EVENT SUMMARY: Innovation in diagnostics for tackling Antimicrobial Resistance

On 31st May 2017, policymakers and health representatives met within the framework of the European Parliamentary Interest Group on Innovation on health and social care to spur debate on innovative diagnostic solutions necessary to manage and fight antimicrobial resistance (AMR) in Europe. In this frame, the meeting entitled Innovation in diagnostics for ­fighting antimicrobial resistance provided the framework to launch the White Paper on rapid diagnostic technologies to tackle AMR, perceived to be valuable tools to curb the antibiotic misuse by reducing unnecessary prescription, tailoring treatment for bacterial infections, and limiting the spread of infections.

As initially underlined by MEP Karin Kadenbach, since the introduction of penicillin in the 1940s antimicrobial medicines, such as antibiotics, have become essential for the treatment of many microbial infections in humans and animals. However, misuse and abuse of antibiotics worldwide has eroded their efficacy and antibiotic-resistant bacteria have emerged and spread across the globe.

Mr Arūnas Ribokas, member of the Cabinet of Commissioner Andriukaitis, indicated some remarkable achievements that have been made possible in the field of AMR. Actions previously taken at EU level enshrined in the EU Action Plan on AMR 2011-2016 have paved the way to develop a One Health approach, which combines both human and animal health. Based on the lesson learnt from the aforementioned Action Plan, the forthcoming one will be focused on three main priorities: making the EU a best practice region in addressing AMR, stimulating research and innovation, and shaping global engagement beyond EU countries. It will include different aspects, like environment and research, and improve knowledge across Europe”.

There is a general lack of new antibiotics pipeline, worrying misuse and overuse of antimicrobials and many concerns regarding the effectiveness of such antibiotics. Here comes the need to work together in order to identify the problem, make further progress and support the level of education of health professionals, by giving them simple ways of analysis and instruments to detect/prevent infections. As emphasised by HFE Honorary President Mr John Bowis, it is important to make things happen.

In line with this, Ms Barbara Kerstiens, Deputy Head of Unit for fighting infectious diseases and advancing public health in DG Research and Innovation, highlighted the aspect of research to combat AMR. While developing new strategies for a prudent and rational use of antibiotics in medicine and agriculture along with novel antimicrobial therapies, the Commission aims at creating and validating new rapid cost-effective diagnostic tests to determine whether and which antibiotic should be prescribed as well as to support the advancement of novel antimicrobials. In this regard, “numerous projects have been developed in the area of diagnostics – such as CAVIDI and MOBIDIAG etc. – and new business models are needed to reflect the societal value of limiting the use of antimicrobials while promoting the use of novel diagnostics”.

To point out the critical role of rapid diagnostic technologies and discuss the current limitation to their uptake, Health First Europe in collaboration with Alliance of Patients’ Organizations (IAPO) and the World Alliance Against Antibiotic Resistance (WAAR) and with the support of the MEP co-chairs of the EP Interest Group on innovation in health and social care worked on a policy White Paper on rapid diagnostic technologies to tackle AMR. New rapid diagnostic technologies represent priority instruments for managing infections treatment, identify the nature of virus and bacteria, and for increasing knowledge on infection control and surveillance. Fostering the use of diagnostic technologies can help the whole society to protect better antibiotic conservation and lower development of resistance over time. More policies and measures are needed to encourage the uptake of such tools and develop public messages in healthcare systems to facilitate clinical evidence for rapid diagnostics.

Mr Jean Carlet, President of the World Alliance against Antibiotic Resistance, called for compelling actions to encourage a change of patients’ behaviour and redefine relationships in healthcare settings. Taking the Dutch model as a reference point, citizens, policymakers, industry and health carers need to create synergies to conduct greater analysis, develop ambitious studies, and enhance trust and cooperation at all levels. With the launch of the White Paper, as underlined by Mr Carlet, there is the imperative to invest more in rapid diagnostic technologies, “as they are vital instruments able to separate at the bedside viral from bacterial infections, identify the type of bacteria, and provide the resistance pattern that will help physicians to decide/select the proper antibiotic immediately”.

