News from HOPE members Romanian Presidency …...policy-makers, managers and many other stakeholders was also considered. In increasingly complex health systems, the ability to use

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8

Newsletter N° 168 - May 2019

In this issue:

HOPE activities

HOPE Agora 2019

HOPE Study Tour - DIGITAL HEALTH: Virtual Hospital in Helsinki

News from HOPE members

NHS Brexit last news

Romanian Presidency of the Council of the European Union

Pharmaceuticals: EU adopts measures in support of generic

pharmaceuticals producers

EU institutions and policies

Public Health

Cross-border healthcare: Manual for Patients - National Contact Points

(NCP) Toolbox

Vaccination: New Eurobarometer study

Substances of human origin

Communications Networks, Content and Technology

Digital is transforming medical doctors’ daily work: common principles to

adapt medical doctors’ training

Digital Europe for all

HOPE – European Hospital and Healthcare Federation

NEWSLETTER N° 168 – May 2019 Page 2 of 34

eHealth Stakeholder subGroups: series of reports released by the European

Commission

Internal Market, Industry, Entrepreneurship and SMEs

UDI Working Group

Employment, Social Affairs & Inclusion

EU social policy: Commission launches debate on more efficient decision-

making

European Economic and Social Committee

Economic, technological and social changes in advanced health services for

the elderly - EESC opinion

European programmes and projects

EURIPHI Consortium Meeting – Paris

Tackling social inequalities in cancer prevention: contest of Best Practices

Commission invites top experts to shape new research and innovation

missions

Active Assisted Living Programme: 2018 Annual Report published

Improving disease detection through ultra-high-field MRIs

Strategic Value Chain Workshops

Reports and publications

Reports

➢ OECD

Improving Forecasting of Pharmaceutical Spending

The full potential of primary health care – policy brief

Addressing problematic opioid use in OECD Countries

➢ World Health Organization (WHO)

Assessing non-prescription and inappropriate use of antibiotics (2019)



Policy coherence as a driver of health equity (2019)

WHO European Centre for Primary Health Care: annual report of activities

2018 (2019)

Transformation in Practice: the third Meeting of the Coalition of Partners to

Strengthen Public Health Services in the European Region (2019)

➢ Other

In-depth analysis: Robots in healthcare: a solution or a prob lem?

Articles

Geographic variation in inpatient costs for Acute Myocardial Infarction care:

Insights from Italy

Development of a novel benchmark method to identify and charac terize best

practices in home care across six European countries: design, baseline, and

rationale of the IBenC project

Factors associated with post-acute discharge location after hospital stay: a

cross-sectional study from a Swiss hospital

Building implementation capacity (BIC): a longitudinal mixed methods

evaluation of a team intervention

Health inequality implications from a qualitative study of experiences of

poverty stigma in Scotland

Other news – Europe

The G7 Primary Health Care Universal Knowledge Initiative

PGEU Position Paper on Medicine Shortages

Migrant Health Training Received by over 2,000 Frontline Professionals

across Europe

The transposition of the Patients’ Rights Directive in Finland—Difficulties

encountered

A review of attitudes towards the reuse of health data among people in the

European Union: The primacy of purpose and the common good



Upcoming HOPE (and co-organised) conferences and events

HOPE-PAQS Webinar: TeamSTEPPS

HOPE Study Tour - DIGITAL HEALTH: Virtual

Hospital in Helsinki

11/06/2019 Helsinki, 24-25/09/2019



HOPE Agora 2019

From 2 to 4 June 2019, the Association of Health Institutions of Slovenia welcomed the HOPE

Agora 2019 in Ljubljana. The two-day conference closed the 2019 HOPE Exchange

Programme.

Since 1981, HOPE has been organising this Exchange Programme for hospital professionals,

which is pivotal in achieving HOPE objective of promoting the exchange of knowledge and

expertise within the European Union. It offers a chance for participants to receive invaluable

experience from hospital and healthcare professionals across Europe. The HOPE Exchange

Programme lasts four weeks during which participants investigated how this topic is developed

in their host country and present together their findings at the event.

More than 300 persons attended the event including the 123 HOPE Exchange participants

from 23 different countries. The focus of the conference was on “Evidence-informed decision-

making in healthcare management”. The participants of the HOPE exchange programme

discussed the role of different types and sources of evidence. The point of view of researchers,

policy-makers, managers and many other stakeholders was also considered. In increasingly

complex health systems, the ability to use all types of available evidence to improve decision-

making in healthcare is crucial to ensure that citizens are offered the best care possible.

Scientific literature is an important source of information. However, decisions are also

influenced by local data, stakeholders’ positions, cultural factors, etc.



On 2 June, the HOPE Liaison Officers met during the afternoon to discuss population health,

value-based medicines, patient safety, study tours, EU projects Medeye and Euriphi and EU

policies. Other participants could register before the welcome reception.

On 3 June, HOPE President Eva Weinreich-Jensen opened the conference stressing out that

the shared knowledge generated thanks to the HOPE Exchange Programme ultimately

benefits the patients. Three high-level speakers welcomed the participants and the audience

of the HOPE Agora 2019: Aleš Šabeder, Minister of Health of the Republic of Slovenia,

emphasized the difficulty of an extended autonomy in decision-making, in politics as well as

any other area such as healthcare. Marjan Pintar, Director of the Association of Health

Institutions of Slovenia and Marjan Sušelj, General Director of the Health Insurance Institute

of Slovenia wished good luck to all the participants.

In addition to the presentations made by the HOPE exchange programme participants, several

experts addressed the audience.

The Module 1 “Setting the scene: Is evidence helpful for management and governance of

health institutions?” consisted in two presentations: “Evidence – informed healthcare

management” presented by Dorjan Marušič, Minister of Health of the Republic of Slovenia

2010–2011. He stressed out that in health systems, quality and safety should prevail on

productivity. Petra Došenović Bonča, Faculty of Economics, University of Ljubljana addressed

the “Incentives for evidence-informed management in public healthcare organisations” and

focused on the difference between efficiency and effectiveness: should we maximize outputs

with given resources or minimize resources for a given output?

After a first round of country presentations, the second module addressed the topic: “What can

we do to improve evidence-informed decision-making”. A first presentation dealt with the

Slovenian experience in evidence-informed management and more precisely: “Smart System

of Integrated Health Care and Home Care – Evidence-based chronic disease management

and Home Care” presented by Dominika Oroszy, University Medical Centre Ljubljana and

Peter Pustatičnik, Telekom Slovenije.

Then Tanja Kuchenmüller, Knowledge Management, Evidence and Research for Policy-

Making Unit, Division of Information, Evidence, Research and Innovation, World Health

Organization Regional Office for Europe remotely presented “Evidence-informed health

policy network (EVIPNet) Europe and evidence-informed health policy-making”. How to

integrate research into policy? She showed how to promote improved health systems through

a networked structure and knowledge translation.

Finally, Ellen Nolte, Department of Health Services Research and Policy, London School of

Hygiene & Tropical Medicine, made a presentation entitled “Learning from elsewhere: what we

know, what we don’t know and what we should know”. She stressed the importance of

definitions to allow for a meaningful comparability and of the impact of national contexts.

In the afternoon, after a second round of country presentations, the Module 3 – “Where are we

now?” was addressed. First, Niek Klazinga Amsterdam UMC, University of Amsterdam,

presented “From measurement to change”. How effective are healthcare organisations in using

data? He presented an EU-US comparison. Then, Dušan Keber International consultant,

addressed “Evidence – informed healthcare management: a side view”. He develops examples



from pharmaceuticals and healthcare policy reform in Croatia. Were the decisions evidence-

based? He also underlined that different sources of evidence are used in private and public

healthcare organisations. A third round of country presentations by HOPE Exchange

Programme participants closed the day, allowing for a meeting of the HOPE National

Coordinators while the rest of the audience got ready for the conference dinner.

Urmas Sule, Vice-President of HOPE, chaired the last day of the HOPE Agora 2019. Following

the final round of presentations of HOPE Exchange participants, a workshop on the use of

management tools in healthcare organisations was organised by Damir Ivanković and Niek

Klazinga, Amsterdam UMC, University of Amsterdam. 125 full responses to their survey were

collected among HOPE Exchange participants prior to the event. They also questioned the

audience in live on its use of performance data for management in healthcare and discussed

the results with a panel of participants.

It was followed by a Round table discussion with Tanja Španić, Europa Donna Slovenia, Niek

Klazinga, Amsterdam UMC, University of Amsterdam, Saša Kadivec, University Clinic of

Respiratory and Allergic Diseases Golnik and Teodor Žepič, University Medical Centre

Ljubljana. The discussion was moderated by Mircha Poldrugovac, Amsterdam UMC,

University of Amsterdam

Finally, Pascal Garel, chief executive of HOPE, chaired the Prize Giving Ceremony and gave

the final words of the HOPE Agora 2018. He congratulated the 3 winning teams: United-

Kingdom for the 3rd prize, Switzerland for the 2nd prize and Spain for the 1st prize.

The HOPE Governors met at the end of the conference to discuss many issues including,

comparative activities, EU Finnish Presidency, Brexit, EU policies such as the Medical Devices

Regulations, the Falsified Medicines Directive, data protection regulation, e-privacy and EU

projects EURIPHI and MedEye. They also gathered to prepare and discuss the HOPE EU

Elections 2019 Manifesto which advocates for more coherent EU health-related policies that

would be centred on public health and a better check of their impact on hospitals and

healthcare facilities.

