This morning, 22 September 2026, ARAN — the body that negotiates public sector contracts — presented to medical unions the draft of the new Health Area National Contract for the 2025-2027 triennium.[1] The main changes: an average increase of €380 gross per month, and — for the first time in a structural way — specific protections for physicians who suffer workplace assaults. ARAN President Antonio Naddeo opened the day cautiously: "We will see whether conditions exist to reach a signature". The draft is a starting point, not yet an agreement.
On assaults, the figures explain the priority: in 2024, over 18,000 healthcare workers in Italy suffered a workplace assault.[2] The figure has been stable for years, but the total number of individuals involved is growing. The new measures — solidarity leave, legal representation, psychological support — do not prevent assaults, but change what happens afterwards. It is a significant shift in approach: from a purely punitive perspective towards support for the victim.
What the new contract does not yet resolve
The documentary burden
€380 more per month does not reduce the 5 hours per day of documentation. Prescriptions, SOAP notes, FSE uploads, reports, letters: volume does not change with the CCNL. It is a systemic problem, not a contractual one.
The structural GP shortage
5,700 missing GPs in Italy. The CCNL does not create new physicians — and as Piedmont showed in August, even increasing training grants does not bring enough candidates.
Waiting lists
A pay rise does not reduce waiting lists. What reduces them is more clinical time per patient — which today is being taken away by documentation.
GP isolation
The contract covers hospital physicians and NHS employees. The contracted GP negotiates at a different table (ACN). Their clinical isolation and bureaucratic burden remain outside this draft.
The four areas the CCNL 2025-2027 does not touch — and which remain the terrain of daily change
A frequently misunderstood point: this CCNL does not cover GPs
The Health Area contract covers employed NHS physicians — hospital doctors, specialists, veterinarians, managers. Contracted GPs negotiate at a separate table: the National Collective Agreement (ACN), currently being renegotiated with the Community Health Centre reform. Today's measures do not apply to contracted GPs.[4]
The contract improves the structural conditions of medical work in Italy — and it is a step in the right direction. But the daily documentary burden is not a contractual problem: it is a workflow problem. And that is solved with tools, not signatures.
See also our articles on Italian physician burnout, on generational renewal and on the documentation time calculation.
Does the CCNL 2025-2027 cover general practitioners?
Not directly. The Health Area national contract — the draft presented today — covers NHS employed physicians: hospital doctors, veterinarians and employed health managers. Contracted GPs negotiate through the ACN (National Collective Agreement), a separate table that defines their contractual conditions. The measures on assaults, pay increases and company funds in today's draft do not directly apply to contracted GPs.
How many assaults does Italian healthcare staff suffer each year?
In 2024, 18,392 assault incidents involving healthcare and social care workers were recorded in Italy — broadly stable compared to previous years but with an increase in the total number of people involved. The most affected staff work in emergency departments, psychiatry and care homes. The new CCNL draft protections — solidarity leave, legal representation, psychological support — shift focus from sanctions against perpetrators to consequences for the victim, who often returns to work without adequate support.
Does the €380 increase close the pay gap with Europe?
Partially. The current gap is significant: Italian physicians earn on average 22% less than the OECD average. An increase of €380 gross per month — approximately €220-250 net — is a real improvement but does not close the structural divide. For a physician with 20 years of seniority earning around €4,000-4,500 net, it represents a 5-6% increase. Not enough to make a hospital career competitive with the private sector or abroad, but an important political signal after years of contract freezes.
What changes for a hospital physician who has been assaulted?
Under the CCNL 2025-2027 draft, a physician assaulted at work would have access to three new measures: first, up to 30 days of solidarity leave voluntarily donated by colleagues, for a recovery period without loss of pay; second, mandatory legal representation at the healthcare organisation's expense for proceedings against the perpetrator; third, a mandatory psychological support pathway offered by the facility. These measures recognise the psychological consequences of assault, not just the physical — a significant shift in approach.
€380 more per month does not reduce the time spent on documentation. Clinovus AI can help: transcription of the visit and SOAP notes structured from your dictation, for you to review and sign and copy into your practice software. Try free for 14 days.
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