While it is clear that managing the use of antibiotics has become an important patient safety and public health issue as well as a global priority, MEP Marian Harkin emphasized how it is essential to work together on a multi-level approach to tackle effectively this public health issue. Not only there is a lot to do, but also a lot that people can learn from each other. Therefore, it is decisive to develop an integrated, comprehensive approach and strengthen coordination with EU agencies, food safety authorities and national competent authorities to spread the problem and share best practices, bringing together human and animal health for new solutions.

EVENT SUMMARY: Tackling AMR and HAIs to improve patient safety

“A prudent use of antibiotics is a cornerstone of the battle against antimicrobial resistance”

Doctor Andrea Ammon, Director of ECDC

On 17th November 2016, in conjunction with the World Antibiotic Awareness Week, policy makers and health stakeholders met within the framework of the EP Interest Group on Innovation on health and social care to discuss how to tackle the global threat of antimicrobial resistance to improve patient safety.

As underlined by MEP Karin Kadenbach, co-chair of the EP Interest Group, “antibiotic resistance represents a sever health threat for everyone and a crucial challenge that needs to be addressed from a global perspective. The resistance to antibiotics not only threatens the lives of individuals who come in contact with drug resistant bacteria, but also presents significant costs to health systems when they can least afford it”. This threat can be stopped and prevented by diagnostic tests that allow doctors to determine when and which antibiotics should be used, training for professionals on antibiotics, preventing surgical site infection, information to patients on the risks and their role in preventing infections. Moreover, it is critical to raise awareness as half of Europeans do not know that antibiotics do not work for viruses. If there are potential tool for actions, why is AMR still a growing threat? And what should policy makers, healthcare professionals, stakeholders do to support collaborative efforts to tackle and raise awareness on AMR?

Doctor Andrea Ammon, Director of ECDC, focused on the importance of prevention of Healthcare Associated infections (HAIs) which represent an alarming concern in European hospitals. Indeed, of all patients, 6% are infected with at least one HAI. “HAIs account for twice the burden of 31 other infectious disease”, Dr Ammon stated. It is possible to reduce impact of HAIs by prudent use of antimicrobial agents (only when needed, correct dose, correct dose intervals, correct duration), infection prevention and control (active surveillance, hand hygiene, screening, isolation), and new antimicrobial agents (with a novel mechanism of action, research, development).

Ms Line Matthiessen, Head of Unit for Fighting Infectious Diseases and Advancing Public Health in the Directorate General for Research and Innovation, emphasised the role of research and innovation to tackle AMR and showcased several examples of the European Commission’s support to projects which have allowed to develop new diagnostic tests, novel antimicrobial therapies and new strategies for rational use of antibiotics in human medicine, food producing animals and aquaculture.

Professor David Leaper, Emeritus Professor of Surgery, University of Newcastle upon Tyne, pointed out the urgency to return to the use of antiseptics for prevention and treatment of surgical site infection. Definitions, surveillance and compliance are required to prevent surgical site infection. Antiseptics do offer an alternative in many areas and, therefore, research is needed. In his opinion “Using the right antimicrobial at the right time, dose and duration is fundamental to reduce the impact of bacteria and in infection treatment”.

Ms Marja Esveld, Senior Advisor Global Health and Innovation at the Department of International Affairs within the Ministry of Health of the Netherlands shared a tangible example of how AMR can be tackled at the national level. The Dutch National Plan aims at reducing avoidable healthcare-associated infections by 50% and incorrectly prescribed antibiotics across the entire healthcare chain by at least 50%. Already, several business cases showed cost-effectiveness of the antimicrobial policy. Either by improving adequate use of antimicrobials or by improving adherence to infection control measures. Antimicrobial policies needed initial investments. Nonetheless, all business cases showed high return of investment and short pay back circles (e.g. less use of restricted antimicrobials, shorter length of stay, less healthcare personnel needed). More importantly, patient health and patient safety improved considerably.