All the presentations are available on the event page

http://www.hope.be/hope_agora_2019/



HOPE Study Tour - DIGITAL HEALTH: Virtual Hospital in Helsinki

HOPE organises a Study Tour to Helsinki (Finland) on 24 and 25 September 2019 during the

Finnish EU-Presidency.

The theme is Virtual Hospital 2.0 which produces specialised medical care -related digital

healthcare services to citizens, patients and professionals. Virtual hospital is a joint project

between the university hospitals in Finland, and their population responsibility and catchment

area covers all Finns. Virtual hospital makes healthcare services available to all Finns

regardless of their place of residence and income level, thus improving the equality of citizens.

Digital services are especially well suited for monitoring the quality of life, symptoms and

lifestyle, and also for living with a long-term illness before and during treatment and in the

monitoring stage of the treatment. The services complement the traditional treatment

pathways.

Production and implementation of services:

• the Terveyskylä.fi ('Virtual village') service offering information, advice, self-care,

symptom navigators, digital treatment pathways, and tools for citizens, patients and

professionals. The service comprises various themed virtual houses, more than 20

houses and services are available for more than 30 groups of patients.

• Innovation farm: innovation workshops, piloting, artificial intelligence, IoT, and research

and the researcher's tools

• Development of services and changes in operation: development model, developer

network and centres of expertise.

There is a site visit to the New Children's Hospital:

• Which is focused on demanding specialised health care for children;

• Which provides care for patients from all across Finland;

• Where patients range from new-born babies to 15-year-old;

• Where families can stay together in New Children’s Hospital;

• Where parents are allowed to stay with their child around the clock.

Finland is facing the same challenges as the rest of Europe: an ageing population, a dramatic

increase in the number of patients/citizens suffering from chronic diseases, and a rise in health

expenditure. Virtual hospital means that we are supporting an operational change in the health

sector instead of just digitalising old services or providing new services within the old service

framework.

Please find all information related to registration as well as the agenda here.

http://www.hope.be/event/hope-study-tour-digital-health-virtual-hospital-helsinki/



NHS Brexit last news

What’s happened since the April European Council

As a brief reminder, the European Council agreed to extend Article 50 until 31 October 2019.

If the Withdrawal Agreement is ratified before this date, the UK will leave the EU on the first

day of the following month. The Council also reaffirmed its position that the Withdrawal

Agreement cannot be reopened but did state that they are prepared to reconsider the Political

Declaration on the future relationship, if the UK’s position were to evolve.

As a result of this extension, all NHS organisations were advised to stop their no deal

provisions being enacted on 12 April, but to keep them on hold.

On Tuesday 21 May, UK Prime Minister Theresa May made a speech setting a new ‘Brexit

deal’. Some of the key points included:

• A legal obligation to seek to conclude Alternative Arrangements by December 2020 to

attempt to avoid any need for the backstop coming into force;

• If the backstop were to come into force, the Government will ensure that Great Britain

will stay aligned with Northern Ireland;

• A vote on the future customs relationship, and a vote on whether the final deal should

be put to referendum;

• The speech can be found here. Under the original timetable, MPs were expected to

vote on whether to approve the Withdrawal Agreement Bill when they returned after

Whitsun recess in early June.

On 24 May, the UK Prime Minister Theresa May announced that she will resign as leader of

the Conservative and Unionist Party on Friday 7 June. She will remain as Prime Minister until

a new party leader is selected. The process to select a new leader is set to begin in the week

commencing 10 June, with the final results “to be announced before Parliament rises for the

summer”.

Next steps

• UK took part in the European elections. If the UK does not pass the deal or withdrawal

agreement by the end of June, UK MEPs will take their seats on 2nd July.

• Cross party talks between the Conservatives and Labour to find a compromise over

Brexit have ended without agreement. This now means that the negotiating teams for

both parties will now have to discuss options to put to Parliament instead

• There should be a vote on the Withdrawal Agreement Bill in early June. The UK needs

to approve this bill to implement the withdrawal agreement and leave the EU, and this

https://www.gov.uk/government/speeches/pms-speech-on-new-brexit-deal-21-may-2019



will be the first time that MPs will vote on this bill. The UK will update the Council on

progress at the next meeting in June.

As a reminder, the legal default in UK and EU law remains that, until a deal is agreed

and ratified, there is a risk of a no deal exit at the end of the extension period on 31st

October 2019.

At their most recent meeting, the Brexit Health Alliance agreed to produce a paper on the future

relationship for health. The Brexit Health Alliance (BHA) believes that the UK and EU should

seek to strike an early deal which aims to protect the health of citizens and patients across the

UK and EU.

NHS European Office: Brexit latest updates

https://www.nhsconfed.org/regions-and-eu/nhs-european-office/brexit-and-the-nhs/latest-brexit-updates



Romanian Presidency of the Council of the European Union

Pharmaceuticals: EU adopts measures in support of generic

pharmaceuticals producers

The EU is taking measures to foster the competitiveness of EU producers of generic medicines

and biosimilar products. On 14 May 2019, the Council adopted a regulation which introduces

an exception to the protection granted to an original medicine by a supplementary protection

certificate (SPC) for export purposes and/or for stockpiling.

Thanks to the exception, EU-based manufacturers of generics and biosimilars will be entitled

to manufacture a generic or biosimilar version of an SPC-protected medicine during the term

of the SPC either for the purpose of exporting to a non-EU market where protection has expired

or never existed or (during the six months before the SPC expires) for the purpose of creating

a stock that will be put on the EU market after the SPC has expired.

SPCs are intellectual property rights that extend patent protection (for up to five years) for

medicinal products that must undergo lengthy testing and clinical trials before being authorised

to be placed on the EU market. The aim of SPCs is to avoid that the term of patent protection

would in actuality be curtailed by the period that elapses between the date of filing of the patent

application and the date of the authorisation to place the product on the market in the EU.

The regulation will remove the competitive disadvantages faced by EU-based manufacturers

of generics and biosimilars vis-à-vis manufacturers established outside the EU in global

markets. The exception will operate only where:

• generics or biosimilars are produced exclusively for export to third countries where

protection of the original medicine does not exist or has expired or for stockpiling

purposes during the last six months of the validity of the SPC;

• the maker has provided the information required by the regulation to both the authorities

of the member state of production and to the holder of the SPC at least three months

in advance;

• the maker has duly informed all those involved in the commercialisation of the product;

• the maker has affixed to the packaging of the product the specific logo provided for by

the regulation indicating clearly that it is only for export.

Until a set date (three years from the entry into force of the regulation), the regulation will affect

only SPCs that are applied for on or after the date of entry into force of the regulation. From

then on, the regulation will also affect SPCs applied for before the entry into force of the

regulation, but which have become effective after the entry into force of the regulation.

The regulation still has to be signed and published in the Official Journal of the EU. It is

expected to enter into force by 1 July 2019.

https://data.consilium.europa.eu/doc/document/PE-52-2019-INIT/en/pdf



Cross-border healthcare: Manual for Patients - National Contact

Points (NCP) Toolbox

Under the Cross-border Healthcare Directive, patients have the right to access health services

in another EU/EEA country and to enjoy assumption of costs by their home country.

This toolbox, released by the EU Commission on 20 March 2019, is intended for patients and

National Contact Points (NCPs) under the Cross-border Healthcare Directive (Directive

2011/24/EU), which are set up in each Member State with the purpose of facilitating the

provision of information to mobile patients.

It contains relevant information on the legal framework of cross-border healthcare, covering

both Directive 2011/24/EU and the Social Security Regulations (EC) 883/2004 and 987/2009.

The toolbox is not intended to impose any obligations. The text of the tools may be copied and

used on the NCP website or other documents. The toolbox should be applied bearing in mind

the specific context of national legislation and organisational specificities at any time.

Manual for Patients - National Contact Points (NCP) Toolbox

Vaccination: New Eurobarometer study

While vaccination policy is a competence of national authorities, the EU plays a role in

coordinating policies and programmes in this area. The survey asks questions about:

• Europeans’ perceptions of vaccine-preventable diseases and of the perceived

effectiveness of vaccines,

• Europeans’ experiences with vaccination,

• levels of Europeans’ knowledge about the effects of vaccines,

• attitudes regarding the importance of vaccinations,

• Europeans’ sources of information about vaccines and the extent to which they trust

them.

This survey was carried out by the Kantar network in the 28 EU Member States between 15

and 29 March 2019. Some 27 524 respondents from different social and demographic groups

were interviewed face-to-face at home in their mother tongue. The survey was commissioned

by the European Commission, Directorate General for Health and Food Safety (DG SANTE).

The methodology used is that of the Standard Eurobarometer surveys carried out by the

https://ec.europa.eu/health/sites/health/files/cross_border_care/docs/2019_ncptoolbox_manualpatients_en.pdf



Directorate-General for Communication (“Media monitoring and Eurobarometer” Unit). It is the

same for all countries and territories covered in the survey.

Results of the Eurobarometer and national infographics

Substances of human origin

The report of the Competent Authorities on Substances of Human Origin Expert Group that

was meeting on 18 and 19 February 2019 has just been published by the European

Commission.

The Commission informed the group that its verification of Directive 2010/53/EU is complete

and that there are no follow-up actions at this stage unless any issues with transposition or

implementation of the legislation are brought to its attention.

