Adaptation to changed conditions: A new draft bill is to be negotiated over the next four months.
For the past year and a half, a workload relief agreement (E-VE) at the Hannover Medical School (MHH) has regulated minimum staffing levels and workload balancing for many employees working in patient care. The goal is clear: to reliably protect the approximately 2,200 employees in Nursing and other areas from being overburdened and to improve their working conditions.
With the planned phase-out of PPR 2.0 as a tool for measuring and planning nursing staff requirements, the previous basis for assessing workloads will no longer apply. Furthermore, far-reaching legislative changes are fundamentally altering the financial framework for hospitals: The Hospital Reform and the Statutory Health Insurance Contribution Stabilization Act will fundamentally change the financing of nursing care starting in 2027. Against this backdrop, MHH Vice President Martina Saurin, a member of the Executive Board responsible for Management and Administration, announced today in a discussion with Verdi that the E-VE will be terminated by the end of this month, effective January 31, 2027. This gives the MHH and the union a little over four months to negotiate a new agreement.
Further developmentaAimed at providing real relief
The state and the MHH remain committed to the goal of reliably and sustainably reducing the workload of MHH Nursing staff and creating good working conditions. However, experience to date shows that it is necessary to assess whether the existing regulations can effectively and permanently achieve this goal. The outstanding issues regarding implementation and the now-necessary further development of the E-VE will now be discussed further in the relevant committees. “The focus must be on reconciling real relief for employees, high-quality patient care, and the MHH’s financial viability,” explains MHH Vice President Saurin.
E-VE not yet a game-changer
An important measure of the E-VE’s success is whether employees’ working conditions have actually improved. The metrics available so far do not confirm this. The MHH Presidium will shortly hold an informational meeting to personally inform employees about the reasons for the renegotiations and the next steps.
When it comes to recruitment, there is also no indication so far that the E-VE represents a significant competitive advantage for the MHH. While the number of nursing professionals has steadily increased in recent years, the increase has been smaller than hoped for. From the job interviews, we learned that other factors for applicants—such as sports programs or discounts on the Deutschlandticket—play a greater role.
Significant effort required for implementation
Another challenge is the complexity of the agreement. After months of intensive efforts, it has become clear that the automated, shift-specific calculation of workload points and days off is technically impossible. In addition, misunderstandings have arisen during the implementation of the agreement, for example regarding its implementation in the Central Emergency Room (ZNA), the transition between the systems specified in the agreement, and the future basis for calculating workload in Nursing.
Over 20 million euros in additional annual costs due to the E-VE
As expected, the E-VE has had a significant financial impact. In 2025, additional staff and days off resulted in extra expenses of over 20 million euros, the majority of which were not reimbursed. Yet the agreement was in effect for only nine months in 2025. Costs on a comparable scale are currently anticipated for 2026 and 2027 as well.
E-VE in effect since April 1, 2025
The E-VE was concluded—in addition to the existing collective bargaining agreement between the states—as a contract under the law of obligations between the MHH and Verdi. It took effect on April 1, 2025. The agreement regulates minimum staffing levels and workload compensation for work on wards, in diagnostic areas, and in outpatient clinics. In addition, the E-VE defines overarching stressful situations that must be compensated for with workload points. These include, for example, a last-minute swap on the duty roster or assignment to a department other than the one in which employees have been trained.
Text: Inka Burow