Participants also raised the importance of screening patients for infections before entering hospitals, investing in and incentivising diagnostic tests to prevent antibiotic misuse, investing in new vaccines as well as encouraging hospitals to publish data on infection and resistance rates so that patients can make more informed choices.

While it is clear that AMR has become a public health threat with a very high position in the national, European and international political agenda, there is still much more to be done. Antibiotic consumption has increased in several EU Member States since 2013 and half of the EU citizens are not aware that antibiotics are ineffective to treat cold and season flu.

It is critical to work together at a local, national, European and global level. Bacteria do not know borders. Infection prevention is a key element to reduce antibiotic consumption. It is important to encourage and support Member States to put in place and monitor national targets for the surveillance and reduction of AMR/HAIs through holistic action plans under a “One Health approach”. Last but not least, patient empowerment is a key challenge. It has been proven that antibiotic consumption decreases as knowledge increases.

EVENT SUMMARY: 11 indicators to accelerate the implementation patient safety policies

“Patient Safety needs to be integrated in the concept of quality of care” – Niek Klazinga OECD Health Division

Patient Safety is a public health issue and needs to be considered a cross sector topic in healthcare policies and upcoming health system reforms. In order to measure EU Member States progress on tacking patient safety including healthcare-associated infections and anti-microbial resistance, Health First Europe (HFE) has developed 11 policy indicators and scrutinised several EU Member States. HFE calls on the European Commission and EU Member States to use effectively these 11 policy indicators to drive and foster the implementation of better standards regarding patient safety in Europe.

John Bowis, HFE Honorary President, stated that “patient safety remains a critical issue as 8-12% of patients admitted to hospital in the EU still suffer from adverse events while receiving healthcare. An estimated 4.1 million patients per year in the EU acquired a healthcare infection, and at least 37 000 die as result”. Since the adoption of the Council Recommendation on patient safety, including the prevention and control of healthcare associated infections in June 2009, EU Member States have taken actions to minimising harm to patients receiving healthcare and to preventing HAIs. However, despite the positive steps, little has been done to set definite and tangible targets for improving patient safety and quality of care. To fill in this gap, HFE launched 11 Patient Safety indicators which cover a broad range of areas from general patient safety policy, to areas like education and training of healthcare workers in patient safety, empowering patients and developing culture of learning from errors, screening and surveillance programmes and use of innovation to reduce HAIs and AMR. HFE believes that these indicators can accelerate the implement of EU patient safety policies by facilitating better uptake of best practices across EU Member States.

According to Mr Klazinga, Head of the Health Care Quality Indicators Project at the OECD, “patient safety is an important issue in the overall healthcare system that should not be isolated”. In particular, “patient safety is a component of high-quality, sustainable healthcare services, which needs to be integrated at all levels”. There is the need to improve it through action programmes, indicators and new strategies at national, institutional and clinical level. Mr Klazinga (OECD) pointed out that ‘getting information is critical for tackling patient safety issues’ and ‘the more accurate statistics are, the more likely are patients to feel confident to provide information’. The OECD has been a pioneer of this approach and its monitoring work has offered a clear map on healthcare-associated infections in Europe.

Participants focused on the need to promote a blame-free culture in healthcare settings where patients and professionals can report errors to create an equitable and transparent process for recognizing such mistakes. To this regards, Mr Bowis stressed the accent on one hand on the education and training for healthcare profession as a critical tool to raise awareness of patient safety and, on the other hand on patient empowerment as well as the relationship between healthcare professionals and individuals to foster a patient safety culture. From the side of the European Commission, Mr Federico Paoli outlined how patient safety is a priority for the European Commission and several EU member States have shown their commitment to keen working in the Patient Safety & Quality of Care Expert Group.