The Commission summarised the state of play of the Blood, Tissues and Cells Evaluation

(BTC Evaluation). The BTC Evaluation is to provide a comprehensive assessment of the BTC

directives, examining their functioning across the EU, assessing if their original objectives have

been met and whether they remain fit for purpose. Key messages emerging from the BTC

evaluation were presented pointing to commonalities between the BTC and Organs sectors.

The Commission invited the competent authorities to follow the process. In particular, the

authorities will be invited to share the Commission report on the BTC Evaluation with the

relevant national, regional and local administrations. The final report will be published in 2019.

The organ authorities recognised that the outcome of the BTC evaluation will be of utmost

importance for the organs field because the report might initiate discussions on topics like

Voluntary Unpaid Donation and other aspects, which are also of high importance to the organs

community.

The information about the ongoing BTC Evaluation can be found here.

An update on the EUDONORGAN Pilot Project- training and social awareness (DTI- ES) was

provided. The project aims to provide training and to increase social awareness regarding

organ donation in the European Union (EU) and neighbouring countries with the ultimate goal

of increasing the number of organ donors. Within the framework of the project, the

EUDONORGAN representatives have been organising the social awareness events on organ

donation across the EU. In 2018-2019 Poland, Belgium, Greece, Hungary, Portugal and

Sweden host events in a co-ordinated effort with EUDONORGAN and the national competent

authorities to highlight the need for increased levels of organ donation to EU citizens. A

successful EUDONORGAN conference took place on 18 February 2019 in the European

Parliament in Brussels. The conference brought together over 120 healthcare professionals

and other relevant stakeholders coming from 33 countries. At the end of the event, the

participants joined the esplanade of the European Parliament for a commemorative act

consisting in a launch of biodegradable balloons dedicated to organ donors.

Several practices were then presented. The Lithuanian NCA representative gave an overview

about the national approach to improving organ donation and transplantation. An “Improving

organ utilisation in the EU” (ODTI, Ireland) representative gave a presentation on utilisation of

http://ec.europa.eu/commfrontoffice/publicopinion/index.cfm/survey/getsurveydetail/instruments/special/surveyky/2223

https://ec.europa.eu/health/blood_tissues_organs/policy/evaluation_en



Organs in the EU. The Czech representative summarized the latest developments of the

FOEDUS Organ exchange portal. A representative of EKHA, the European Kidney Health

Alliance, gave a presentation on the Thematic Network on the European Commission Health

Policy platform called Improving organ donation and transplantation.

Finally the plans of the Croatian Council presidency in relation to organ donation and

transplantation were presented. Organ donation and transplantation will be one of three health

priorities under the Presidency. Possible focus might be a call for a new Organs Action Plan,

and for a follow up of the Commission Evaluation on Blood, Tissues and Cells legislation.

Croatia might aim for a resolution, and host a high-level conference on organ donation and

transplantation in February 2020.

Digital is transforming medical doctors’ daily work: common

principles to adapt medical doctors’ training

Training in digital knowledge and skills should become a new core component of training for

future and current doctors in all Member States: this was agreed by representatives of

students/junior doctors and deans, gathered at the initiative of the European Commission and

Erasmus University Medical Center on 12 April 2019 in Rotterdam. A set of recommendations

for action were developed at this meeting, and participants committed themselves to taking

them forward in their own national context to raise policy makers’ awareness.

Based on day's discussions, participants agreed on four key principles, accompanied by

concrete actions to be brought forward:

• to advance digital knowledge, skills and competences as a new core component of

training for future and current doctors; this could entail updating education programmes

and curricula, but also developing cross-disciplinary communication skills;

• to embed in co-creation training for future and current doctors in institutional

digitalisation strategies and policies, by co-creating courses with stakeholders and

monitoring impact at all levels;

• to promote innovative structures and networks to create diversity in digital skills training

for medical doctors. This would entail capacity building, peer to peer learning, but also

funding for training and new platforms;

• to increase interoperability and mobility for medical students, doctors, patients and data

by reviewing the legal and regulatory frameworks or setting minimum digital health

competency.

Participants were encouraged to promote these principles in their own national context and to

raise policy makers’ awareness of them, in order to embed them in future considerations on

curricula design. Education and training curricula for health professionals are designed



differently across countries, and their development may involve various stakeholders, including

from government, universities and medical organisations. One of the clear messages of

participants was that reform should not only address the initial training of doctors (i.e at

undergraduate level), but that life-long learning opportunities in this area should be made

available.

Some participants called for action at EU level, for instance by placing specific digital

healthcare skills on the EU skills agenda, defining EU-wide standards on core digital skills, or

ensuring continued EU funds for digital training.

Digital Europe for all

On 15 May 2019 the European Committee of the Regions organised a meeting Digital Europe

for all, a strategy that the Committee of Regions and its stakeholders would like to develop

jointly with the aim of ensuring that deployment of digital solutions and innovation brings

benefits to all cities and communities of the EU.

A draft strategy document proposed for discussion by the CoR President, Karl-Heinz Lambertz,

and the First Vice-President, Markku Markkula, had been sent to the registered participants in

the beginning of May.

This strategy will contribute to the priorities for the new mandate of the European Commission

and will be discussed on high level at several upcoming events, such as the Digital Assembly

2019 (DA 2019), that will take place in Bucharest, 13 and 14 June 2019, organised by

European Commission and Romanian presidency.

During this stock-taking meeting the local and regional organisations and stakeholders

discussed with the representatives of the European Commission (Directorate-General

CNECT) the future EU digital strategy aiming at scaling up and sharing digital solutions and

measuring progress of the deployment of digital innovation across many sectors of local

economy, services and democracy. Special focus was given to the needs of the smaller and

less digitally advanced cities and communities regarding their digital development.

Moreover, during the meeting the participants were briefed on the latest plans and aims of the

'Digital for Communities' workshop at the Digital Assembly conference in Bucharest on 13 June

2019 and discuss opportunities of their active participation at the workshop and conference.

For more information please refer to the web page of the event.

eHealth Stakeholder subGroups: series of reports released by the

European Commission

The Directorate-General for Communications Networks, Content and Technology (DG

CNECT) has published a series of four reports prepared by the eHealth Stakeholders

Subgroups. The Subgroups are the thematic focus working groups on eHealth. They were

https://cor.europa.eu/en/events/Pages/sedec-stock-taking-digital-europe.aspx.



established under the mandate of the eHealth Stakeholder Group, an expert contribution to

the development of legislation and policy related to eHealth.

One report on care continuum (looking into how eHealth tools could play a key role for a better

integration of health and social care needs), one on citizen and health data (setting out the

ambition that every EU citizen should be able to collect, curate, and control relevant health

information from multiple sources), on reimbursement (taking the view that appropriate criteria

should be used to reimburse relevant products, following EU-based guidelines for evidence

generation all while taking into account the specificities of digital health products when

developing instruments for reimbursement) as well as on standards and interoperability

(including a set of recommendations to adopt the eStandards roadmap, a Roadmap for

allowing collaboration between citizens, healthcare workforce, researchers, vendors and

payers drafted as part of a Horizon 2020 call).

The eHealth Stakeholder Group has now reached the end of its mandate.

Access the reports

UDI Working Group

HOPE was invited on 21 May 2019 to join the Unique Devices Identification (UDI) meeting for

a presentation of the progress related to future UDI database in EUDAMED.

The Draft guidance regarding “Considerations on the control of the Manufacturer’s Quality

Management System (QMS)” was also discussed followed by a presentation from Germany

on Implant Card and interpretation of Art 18 of the Medical Devices Regulation.

The Commission presented the final list of UDI devices and data elements.

The differences in the US-EU UDI systems were presented by MedTech.

After a discussion on the Medical Devices nomenclature and the designation of issuing entities,

the meeting was concluded y a presentation of the relevant IMDRF activities.

https://ec.europa.eu/digital-single-market/en/news/new-members-ehealth-stakeholder-group-have-been-selected



EU social policy: Commission launches debate on more efficient

decision-making

Most social policy areas, where the EU has powers to act, are already subject to qualified

majority voting. This has allowed putting in place a comprehensive social "acquis" over the

years. A very limited number of areas, however, still requires unanimity among EU Member

States and special legislative procedures, in which the European Parliament does not have an

equal role as the Council as co-decision maker.

With this Communication released mi-April 2019, the Commission is launching a debate on

an enhanced use of qualified majority voting in social policy, rendering decision-making more

timely, flexible and efficient where an EU competence already exists.

This possibility is provided for in the EU Treaties for several specific areas through so-called

'passerelle clauses'. These clauses allow for a shift from unanimity to qualified majority voting

under certain circumstances.

As a first step, looking at the merits and challenges of each case, the Commission proposes

to consider the use of the passerelle clause to facilitate decision-making on non-discrimination.

This would help further develop equal protection against discrimination.

The use of the passerelle clause could also be considered in the near future to adopt

recommendations in the area of social security and social protection of workers. This would

help to guide the process of modernisation of and convergence between social protection

systems.

Economic, technological and social changes in advanced health

services for the elderly - EESC opinion

The European Economic and Social Committee believes that ageing in dignity should become

a fundamental right. In its opinion published on 15 May 2019, the EESC highlights the

enormous potential older people represent for new jobs and technological progress.

