly. The regulation no longer restricts who an optician may independently prescribe glasses, contact lenses or comparable optical devices for. Under the Act on Health Care Professionals, an optician may prescribe glasses and contact lenses within the limits of their training and competence, provided it is appropriate and safe for the patient. In other cases, the client must be referred to a doctor. Both the healthcare professional and their employer must assess whether the individual has sufficient training and professional skills. For each patient, the optician must weigh the benefits and risks of their professional practice and recognise situations where prescribing glasses would compromise patient safety. In public healthcare, glasses are prescribed for children under 8 whose eye condition requires them, or for hospital patients whose continued care depends on up-to-date glasses, such as those awaiting strabismus surgery.

A clinical dental technician may make partial dentures independently to the extent that their training and competence allow. Typically, the technician receives a referral from a dentist, who ensures the patient’s mouth and teeth are in suitable condition and any necessary adjustments have been made before the denture is produced.

A dental hygienist may always carry out an oral health check for an adult patient, but only a dentist can decide on dental examinations, diagnoses and related treatment. If the hygienist identifies a need for a dentist’s examination or treatment, the patient must, under the legislation on the maximum waiting times for access to care, get an appointment within 6 months of contacting oral healthcare and having their need for treatment assessed. For patients under 23, the appointment must be within 4 weeks of the need being identified or within 3 months of first contact and assessment. The employer is responsible for ensuring that oral healthcare professionals have the skills required for the tasks assigned to them.

The employer is always responsible for the division of duties in the unit and for ensuring staff have the skills required for the tasks assigned to them. A care assistant can accompany a client to a scheduled healthcare appointment if the client’s condition does not require a healthcare or social welfare professional to go along. There is no legal barrier to a care assistant acting in this role. However, a care assistant cannot assess whether the client needs treatment or an appointment. That assessment must be made by a healthcare professional.

Legislation on healthcare and social welfare professionals only applies to regulated professions and does not govern the activities of staff who are not covered by that legislation. The employer therefore has full discretion to decide how other staff are assigned to non-professional tasks and what skills are required. Employers can flexibly recruit and train assisting and support service staff and give them targeted further training for specific tasks. This ensures they have the skills needed to assist healthcare professionals. In practice, a patient can be transported from the emergency department to, for example, diagnostic tests by someone without nursing training if: the patient does not need monitoring or care during transport (for example, their condition is stable and they have no complex treatment needs), a healthcare professional has assessed the patient and confirmed they are suitable for transport by assisting staff, and the employer has established internal rules or organisational procedures for patient transporters. A designated responsible person ensures that competence requirements and patient safety standards are met.

The Act on Care Services for Older Persons allows the use of various types of staff to meet clients’ needs in services for older people. In round-the-clock care for older people, the skills of other healthcare and social welfare professionals besides practical nurses and registered nurses can be widely utilised. Supporting social functioning can also involve other suitable professionals, such as those from the arts and cultural sector. For some staff categories, restrictions apply. For example, certain professionals cannot work alone on a shift or participate in medication. Every shift must always include a sufficient number of healthcare and social welfare professionals.

Legislation on healthcare and social welfare professionals only applies to regulated professions and does not govern the activities of staff who are not covered by that legislation. The employer has full discretion to decide how other staff are assigned to non-professional tasks and what skills are required. A healthcare logistician or other logistics staff may collect supplies if processes are clearly defined and instructions provided. Some hospitals already use models where healthcare logisticians or instrument technicians handle supply collection for certain surgeries instead of nurses. The process can also be partly automated (for example, electronic ordering systems and warehouse management).

Manual therapy providers can work in health and social services centres. A physiotherapist practising as a licensed healthcare professional must hold the right to practise in Finland, granted by the Finnish Supervisory Agency on application. The Agency also grants the right to use protected occupational titles such as chiropractor, naprapath, osteopath and trained massage therapist. Tasks under a protected title can also be performed by other individuals with sufficient training, experience, and professional skills and knowledge. Health and social services centres may also employ manual therapy practitioners who are not healthcare professionals. The employer must ensure that staff have the skills required for their tasks and that client and patient safety is not compromised. It is also important that patients know which professional is treating them.

Employers have broad discretion and flexibility in organising work and sharing tasks among professionals. A client-initiated appointment means that clients can book directly with a professional without first seeing a doctor and getting a referral. There is already considerable positive experience with client-initiated physiotherapy appointments. Offering occupational therapy without a referral is also well suited to a health and social services centre. The need for a functional capacity assessment should be identified during client assistance.