While it is clear that there is a raised awareness in Europe on patient safety, all health stakeholders emphasised that there is a need for continued effort at EU level to support Member States in improving patient safety and quality of care. Mr Klazinga emphasised how “patient safety has no boundaries and is part of an intercultural dimension”. EU policymakers in close collaboration with Member States and stakeholders need to keep working on patient safety and quality of care by promoting the exchange of good practices, effective solutions and a better understanding of the cost-effectiveness of patient safety policies under the principles of efficacy, efficiency, appropriateness, safety and quality of care.

Check HFE Patient Safety indicators here.

EVENT SUMMARY: How can we translate innovation into policy recommendations?

It is possible to use a myriad of different technologies to improve patient safety and healthcare. We can do more by making sure that Member States are committed in incorporating these technologies into their health systems and that they are supported by policies that guarantee that patients receive the best care possible.
Karin Kadenbach (S&D, AT)

On June 1 2016, the EP’s Interest Group on Innovation and Health and Social Care met to finalise 5 policy recommendations to be addressed to the European Commission and EU Member States on how to translate innovation into national healthcare systems. To achieve this aim, the work of the Interest Group was supported by the participation of Mr. Sylvain Giraud, Head of Unit for Performance of National Health Systems at DG-Santé, and Prof. Walter Ricciardi, Member of the Expert Panel on effective ways of investing in health.

The interest Group with the support of its Co-chairs has been working to define and showcase the role of innovation to improve patient lives since its launch in November 2014. As stated by MEP Karin Kadenbach (S&D, AT) “We have seen how technological innovations have added value to the health system across countries with wearable devices that can help physicians give more specific diagnosis, and patients in helping them in creating a thorough medical history, thus giving them tailor-made treatment”. She insisted that it was necessary to work together between European institutions and EU Member States to guarantee the strengthening and sustainability of national healthcare systems.

Mr John Bowis, Health First Europe Honorary President, highlighted how any national reform should put the patient at the center and focus on better use of resources. In his opinion We need to work more and together to provide European citizens with the best quality healthcare, taking full advantage of the new technological innovations in the sector without compromising the healthcare national budgets.

To make patients beneficiary of innovative healthcare solutions “It is essential to have innovative reforms” Mr Sylvain Giraud stated. His contribution emphasised the tension between innovation and budgetary restraints. Nevertheless, patients expect cost-effective innovation as Mr Giraud said “It is not only about new technologies and new products, but it is also about new structures, new delivery model, new processes, new services, new financial mechanisms, new pricing mechanisms, and also workforce skills. What we need is a mix of all these innovative elements”. Bearing in mind the European Union competencies in the health policy, the European Commission is currently supporting Member States to look for new ways to deliver new treatments and technologies or other types of innovative solutions to meet patient expectations.

To provide new tools to Member States to reform healthcare systems, Prof. Walter Ricciardi introduced the concept of disruptive innovation, which is “an innovation that creates a new market or expands an existing market by applying a different set of values, which ultimately (and unexpectedly) overtakes an existing market”. There is no one-size model which can fit for European healthcare, Member States need to look to their own health systems and structures and see which areas can be innovated. As he said “Innovation is telling our decision makers that more of the same is not enough”.

To answer our initial question: How can we translate innovation into policy recommendations? Some suggestions included access to proper insurance for all citizens, enhancing patient role in the healthcare reforms, sharing best practices, investing in training on the healthcare workforce. Bearing in mind the critic role of innovation in improving patient lives, it is necessary to work together to motivate Member States to invest in cost-effective innovation.

EVENT SUMMARY: Antimicrobial resistance – Prevention and not just treatment

“We need to act with urgency.”

During World Antiobiotic Awareness Week, experts from the European Centre for Disease Prevention and Control (ECDC), the World Health Organization (WHO), and the University of Antwerp, all conveyed the clear message that antimicrobial resistance is a growing global problem with severe consequences for all of us if we do not act now.