• Harmonised minimum level of education

Literature and studies confirm that home-helpers, personal carers, care assistants and nurses

are among the occupations that will create most jobs in the future. Special support should be

https://ec.europa.eu/social/BlobServlet?docId=21081&langId=en

https://www.eesc.europa.eu/en/our-work/opinions-information-reports/opinions/economic-technological-and-social-changes-advanced-health-services-elderly-own-initiative-opinion



provided for proper training, since their presence and activities are inextricably linked to the

well-being of older people.

The EESC also proposes to establish a European minimum training/education programme for

nurses in gerontology, caregivers and care assistants, not only on a technical level but also on

a social and human level, in order to enable and strengthen the mobility of workers and

services for older people.

Furthermore, the EESC advocates access to training should be facilitated, for instance through

ICT tools that provide access to theory and information, or by organising online communities

to facilitate exchange of knowledge and practices. Given the different approaches in the

Member States, the EESC recommends establishing a common EU framework that includes

the best of existing training programmes.

• Housing policy with high-tech support

Older people want to live as long as possible in their own environment. For the EESC, it is

essential that their preferences be respected, in dialogue with their families and

relatives.However, the choice can no longer only be between live-in care and residential care

homes, alternative facilities already exist, and those yet to be built need to be geared towards

facilitating independent living. Thus, their design should be based on people's profiles and any

particular medical conditions they may have.

The EESC also calls for better use of digital technology innovations: telemedicine, sensors, a

digital clinical card and digital medical records, as well as home automation technologies would

not only enhance older people's independence, but also make care more efficient and secure.

Building and urban policies should become more dynamic and flexible. A specific funding

programme under the European Structural Funds should better promote and support

innovative housing schemes

Furthermore, the idea of age-friendly cities – promoted by the WHO -, which aim at optimising

the health, integration and safety of older people, could be the taken up by the EU with a view

to creating a programme that supports pilot projects in different European cities or semi-rural

areas.

• Guaranteeing suitable funding

An ageing society needs better and more sustainable concepts to help guarantee that people

can age with dignity and with as much independence as possible. Member States' social

security systems alone, however, will not be able to fund this solely through taxation.

Therefore, other public and private sources, including pension funds, should be considered as

potential sources of finance.



EURIPHI Consortium Meeting – Paris

On 13 and 14 May 2019, HOPE took part to the EURIPHI consortium meeting, held in Paris.

The two-days event gathered the partners of the consortium to share updates about the

progress of the project as well as future actions.

Among the points discussed in the agenda, there was the status of the Health Authorities

Network and of the Community of Practice. These two hubs will be crucial for the definition of

unmet needs and for the adoption of value-based procurement (VBP) for innovation in cross

border and integrated care contexts. Interesting results were presented also in the field of VBP

for Ventilator Associated Pneumonia (VAP) and chronic diseases in integrated care contexts.

The legal framework was also clarified, and the dissemination and communication tools

delivered so far presented, including EURIPHI website.

For more information on the project, click on the following link.

Tackling social inequalities in cancer prevention: contest of Best

Practices

On 5 May 2019, FISABIO (the Foundation for the Promotion of Health and Biomedical

Research in Valencia Region, Spain) launches through the present call the Contest of Best

Practices tackling social inequalities in cancer prevention, aiming at:

• Identifying and compiling relevant European experiences,

• Disseminating them among European countries in order to promote and facilitate their

implementation,

• Contributing to the exchange and replication of best practices on equality in cancer

prevention.

Institutions and or professionals willing to submit their practice are invited to complete and

send their Best Practice Application Form to [email protected].

Further information on the contest rules and evaluation criteria can be found in the Submitter's

Guide. Deadline for submission is 10 August 2019.

https://www.euriphi.eu/

https://www.ipaac.eu/res/file/20190513-contest/contest-best-practice-application-form.pdf

https://www.ipaac.eu/res/file/20190513-contest/submitter-guide.pdf

https://www.ipaac.eu/res/file/20190513-contest/submitter-guide.pdf



Commission invites top experts to shape new research and

innovation missions

On 13 May 2019, the European Commission launched a call for experts to join ‘Mission

Boards’, which will advise the Commission for the identification and implementation of missions

in Horizon Europe, the next EU research and innovation programme.

These missions will be high-ambition, high profile initiatives, to find solutions to some of the

major challenges faced by European citizens, with a clear target that captures the imagination

of citizens at large.

There will be five ‘Mission Boards’, one for each of the following areas:

• Adaptation to climate change including societal transformation;

• Cancer;

• Healthy oceans, seas, coastal and inland waters;

• Climate-neutral and smart cities;

• Soil health and food.

The first task of the ‘Mission Boards’ will be to identify and design one or more specific missions

for each of the mission areas, in consultation with stakeholders and citizens.

Missions will be implemented through a systemic approach, combining new knowledge and

technology with business model, finance, regulatory, governance, skills and social innovation.

The ‘Mission Boards’ will be comprised of high-level independent experts, who will help shape

the missions including their respective objectives, indicators and timelines. The Commission

is looking for individuals who can bring strategic skills and expertise, from across the spectrum

of possible fields to support the work of the missions, and with profiles from industry, innovation

and business; academia and research; policy makers and practitioners; end-users and key

stakeholders.

The call for applications is available online. The deadline for applications is 11 June 2019.

Each of the ‘Mission Boards’ shall consist of up to 15 members.

Active Assisted Living Programme: 2018 Annual Report published

On 3 May 2019, the annual report of the Active Assisted Living Programme was released.

This report provides an overview of the activities that the Active Assisted Living (AAL)

Association has carried out over the year 2018. It highlights major events and actions, but also

provides a deeper understanding of what has happened and how to better communicate it.

Full report

http://ec.europa.eu/transparency/regexpert/index.cfm?do=calls.calls_for_app

http://www.aal-europe.eu/wp-content/uploads/2019/04/Annual-report-2018_final.pdf



Improving disease detection through ultra-high-field MRIs

The widespread adoption of magnetic resonance imaging (MRI) revolutionised clinical

medicine, and the revolution has not stopped. Scientists in the FET-Open project are exploring

ways to make MRIs even more effective - aiming to help patients get the best possible

treatment through early disease detection.

MRI clinical imaging has limits that can hinder the quick and effective diagnosis of health

problems in patients. For example, typical low-power (or ‘low-field’) MRIs produce reduced

spatial and temporal image resolutions that can make it hard for medical practitioners to spot

developing diseases.

‘Ultra-high-field’ MRIs – or scanners that produce more intense magnetic fields – can create

more accurate and useful images. But their everyday use remains limited, in part because

using conventional materials to produce stronger fields is a complex, expensive, and

potentially hazardous task. For example, using too much power could overheat scanned bodily

tissues, causing cellular damage.

The FET-Open M-CUBE project aims to solve this problem through the use of ‘metamaterials’

in MRI scanners.

Full article

Strategic Value Chain Workshops

In the context of the Renewed EU Industrial Policy Strategy, the European Commission has

set up the Strategic Forum (SF) for Important Projects of Common European Interest

(IPCEI) to foster a proactive cooperation with Member States and industry on the key Strategic

Value Chains (SVC) for Europe that use advanced technologies. This complements the more

horizontal reflections of the High-Level Industrial Roundtable “Industry 2030” on a longer-term

industrial policy strategy. The initiative is also in line with one of the priorities of the Horizon

Europe and builds on the results of EU wide R&I programmes, such as Horizon 2020.

The role of the Strategic Forum – a high-level expert group - is to identify key Strategic Value

Chains (SVC) that require well-coordinated actions and investments from industry and public

authorities from several Member States. It aims at building a common vision for joint efforts

and investments in these strategic value chains, potentially making use of instruments at EU

and Member State level. The value chain approach reflects a renewed industrial policy for the

EU.

The work in the Strategic Forum started in May 2018 with identification of potential strategic

value chains in Europe. At its second meeting in November 2018 the Strategic Forum selected

16 SVCs out of 72 initial proposals from its members. At its third meeting in January 2019 the

Strategic Forum finally selected six key strategic value chains for which it will develop

recommendations for actions:

• Smart health

https://ec.europa.eu/programmes/horizon2020/en/h2020-section/fet-open

http://www.mcube-project.eu/

http://ec.europa.eu/research/infocentre/article_en.cfm?artid=50077

https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=OJ%3AJOC_2018_039_R_0003

https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=OJ%3AJOC_2018_039_R_0003



• Connected, clean and autonomous vehicles

• Low carbon industries

• Hydrogen technologies and systems

• Industrial Internet of Things (IIoT)

• Cybersecurity

The Strategic Forum has also recognised an additional three strategic value chains – batteries,

high performance computing and microelectronics – as of key importance, for which

transnational work is already ongoing.

Recommendations from the Strategic Forum to the Commission

In its Final Report by summer 2019, the Strategic Forum will present recommendations for

each selected key strategic value chain in the form of recommendations for actions for EU,

Member States, regions, industry and other stakeholders. These recommendation cover all

relevant aspects of the value chain, and could include a call for joint investments and

accompanying measures, e.g. on skills, regulation and standards.

The Commission has engaged a contractor to support the Strategic Forum with analytical

reports and the organisation of stakeholder workshops, in order to have an open and

transparent discussion among all key stakeholders across Europe. The analytical reports are

prepared as background information for the two rounds of stakeholder workshops for the

selected SVCs.

Two round of “SVC stakeholder workshops” were organised. The results of both workshop

rounds will define the basis for the task forces to finalize their action plans, which finally feed

into the Final Report from the Strategic Forum (in June 2019).