The Health First Europe roundtable focused on how to prevent antimicrobial resistance and the role of various stakeholders to support prevention.  While there is great variation in the consumption and use of antibiotics throughout the Europe, what is clear is that changes to policy can have a significant impact on reduction.  Member of the European Parliament Renate Sommer (EPP, Germany), kicked off the discussions by highlighting  what the Parliament has been doing to tackle this growing problem, including calling for “the use of diagnostic tests that allow doctors to determine when and which antibiotics to be used, training of professionals on antibiotics and information to patients on the risks and their role in prevention.”

Prof. Herman Goossens from the Univeristy of Antwerp, discussed how Denmark set a policy which only allowed prescribing based on diagnosis, creating a large reduction in consumption.  Likewise, Belgium invested €4.9 million in public awareness campaigns on antibiotic use through media channels between 1999 and 2015 which equated to a decrease in reimbursement for antibiotics and a cumulative savings to the health system of €642.2 million in the same period of time.  For every euro invested in the campaign, there was a cumulative saving of €131. To encourage smarter prescribing and use, Prof. Goossens explained, “More and more countries are moving towards target setting” including Sweden, Norway and the United States.

Dr Dominique Monnet from the ECDC pointed out the urgency for action given that the ECDC is seeing more and more resistance which changes rapidly from a sporadic occurrence to an endemic situation. Despite the fact that 5 countries reported decreasing use of antibiotics between 2010 and 2014, he emphasised that modern medicine (i.e. hip replacement, organ transplants, intensive care therapy, etc.) will not be possible without antibiotics.

Dr. Stéphane Vandam from the WHO, reiterated the urgency of action globally to fight antimicrobial resistance just as the world has done so with climate change. He affirmed the need to prevent infections through infection control programmes such as via the “Saves Lives: Clean your hands” campaign.  Highlighting the tools the WHO has developed with other global organisations and countries to support prevention and surveillance of antimicrobial resistance, he encouraged participants to utilse the information available from the WHO to raise awareness at national levels.

From a Health First Europe perspective, Amanda Massey expressed that antimicrobial resistance is a patient safety issue for every single one of us. “Imagine a world where ourselves, our children or our parents could die because of a simple infection?” She strongly advised that the next steps at European level include minimum patient safety standards which include information to patients on antimicrobial resistance and healthcare associated infections (HAIs), as well as setting targets for reduction of antibiotic use and HAIs at national level to be monitored by the EU.

Participants also raised the importance of screening patients for infections before entering hospitals, changing the reimbursement structures for diagnostic tests that support improved antibiotic prescribing, as well as encouraging hospitals to publish data on infection and resistance rates so that patients can make more informed choices.

While it is clear that there are many great initiatives being undertaken by various organisations and Member States, the outcome of the debate showcased that there is still much more to be done. In particular, the next steps at European level could have a positive impact on the rates of consumption and resistance in the coming years if we can work together to get it right.

EVENT SUMMARY – Innovative Health Systems Reform: the role of the EU in advancing innovation

“Why is that innovations that have proven to be cost-effective in the long term, are not invested in, in the short term?” – Kay Swinburne (ECR, UK)

This question was at the heart of the second meeting of the European Parliamentary Interest Group on Innovation in Health and Social Care. Opened by Co-Chair Kay Swinburne (ECR, UK), the question she posed went to the heart of how the European Parliament can work together with stakeholders to encourage Member States to look at investment, rather than just cost-containment, in health systems.

Ms. Swinburne, Ms. Kadenbach (S&D, AT) and Health First Europe Honorary President John Bowis all highlighted particular innovations that should be taken up by healthcare systems to support sustainability. From at-home remote monitoring tools for cardiac health in rural areas, to rapid screening technologies for appropriate antibiotic prescribing, the innovations cited by the speakers showed clear benefits for patients and health systems. So why aren’t they invested in more broadly?

Providing an overview of the implications and complications of health system investment, Christophe Schwierz from DG ECFIN, suggested fiscal sustainability in the short term is still imperative if we are to find investment for innovation in the long term.

In his work with the European Semester process, (itself an innovation), Mr. Schwierz noted that, “We don’t know the price or value of innovations in Member States” and therefore “haven’t solved problems related to health care proficiency and hospital efficiency.” While innovation in benefits packages have been pursued by some Member States, innovation in efficiency (i.e. primary care, eHealth, health promotion) has not been pursused by many governments – instead focusing reform efforts on savings.

In order to understand the choices and trade offs faced by national health ministries, Dr. Paul Thewissen from the Health Insurance Directorate in the Netherlands discussed the questions his Ministry had to answer when reforming the system 10 years ago. The Dutch opted to introduce competition into the health system and mandated all citizens to be insured. He explained that over time, the Dutch system increased in efficiency, reduced hospital mortality and length of stays, and saw a growth in hospitals focusing on services they could provide well – as opposed to trying to provide all services. Suggesting “you get what you pay for,” Dr. Thewissen noted the decline in length of hospital stays after the reform ceased payments for hospital beds.

So what can be done to incentivise investment in proven innovations? Some suggestions included greater reliance on health technology assessment to measure cost-efficiency, limiting unnecessary procedures, utilization of information and communication technologies, and changing health system governance. Bearing in mind efficiency increases will not bring enough savings for fiscal sustainability in most health systems, there is still work to be done to convince Member States to invest in innovations for efficiency now.

EVENT SUMMARY: Making patient centred community care a reality

3 June 2015 – How do we develop sustainable patient centric community care policies while meeting the demands of various key stakeholders? This was the question at the heart of the discussions during Health First Europe’s conference on ‘Making Patient-centred community care a Reality’.

Held in collaboration with the Latvian Presidency of the EU, the event was the launching ground for a Declaration from the Latvian Presidency to facilitate commitment from Member States to an EU policy on community care that supports and empowers patients, nurses and informal carers to access innovations outside of acute settings.

The Secretary of State for Health in Latvia, Solvita Zvidriņa, opened the event by reminding participants of the focus on the Latvians during their term has been on healthy lifestyles, innovation and ehealth, and early diagnosis and screening of cancer. However, her main remarks focused on the need for community care, stating, “I am quite confident that there is a real need to focus on the patient and coordinating care at all levels“.

Panel 1: Instituting dedicated community care for patients in Europe

Discussions amongst the first panellists raised a variety of questions with regards to health policy agenda priorities, topical focuses from both the Latvian and Luxembourgish Presidencies, core definitions of community care and financing policies.

Presenting the priorities of the upcoming Luxembourg Presidency, Ms. Laura Valli explained that patients will be at the centre of their work which will focus on personalised medicine, dementia and implementation of the Cross-border healthcare directive. This work will tie into various Commission activities on resilient health systems and health systems performance assessment according to Ms. Maria Iglesia Gomez from the European Commission, DG Santé. She stressed the importance of putting the patient at the centre of both health and social care stating, “Healthcare of the future will be more patient-centered. It has to be.”

Similarly, Professor Jan de Maeseneer insisted on the need to integrate health and social care and said that “the money needs to follow the care” in order to increase efficiency in resource allocation. He also argued that we need to talk about the “citizen” rather than a “patient” particularly if policies are going to be aimed at helping to prevent disease.

Panel 2: Partnering for patient-centred community care- Role and demands of key stakeholders

The conversation of the second panel, which included representatives of various stakeholder communities, showcased personal experiences to highlight the importance of the Health First Europe roadmap for community care.

For example, John Dunne, President of EUROCARERS, emphasised the undisputable importance of ‘informal carers’ in the health system. He asked a poignant question to the audience – “What happens if the state promotes a patients’ rights agenda in principle, but leaves it to informal carers to deliver?” This focus on “out-of-a-building” care was also a key tenet from Ms. Marina Lupari, Professional Lead for Primary and Community Nursing at the Royal College of Nurses. She advocated for the term “community care” as opposed to “primary care” because primary care is often associated only with GPs and not with all care settings outside of a building (i.e. at home). She advocated for better information (dissemination & sharing) channels and early assessment procedures on behalf of the nursing community. Much like Mr. Dunne, Ms. Lupari stressed the cost-effectiveness and compatibility of enhancing ‘out-of-building’ support systems.