➢ OECD

Improving Forecasting of Pharmaceutical Spending

On 6 May 2019, with the support of Health Programme, the OECD has published the report

on “Improving Forecasting of Pharmaceutical Spending” and the 23 EU/EEA Country Notes.

The report explores the different approaches to track pharmaceutical utilisation and

expenditure and to anticipate changes in pharmaceutical market dynamics. It examines how

EU/EEA countries use them to inform the setting of budgets and spending caps, and as inputs

to modelling future expenditure.

The report also shows the challenges for health systems to predict more precisely the

pharmaceutical expenditure, highlights best practices across OECD countries and proposes

recommendations for those countries currently undertaking or planning to introduce better

pharmaceutical expenditure projections to inform future policymaking. This is the second

deliverable under the EU/OECD project.

Link

The full potential of primary health care – policy brief

A policy brief, released on 16 May 2019 has been produced to support discussions among G7

Health Ministers at their meeting in Paris, France, on 17 and 18 May 2019.

Strengthening primary care, and getting greater value out of this sector, is a priority for all

OECD health systems. Primary care is defined as the first level of contact for the population

with the health care system, bringing health care as close as possible to where people live and

work. It addresses the main health problems in the community, providing preventive, curative

and rehabilitative services. Primary care goes beyond services provided by primary care

physicians to encompass other health professionals such as nurses, pharmacists, auxiliaries,

and community health workers. Primary care as the first point of care, where primary care

providers deliver people-centred care, has the potential to respond to major health challenges

and to promote health for all. As societies age and the burden of chronic disease grows, people

need care that is centred on increasingly complex care needs, co-ordinated across the care

pathway, and accessible (financially, geographically and around the clock). This makes good

primary health care ever more vital. It provides a broad overview of the main policy issues and

some of the policy actions that policy makers can put in place to strengthen primary health

care.

Link

https://ec.europa.eu/health/sites/health/files/policies/docs/pharmaceutical-expenditure-analytical-report-april-2019_en.pdf

http://www.oecd.org/health/health-systems/OECD-Policy-Brief-Primary-Health-Care-May-2019.pdf



Addressing problematic opioid use in OECD Countries

This report released on 16 May 2019 presents evidence on the magnitude of problematic

opioid use across OECD countries, describing the main drivers, and identifying a set of policy

actions to address them.

The report highlights the opioid crisis as a complex public health issue that requires a

comprehensive approach across all sectors, including health, social services, and law

enforcement. Strong health information systems are also needed, particularly data and

research. Preventing problematic opioid use requires a combination of policies that ensure

more information is provided to patients and health care practitioners, while providing access

to appropriate pain management treatment for patients. A public health approach to

problematic opioid use must incorporate socio-economic considerations (e.g. employment and

housing), which also need to be addressed to prevent problematic substance use in general.

Link

➢ World Health Organization (WHO)

Assessing non-prescription and inappropriate use of antibiotics

(2019)

A report on assessing non-prescription and inappropriate use of antibiotics has been published

by the WHO in May 2019.

Eighteen countries and areas that are members of the WHO Regional Office for Europe

Antimicrobial Medicines Consumption Network undertook a survey to assess the current status

of regulatory and national/area-level activities in eastern European and central Asian countries

and areas to support the appropriate use of antibiotics. All countries and areas reported an

existing legislative framework governing the marketing authorisation of antimicrobial agents,

their distribution, assessment of the quality of products in circulation, their prescription and

dispensing. Respondents reported a wide range of activities in support of appropriate use of

antimicrobials that targeted the general public, doctors and pharmacists. Priority actions for

improving the appropriate use of antibiotics identified by respondents were greater

enforcement of existing regulations on prescribing and dispensing of antibiotics to ensure

prescription-only access, educating health-care professionals about antimicrobial resistance

and appropriate use of antibiotics, improving public awareness on rational use of antibiotics,

and establishing and implementing standard treatment guidelines for use in clinical practice.

Link

https://read.oecd-ilibrary.org/social-issues-migration-health/addressing-problematic-opioid-use-in-oecd-countries_a18286f0-en#page1

https://apps.who.int/iris/bitstream/handle/10665/312306/9789289054089-eng.pdf?sequence=1&isAllowed=y&ua=1



Policy coherence as a driver of health equity (2019)

In a report, published in May 2019, the WHO-Europe suggests that to promote health equity,

rigorous analysis of complex policy interventions and effects must be coupled with equally

rigorous analysis of policy making, governance and politics.

Health is a human right and therefore states must ensure access to timely and affordable

health care of appropriate quality, and provide for the underlying determinants of health, such

as safe and potable water, sanitation, food, housing, health-related information and education,

decent work and gender equality. This highlights the need for coherent action across different

policy domains. The United Nations Sustainable Development Goals provide the framework to

advance policy coherence for health equity. As policy coherence concerns different levels of

governance, the mechanisms for the public health community to drive for policy coherence are

both systemic and administrative. The former concerns transparency (access to health and

other relevant data and capacity to use the data) and accountability (reporting to the legislature,

initiatives by ministries of health and the strength of civil society). The latter mechanism

includes ministerial linkages between health and others (interdepartmental committees and

public engagement), public health legislation, governmental plans and targets, joint budgeting

and delegated finance.

Link

WHO European Centre for Primary Health Care: annual report of

activities 2018 (2019)

The annual report of the WHO European Centre for Primary Healthcare, released in May 2019,

highlights the activities of the Centre in 2018 across its core areas of work—analysing,

advising, and sharing. The report also highlights events related to the 40th anniversary of

primary health care and the Centre’s plans for 2019.

From new technical collaborations on topics including antimicrobial resistance, after-hours

care and men’s health, to supporting more than 20 countries across the Region to assess

primary health care, measure performance and develop health services delivery polices, the

year was rich with technical explorations and policy advice to advance integrated health

services delivery, people-centred systems and universal health coverage. The Centre brought

together country representatives, renowned experts and civil society to share their expertise

and first hand insights in transforming health services delivery through numerous workshops,

events and consultations.

Importantly, in 2018 WHO European Centre for Primary Health Care also celebrated the 40th

anniversary of the Declaration of Alma-Ata. In commemoration of this landmark event, the

Centre supported yearlong technical preparations to publish a special issue of Public Health

Panorama, host a regional scientific conference on primary health care, disseminate key

messages through various media channels across the Region and, ultimately, convene the

Global Conference on Primary Health Care in Astana, Kazakhstan. Now in its third year at its

https://apps.who.int/iris/bitstream/handle/10665/324736/9789289054119-eng.pdf?sequence=1&isAllowed=y&ua=1



premises in Almaty, the WHO European Centre for Primary Health Care has consolidated a

diverse network of local partners.

Link

Transformation in Practice: the third Meeting of the Coalition of

Partners to Strengthen Public Health Services in the European

Region (2019)

The WHO Regional Office for Europe and Slovenia’s Ministry of Health convened the Third

Meeting of the Coalition of Partners to Strengthen Public Health Services in the European

Region in November 2018 in Ljubljana, Slovenia to enable the participants:

• to discuss the questions that mattered most to them and the Coalition of Partners;

• to learn from the past, present and emerging future about the art and science of

strengthening public health services;

• to co-create activities for 2019

• to explore what the Coalition of Partners would become.

The participants reflected on the lessons learned since the Coalition of Partners was founded

in 2017, explored further opportunities for joint work in 2019 and formed a core group and

advisory group to guide the further development of the Coalition of Partners. The evidences

emerged during the meeting have been gathered in the present report, which have been

released in May 2019.

Link

➢ Other

In-depth analysis: Robots in healthcare: a solution or a problem?

A report released on 17 May 2019 summarises the presentations and discussions of a

workshop on the use of robots and AI in healthcare, held at the European Parliament in

Brussels on Tuesday 19 February 2019.

The aim of the workshop was to provide background information and advice for Members of

the ENVI Committee on the status and prospects of applying robotic and artificial intelligence

(AI) based technologies in healthcare.

The first part of the workshop focused on the practical application of AI and robots in

healthcare, while the second part examined the ethical implications and responsibilities of AI

and robotic based technologies in healthcare.

Link

http://www.euro.who.int/__data/assets/pdf_file/0009/399510/ENG-2018-GDO-report-web.pdf?ua=1

http://www.euro.who.int/__data/assets/pdf_file/0006/397914/CoP3Report-_Final_ENG.pdf?ua=1

https://www.europarl.europa.eu/RegData/etudes/IDAN/2019/638391/IPOL_IDA(2019)638391_EN.pdf



Geographic variation in inpatient costs for Acute Myocardial

Infarction care: Insights from Italy

Geographic variations in healthcare expenditures have been widely reported within and

between countries. Nevertheless, empirical evidence on the role of organisational factors and

care systems in explaining these variations is still needed.

This paper, released in May 2019, aims at assessing the regional differences in hospital

spending for patients hospitalised for Acute Myocardial Infarction (AMI) in Tuscany and

Lombardy regions (Italy), which rank high in terms of care quality and that have been, at least

until 2016, characterised by quite different governance systems. Adjusted hospital spending

for AMI patients were significantly higher in Lombardy compared with Tuscany. In Lombardy,

patients experienced higher re-hospitalisations in the 31–365 days and longer length of stays

than in Tuscany. On the other hand, no significant regional differences in adjusted mortality

rates at both acute and longer phases were found.

Comparing two regional healthcare systems which mainly differ in both the reimbursement

systems and the level of integration between hospital and community services provides

insights into factors potentially contributing to regional variations in spending and, therefore, in

areas for efficiency improvement.

Link

Development of a novel benchmark method to identify and

characterize best practices in home care across six European

countries: design, baseline, and rationale of the IBenC project

Europe’s ageing society leads to an increased demand for long-term care, thereby putting a

strain on the sustainability of health care systems. The “Identifying best practices for care-

dependent elderly by Benchmarking Costs and outcomes of Community Care” (IBenC) project

aims to develop a new benchmark methodology based on quality of care and cost of care

utilisation to identify best practices in home care. The study’s baseline data, methodology, and

rationale are reported. Home care organisations in Belgium, Finland, Germany, Iceland, Italy,

and the Netherlands, home care patients of 65 -years and over receiving home care, and

professionals working in these organisations were included. Patient data were collected

according to a prospective longitudinal design with the interRAI Home Care instrument.

Assessments were performed at baseline, after six and 12 months by trained (research)

nurses. Characteristics of home care organisations and professionals were collected cross-

sectionally with online surveys.

Through this research, whose results have been published on 15 May 2019, a unique,

international, comprehensive database is established, containing in-depth information on

https://pdf.sciencedirectassets.com/271761/1-s2.0-S0168851019X00056/1-s2.0-S0168851019300211/main.pdf?x-amz-security-token=AgoJb3JpZ2luX2VjEGsaCXVzLWVhc3QtMSJHMEUCIDUxc2g5n6n11J%2BqOeDrSZfmFgugv3ytma4jEwluyKo6AiEA81LVU8X%2FG8C0L76X0%2BGDaVLFrQawSoJ2DtWndZJgmFQq2gMIcxACGgwwNTkwMDM1NDY4NjUiDI%2BKDPaoQ%2FhbJVFmqSq3A7bdSMvz1og5Lw0kV6GBmxokwe38cG6Rzfyh2l4SGxuFdEN6y7gW6mJDUdsQuLj7%2BFJFWVQ%2Fr5vrKzmNgS1mkgXx4H6CXZfbpOZQ5MDoiw97S%2FnDXx0luoscynVky8AoSWdRrrCTCB8%2BX0v9i5koGLOt9lj7UGc3TqMMjjwL4A8JBo1AkR0kqiQm5yV%2FV9dlCvrmNrNa6j0uMcr4M9B0lOMKOKLiGGWn1n8fHrC9nx9JKaz2WpHpANSGc0lytPHMwGBGXUmuIBO5KX7j0%2FmnOGGA5GUXfE1e7ouDJOkdszMYS3r4aHdBmXJcwUIAGigLrup84otLms9lwSDo9%2FAX50sjimA8Ysd5eqR3BV%2BtIcJfjOgMFJcgBVv%2FXjvupOiox6TLSOW9wGydmMahpz8%2FCxnisCayHaU2aAUnY7y%2FAGfm6A7sAhQf1dzBcnjXE1Gk9oGLwrWpF5RetONtxOfHKLLkUvxdXSQyEhDv2GOJguN0YztcveEVJhVKdTqZ8Swhd7wfeoNIbODai12MleF1tXlX%2FJfmf7j5Y25zMUs%2B0Za2S64En%2FdU%2FyIPBv93hRqNe7SeC4yGLKUwnf6J5wU6tAEOXXOhtp9gAtFQSReSDAkPsUPaFnhNKFk%2BKA0Hq7r9wnYF2vZRlIC2ofRuV2dOdqrgoFGR%2Bdn0CbQ9Q%2BaTukzL9d4gOA6wFarSRiq4TYVjYunndk3mbRw2C3gZuT%2F9Is2blNAHvTrrryLhfdqZDtaOPRT42YpzcNzbwkK4hin6kujrShadpQtFvAy70BMpCLvx4vjp%2FsMhSi5JGxooS9DF2cWU%2FLK9TVTLk5lZ08mvHFVhiM0%3D&AWSAccessKeyId=ASIAQ3PHCVTYWQWJFYIS&Expires=1558354225&Signature=RHUnnjgKkfRuZhrrPgr5hDc7dc4%3D&hash=452ed81f4bead8af92d161daafc8c33548c09baeedb46b1454e7915f5c357abe&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S0168851019300211&tid=spdf-6c1157b2-aec3-4e40-b9e2-8306bf7a138c&sid=e2cbac3874ce1441f91be46584f3d430232cgxrqb&type=client



home care organisations, their clients and staff members. The variety of data enables the

development of a novel cost-quality benchmark method, based on interRAI-HC data. This

benchmark can be used to explore relevant links between organisational efficiency and

organizational and staff characteristics.

Link

Factors associated with post-acute discharge location after hospital

stay: a cross-sectional study from a Swiss hospital

In 2012, Switzerland introduced the diagnosis-related group hospital payment system. Fearing

that vulnerable patients may be discharged early, Acute and Transitional Care (ATC) was

introduced to address the nursing care of patients who no longer needed an acute hospital

stay. ATC is more costly for patients when compared to other discharge options like

rehabilitation while providing less rehabilitative services.

This study published on 8 May 2019 investigates factors associated with the place of discharge

for patients in need of care. Older patients with higher Delirium Observation Scale (DOS), lack

of supplementary health insurance, resuscitation order and a lower social network were more

likely to be discharged into ATC than rehabilitation. The association of supplementary health

insurance and social network with discharge into ATC or rehabilitation is problematic because

patients that are already vulnerable from a financial and social perspective are potentially

discharged into a more costly and less rehabilitative post-acute care facility.

Link

Building implementation capacity (BIC): a longitudinal mixed

methods evaluation of a team intervention

Managers and professionals in health and social care are required to implement evidence-

based methods. Despite this, they generally lack training in implementation. In clinical settings,

implementation is often a team effort, so it calls for team training.

The aim of this study published on 9 May 2019 was to evaluate the effects of the Building

Implementation Capacity (BIC) intervention that targets teams of professionals, including their

managers. A non-randomised design was used, with two intervention cases (each consisting

of two groups). The longitudinal, mixed-methods evaluation included pre–post and workshop-

evaluation questionnaires, and interviews following Kirkpatrick’s four-level evaluation

framework. The intervention was delivered in five workshops, using a systematic

implementation method with exercises and practical working materials. To improve transfer of

training, the teams’ managers were included. Practical experiences were combined with

theoretical knowledge, social interactions, reflections, and peer support. The intervention had

positive effects with regard to the first two levels of the evaluation model; that is, the

participants were satisfied with the intervention and improved their knowledge and skills. Some

https://bmchealthservres.biomedcentral.com/track/pdf/10.1186/s12913-019-4109-y

https://bmchealthservres.biomedcentral.com/track/pdf/10.1186/s12913-019-4101-6



positive changes also occurred on the third level (behaviours) and fourth level (organisational

results), but these were not as clear as the results for the first two levels. This highlights the

fact that further optimization is needed to improve transfer of training when building teams’

implementation capacity. In addition to considering the design of such interventions, the

organisational context and the participants’ characteristics may also need to be considered to

maximize the chances that the learned skills will be successfully transferred to behaviours.

Link

Health inequality implications from a qualitative study of experiences

of poverty stigma in Scotland

Individuals living in Scotland most deprived communities experience a higher burden of

morbidity and early mortality than those living in more affluent areas. Experiences of poverty-

based stigma may be one psychosocial mechanism through which socioeconomic position

influences health, although there is little available data on this issue from a Scottish

perspective.

The aim of this study published on 25 April 2019 was to identify which aspects of poverty

stigma are particularly salient to individuals with lived experience of poverty and may therefore

contribute to health inequalities. Five focus groups were conducted with 39 individuals with

experience of living on low incomes in Scotland in order to explore their experiences and

perceptions of poverty stigma. Five main themes were identified, reflecting aspects of poverty

stigma operating at various structural, public and individual levels: media representations of

poverty; negative encounters with social security systems; perceived public attitudes regarding

poverty in Scotland; lowered self-esteem and internalisation of negative attitudes, and;

emotional responses to stigma. These dimensions of stigma potentially influence public health

and health inequalities in Scotland, although future research will be necessary to quantify these

and estimate their relationships with health outcomes.

Link

https://bmchealthservres.biomedcentral.com/track/pdf/10.1186/s12913-019-4086-1

https://pdf.sciencedirectassets.com/271821/1-s2.0-S0277953619X00118/1-s2.0-S0277953619302333/main.pdf?x-amz-security-token=AgoJb3JpZ2luX2VjEG0aCXVzLWVhc3QtMSJIMEYCIQDCl%2FuWlYIcLUc4hXier%2BGYIA%2F7IpD%2FNWG9K%2BB4olw9EwIhAM8ofQPqEVFh7Bbkxsz775IUwMOrwr%2FMWtFSC2I7cmpVKtoDCHUQAhoMMDU5MDAzNTQ2ODY1IgxGFxg5R1Ug9LVpvDMqtwPrEf%2BNWCVw2cmBXYbmWj6k9WacOnuuGCb9HPrjTmuEvTLP1NDo%2BhhuLJFH%2F1tn%2FSMnfc8XHRdIvTVWD5iu0pKHhKAPgG95FUzHKOrZM3%2Fgc020XUT%2Bux1A8BSXlB1KVrOTgDoWGFlAo8loSM6Sj2YX9FmA49I9M5AujvYqBJWApKPVI62%2FAuYiktSvI%2Fe5jtufpIeJGQnULKUT4ZDailYtkiEXeD1rWkY2jYG%2BXdmZBDZiQVMz%2BrJLtBfr0VZ%2BJUO%2FeJNWbcnX9XjQRiLjHPaHLhbeMVgMZSogF0%2B02E09Bpa1%2BgjHDrAg0NVlcG%2BoVtYHllrIqLQWYKAqd09d0AW5Z8bzggPK8aLkAqBe11W7%2BL6JUOUFPKab7EaMPhW48kauLk4yvCcWH%2F8TYOs5Zt%2F1LUzFuFfQGhqU4sSq1iJQc75MK6zTpfXHa3rPSlUzrNNzLfYuLdm4HMD%2B5wWcgS4so0ljkNNfQUhhDftZ4M7lm4A%2B3EzEcEptsv9mcFCbgouPvaJRmArSknhQUnlrSQ4jtKsFD%2F%2FOi5Lw4z0%2Fra7nVKg0BeStxuGiCLdundonHmaaO5BfL7GxMMq1iucFOrMBdvlnaUAtsVeEVsxd%2BOyENBxN%2FFq0eZmAGDDg1ZMfgnDdj8okmei9KAEiE3%2BxyJADc7oQSd%2FL0QEDpjUMUeS7wCNcq60PX6%2Fyi%2BtQxQBqtYovc%2FeDoUuS%2Fv2%2F9Zbk7d2GHAHXBHEgGQQWpiY6OtMWg3s7hqCBrjAU%2F10eTAqnqDj%2F3BL9hyxSqspk9Dl3kcj%2B1ViWb58S7V5IwLqeERmxXIW3%2FNuUs94QjFhznwIfdywo9r8%3D&AWSAccessKeyId=ASIAQ3PHCVTYY63RZFLM&Expires=1558358066&Signature=9Hry%2FwgK52JUdjve0MVsR2rzLq8%3D&hash=71a05354b9cd98dfc00fd61a2e6ac25bc42b2b99fa36f7c7245cf007ba8949ea&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S0277953619302333&tid=spdf-dbbfacfe-ad46-4bd7-96e7-ff345be030dc&sid=7f60d53b9df573418a696f01f383827d3570gxrqb&type=client



The G7 Primary Health Care Universal Knowledge Initiative

On 17 May 2019, health ministers from the G7 countries met in Paris and reinforced their

commitment to strengthen primary health care systems. They launched the G7 Primary Health

Care Universal Knowledge Initiative (see the G7 declaration). From low to high income

countries, people-centred primary health care systems are becoming more important.

There are three main reasons for this. First, a people-centred approach helps keep health

inequalities low. It is the one part of current health systems that delivers this, with little

difference in the proportion of high- or low-income groups seeing a GP. Second, being people-

centred can help keep costs down. By treating people early at a local level, costly hospital

admissions can be reduced, saving the equivalent of 6% of total bed days. And third, the

approach is well-suited for addressing the health needs of the future, including a greater

emphasis on preventive services, and for coping with the increasing complexity and care needs

of ageing populations.

But to meet these future challenges, primary health care services will need to transform. In

fact, in too many OECD countries, primary health care is failing to deliver its full potential. While

primary health care teams are in a unique position to advise patients on lifestyles, deliver

preventive care, and manage the progress of chronic diseases, as low as one person in four

suffering from some chronic conditions did not receive any of the recommended preventive

tests in the past 12 months, according to latest available data. Hospital admissions for chronic

conditions, which could be averted by better prevention and diseases management, are also

too high–equivalent to at least US$ 835 million on average across OECD countries. Moreover,

inappropriate use of antibiotics, another marker of poor primary health care quality, ranges

between 45% and 90% of reported cases–a higher share compared to other health care

services.

The good news is that policy makers can change things, particularly if they harness the best

of what innovation around the world has to offer. There are many significant and useful

innovative developments to draw inspiration from in primary health care services, such as Ma

Santé 2022 (My Health) in France, My Health Teams in Canada, or the Friend and Family Test

in the United Kingdom. By sharing experiences such as these, policy makers can identify the

reforms they need, evaluate them, and help each other to make progress.

Five international organisations, the OECD, the World Bank, the World Health Organization,

the Global Fund and GAVI, a vaccine alliance, have issued a statement to work together to

produce a joint report. The report will include among other things an identification of the need

for a universal knowledge exchange platform, a mapping of existing expert platforms, and an

identification of the current shortcomings regarding knowledge dissemination and the

exchange of good practices in the area of people-centred primary health care. The joint report

https://www.elysee.fr/en/g7

https://solidarites-sante.gouv.fr/IMG/pdf/declaration_de_l_engagement_des_etats_du_g7_.pdf



should help to accelerate progress among all our countries, and will be a key step towards

achieving and sustaining universal health coverage.

Future health care challenges are already mounting, and a drive towards people-centred

primary health care is the best way forward for policy makers in all our countries, which is why

we welcome the G7 Primary Health Care Universal Knowledge Initiative.

PGEU Position Paper on Medicine Shortages

European community pharmacists are very concerned about medicine shortages, which are

on the rise in Europe and can seriously compromise patients’ health. In recent years mitigating

shortages has unfortunately become a daily activity of community pharmacists in Europe which

leads to high inconvenience and distress to the patient, but worse, may negatively affect health

outcomes. Both the recent work of the HMA/EMA Taskforce on Availability of Authorised

Medicines and the Juncker Commission recommendations for the EU strategic agenda 2019-

2024 clearly highlight the need to address the problem at European level.

PGEU calls for a number of coordinated actions to reduce the burden of shortages on patients,

healthcare professionals and supply chain actors:

1. Put patients’ needs first when developing business policies, national laws and

strategies that can affect the timely and adequate supply of medicines and assure

effective compliance with EU & national laws related to the public service obligations

of supply chain actors.

2. Expand the scope of pharmacy practice when medicines are in short supply, so that

pharmacists can better use their skills and knowledge to better manage patient care.

3. Establish effective communication frameworks between all medicines supply chain

actors and national competent authorities so that timely information on a (foreseen)

medicine shortage is provided to all actors.

4. Compensate the negative financial impact medicine shortages cause on patients and

healthcare professionals through appropriate reimbursement and remuneration

provisions.

5. Develop effective governance systems to improve reporting, monitoring and

communication on medicine shortages. A close collaboration between EU Member

States and the European Medicines Agency (EMA) as well as more structural, timely

and transparent collaboration models between supply chain stakeholders and national

competent authorities are needed to increase the efficiency and effectiveness of joint

notification and assessment practices, and to empower pharmacists in reducing the

impact on patients.

Link to the Position Paper

https://www.pgeu.eu/wp-content/uploads/2019/03/190514E-PGEU-Position-Paper-on-Medicine-Shortages.pdf



Migrant Health Training Received by over 2,000 Frontline

Professionals across Europe

The International Organization for Migration (IOM) has wrapped up a first-of-its-kind training

initiative on migration and health across Europe for more than 2,000 health professionals, law

enforcement officers and social workers who work directly with migrants and refugees.

Higher migrant arrivals to Europe and the subsequent need to strengthen the awareness,

knowledge and skills of health professionals who work with migrants and refugees provided

the impetus for the initiative. In response, IOM, together with national partners and

stakeholders, and with European Union (EU) support, conducted 69 trainings in 21 countries

between December 2018 and April 2019.

The trainings across Europe aimed to improve the responsiveness of health services to

migrants’ needs and tackle multiple aspects of migration health including individual health,

recognizing and dealing with vulnerabilities, providing mental health support and highlighting

the importance of intercultural skills. They also provided a venue to share good practices and

experiences working in different national migration health contexts, and to build stronger

networks among representatives with diverse professional backgrounds.

The workshop-format trainings were provided in countries that are part of the European

Commission’s “Third Health Programme”: Belgium, Bosnia and Herzegovina, Bulgaria,

Croatia, Estonia, Finland, France, Germany, Greece, Hungary, Italy, Latvia, Luxembourg,

Malta, Norway, Poland, Portugal, Romania, Serbia, Slovenia, and Spain. Professionals from

the Czech Republic, Iceland, Ireland, Lithuania, Moldova, the Netherlands, Sweden, and the

UK also participated.

The training programme was carried out through project Provision of training for first-line health

professionals and law enforcement officers working at local level with migrants and

refugees (TRAIN4M&H) was funded and supported by the European Commission (DG

SANTE). The TRAIN4M&H project is undertaken as part of the EU Action Plan on the

Integration of Third Country Nationals, coordinated by GIZ International Services in

collaboration with IOM, the Istituto Superiore di Sanità (ISS), École des hautes études en

santé publique (EHESP), the Institute of Public Health of the University of Porto (ISPUP),

the Dipartimento di Sanità Pubblica e Malattie Infettive – Università Sapienza Roma and the

Association of Schools of Public Health in the European Region (ASPHER).

The transposition of the Patients’ Rights Directive in Finland—

Difficulties encountered

The Directive on the application on patient rights’ in cross-border healthcare (2011/24/EC) was

transposed in Finland by the Act on Cross-Border Health Care (1201/2013), which entered into

force on 1 January 2014.

A new reimbursement model for cross-border health care costs was designed. The Finnish

legislator considered the chosen reimbursement model to correspond both with the aims of the

https://ec.europa.eu/health/funding/programme_en



Directive as well as to the functioning of the national health care scheme. The European

Commission, however, initiated the first infringement procedure against Finland already in

January 2014.

In spring 2015, the Government launched a Regional government, health and social services

reform, which would fundamentally transform the organising, production and financing of

health care services in Finland. Consequently, a Government bill to change the existing

reimbursement model for cross-border health care costs was delivered to the Parliament on 1

June 2017.

In this article released online on 24 May 2019, Finland implementation process of the Directive

is reviewed. Special attention is drawn to the argumentation concerning the reimbursements

of cross-border health care costs. The differences of views on reimbursements can generally

illustrate the conflicting objectives to expand access to cross-border health care services and

to ensure financial sustainability of states thereof.

Link

A review of attitudes towards the reuse of health data among people

in the European Union: The primacy of purpose and the common

good

Health data are used for still more purposes, and policies are enacted to facilitate data reuse

within the European Union. This literature synthesis published on 24 May 2019 explores

attitudes among people living in the European Union towards the use of health data for

purposes other than treatment. The findings indicate that while a majority hold positive attitudes

towards the use of health data for multiple purposes, the positive attitudes are typically

conditional on the expectation that data will be used to further the common good. Concerns

evolve around the commercialisation of data, data security and the use of data against the

interests of the people providing the data. Studies of these issues are limited geographically

as well as in scope. The authors therefore identify a need for cross-national exploration of

attitudes among people living in the European Union to inform future policies in health data

governance.

Link

https://pdf.sciencedirectassets.com/271761/1-s2.0-S0168851019X00068/1-s2.0-S0168851019300405/main.pdf?x-amz-security-token=AgoJb3JpZ2luX2VjEBUaCXVzLWVhc3QtMSJIMEYCIQD7TqkWBMbRvOVh%2BatmNCHgZ3xC1fmkq%2FzUIuiq2rPTVQIhAKnts4gneMSbZGvaeefmZOGI27XAEqCfxmeBoWs4btizKtoDCC0QAhoMMDU5MDAzNTQ2ODY1IgwjSbyha2Mpi8BvUA0qtwO16OxHfvrzxRA4OI%2BYYSt%2BaEkgZ4VhutvApifLWj0KLxEu2tS57SbBMi0iWdV8LRasWiiMKvGp96WA1V6arItAOsp21Jl6U50lsQprXG7PmlrJqtCofLj1zkaeDCg8fJmV5rSW1FkicVmOeFZol4wC%2FbXvfZnXEQ9gQPtEFfDgiO8ZTfDORbuSWEvB%2BdhIYkzeQkDrXENFMTqr%2Fce9efQvtF0kQBZhg0J1oZUq8SnOjM9UzT1T2MSsCwmqBjlPsIyOKmO4UFrABqAMH7om48NaJyEuG1ERS1B94tlUs7MareQAtkyBAYDXBmyAYBQQIRR2IOI6jBv9uwmz0IaTyhOnfoVvOrsOVdK19sERmchDGjbqt6WV5wZ9Z868DezUhTBUBD2N8s8NWfJHOzFYqIGnQRVcemiBXDqddyeDLutM3MJh7WS9E%2FAMJWrz01XEWubjJdWR8KqznrCYVypl8xXGasW44a03P2V3HSvX%2FS8LIXT39qmvCXCg4ERiy0F4E0syqNFkpZh0gIvj%2Fiwo6SQC4ngFUKdaQYTrq%2Fv2HaSigPJiUp8trCvEnrV2K7oA1UPvsdUNm6E5MNKrr%2BcFOrMB6beFcHowTWd7zMfftGxbRNkZgQpQefuySWDEj0Ios7NFqadMFP7MKhhsF10qbcYo50Bg2cl1x%2BYVBsh2wFZFGBua4DCfBFThSXbg1YGkjQEiHmUuinbNF%2FCOHDPe7KgIINUISbznEu2C8BTXrlA8XMcxwubdDpQ5W9JiQY9uVhfbU0xX%2FAQaR64L4mDGVlh1pqAz9HG7zqhrs7uLqDgKGy4Bi0opUUzNGDgflOD2VTPYhNU%3D&AWSAccessKeyId=ASIAQ3PHCVTYSZU2VM6Y&Expires=1558964230&Signature=7pYLbq1AjNCBpmBIaR8YApRdGQE%3D&hash=48ce9c952a3296729417d4af35c28ed54babed7c3e6284de4c74d859f19a511c&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S0168851019300405&tid=spdf-0eb83e79-8109-4fa1-bbb2-ec95de762ced&sid=068059a283e85240132b60049aa1ee227dafgxrqb&type=client

https://pdf.sciencedirectassets.com/271761/1-s2.0-S0168851019X00068/1-s2.0-S0168851019300818/main.pdf?x-amz-security-token=AgoJb3JpZ2luX2VjEBUaCXVzLWVhc3QtMSJHMEUCIQCr%2BtcOXLx0lqmLzujtIw40hBeSOFhqq%2FoeKM5XZ3TfIQIgLcK51tv6j%2F5ecD2sw%2FPruWVHz7%2BjscqAMuRixqZz3DIq2gMILhACGgwwNTkwMDM1NDY4NjUiDG6wKoF4PBz9DsTvXSq3A%2FVPu7yS%2Fqs%2Fg0lQEj0wkhQDyMPiw1v%2Fo3t%2BFAwOjcbTJku8qpT2OEoP%2FNrKrmD2S4BIuHcQzyI7qVxupyoJvhDz3qOOCjS441TSM1dd4YW55gILs7oK5JB8xjNhBwPrAECpba4ZYMqoFBExISKB2koROPG5bHRTNFeZ%2Fa%2BDM%2BtucuYWZ8UHb0tl0hX6CJZzB%2FkJ0Z8EW6g4zspv5VwFGaKAyqWlW53Iul8pD%2BfWlr2j4N%2Fx%2BegHVjdOO6lAHmdTswboxW%2FS7mjyi4FMIMq4fLMxRMpwbpo7L5IjJDXOld95oak9kGC%2FbZg9fRh5XY9bZhVNoT3A75a9KUcpSTEvZ1d6ksXWSeghtWydVyvpZkgctuZeQDO9oX8Xa2dfcDqFwLgQ%2FSHbAHRcipR4Ue%2FUCiDC%2FZod6vx1DQa4q2cnKOoLLcj3jsNwr4fGSutYJpbCzrigaB%2FLin%2BYk7Lhb%2F6TRrm3dJdiqekwBGPErFQ%2FjpI6jKEakv%2BPUQfj6mcbDkFyWhnODHqW9OdmfHTIT77RqlhpUfXaV%2Bkwk6PuSyJGn6hAcLbjowJ8c2sVUKgAQRVj0kOx%2Fl7sLxkwpbev5wU6tAEmm%2FIt4PdPaQpyEq8GmLOKcco1FcjIOUCBvnaGIBt1DeMSPczELnkp1nIsUORCIvaZGEgv6Ipvm6hE7zItZOrrFkQyLCro1LgoUcu3FhT1ZEftLtdRvWnSCmALjOYwWjwXiMHcc9Vlae5IpOYPQFtXJyY40NO7n0vR64Ov27V%2Bozod%2FpCDhhPX9KoqdZY2kjnfCIIW6C8%2BXtOru9IKf88mOnNlC0lA7CoapEbLhq6PwgDwg5M%3D&AWSAccessKeyId=ASIAQ3PHCVTY7XBPHBQT&Expires=1558964700&Signature=JA76TpjHHcjuDA%2BR21CmyCPWuEI%3D&hash=188ede91b4e61fdee9002e953da60d6c8324f12a214445e17c114a50a502d71d&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S0168851019300818&tid=spdf-5d8958b6-f76f-4936-8040-f7de27abf132&sid=068059a283e85240132b60049aa1ee227dafgxrqb&type=client



HOPE-PAQS Webinar: TeamSTEPPS

These last few years, HOPE and PAQS have had several collaboration opportunities, e.g.

HOPE study tours, presentations at the European Parliament and HOPE Agora. Sharing best

practices and experience is known to be one of the most effective ways to improve our health

systems and more particularly quality of care and patient safety issues. Considering the

absence of concrete actions carried out by the European Union, we see an opportunity to

develop a structured network to share quality and safety best practices between European

countries.

Supported by HOPE members and their respective networks and by the expertise and

resources PAQS holds, the creation of a “Quality and Safety network” at European level

will:

• Create/reinforce links between different organisations working on quality of care and

patient safety in Europe;

• Strengthen the image and visibility of the two organisations;

• Increase learning opportunities and share best practices;

• In the long run, facilitate the implementation of common projects in different European

countries.

The Quality and Safety network will gather on a quarterly basis by means of educational

webinars to present and share best practices across Europe.

If you want to stay informed, subscribe and register for the first webinar organised on 11

June 2019. It will present the TeamSTEPPS pilot-project which started in 2018 in Belgium.

TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) is an

evidence-based framework to optimise team performance across the healthcare delivery

system. The objectives of the webinar are to:

• Present what TeamSTEPPS is;

• Describe the methodology used by PAQS in Belgium to promote the use of

TeamSTEPPS;

• Present the first results of TeamSTEPPS’ implementation in Belgian hospitals.

Register here

https://www.paqs.be/en-GB/Accueil.aspx

https://www.surveymonkey.com/r/HOPEPAQSQualitynSafetynetwork

Documents

News from HOPE members Romanian Presidency …...policy-makers, managers and many other stakeholders was also considered. In increasingly complex health systems, the ability to use