Mr. Paul Buchanan, Founder of TeamGB, subsequently brought about a more personal and concrete account to daily care and the potential of social media for supporting patients to monitor their conditions in the community. Mr. Buchanan’s own battle with Type 1 diabetes saw him speak to what does and doesn’t work when it comes to health systems communicating to patients about chronic conditions. He suggested that health systems “don’t fit with lived experience“. Likewise, Mr. Serge Bernasconi, CEO of MedTech Europe, also cautioned that health systems are not in tune with current realities. Citing the trends in technology and innovation that are inaccessible to patients because of out-of-date structures, Mr. Bernasconi said that health systems need to reform to adapt to a patient who will demand access in the community. “The fact that the patient will be moved to the community, is tomorrow’s healthcare“, he said.

The key outcome of the discussions was the launch by the Latvian Presidency of the Declaration on “Making Patient Centred Community Care a Reality” and where the Presidency called upon the European Commission to invest in a dedicated policy for community care to:

  • Increase preventive care in the community
  • Facilitate access to innovation for patients in the community setting
  • Support training of healthcare professionals in the community
  • Promote integrated care across all points of patient care
  • Strengthen the governance of integrated care

Overall, the key contributors and participants agreed the community care is the future for all citizens and we need to take steps now to ensure that high quality care can be delivered to patients where and how they want it.

To view photos of the event click here.

EVENT SUMMARY: Health First Europe – 10th Annual General Assembly

At the occasion of its 10th Annual General Assembly, Health First Europe gathered together pan-European organisations and the European Commission to contribute to the HFE Road Map for the next Parliamentary term and share ideas on the future of public health in the European Union.

Health First Europe Honorary President John Bowis welcomed the participants and gave an overview of the achievements of HFE for the past 10 years. He noted that “HFE has worked in the direction of protecting patients from unnecessary harm, worked towards balancing safety and access to medical innovations and supported the shift from acute to community care”.

The 10th Anniversary meeting represented an opportunity to set out priorities for Health First Europe in the next Parliamentary term. To better fulfil this task, HFE members and invited guests participated in roundtable discussions to define key health objectives and associated challenges for next the European Commission and Parliament. This dynamic debate on the future direction and priorities of HFE culminated in a keynote speech delivered by the European Commissioner for Health Tonio Borg.

With his mandate as Commissioner coming to an end, Commissioner Borg provided a comprehensive overview of the European achievements on public health and he pointed while also noting some of the barriers inherent to the development of European health policy. He highlighted the natural tension between Member States and the Commission on health policy given the subsidiarity principle which can narrow the initiative taken by the Commission and slow the implementation of EU directives.

However, Commissioner Borg highlighted the impact of the European Commission policy towards promoting and implementing measures designed to have a positive impact on citizens’ life. He reiterated the need to see health as an opportunity to increase the European competitiveness, and stated “Health is a resource for the economy. In the formulation and implementation of EU policies, health and economy cannot be considered as two separate chapters.” He went on to say, that it is “imperative to reform our health systems” to build a system where a people can “live longer in healthy conditions”. This reform should “reduce the costs without reduce the healthcare standards for our citizens”.

Moreover, the Commissioner Borg reminded the audience of the recent developments on eHealth, saying “eHealth is not a solution for all problems”, but it represents a tool to improve care for European citizens and to boost the efficiency of national health systems. For this reason the European Commission is committed to supporting Member States in getting the best out of eHealth.

Last but not least, the Cross-border Healthcare Directive, which should have been transposed into national laws by October 2013. Commissioner Borg emphasized “This piece of EU legislation will bring direct benefits to patients by enabling them to use their rights in practice”. He further stated that, “This directive and its implementing tools such as: eHealth Network, Health Technology Assessment and ePrescriptions represents “a clear sign of a growing European dimension to national health systems”.

In the end of his speech, he tried to oversee the future developments of EU health policies. The Commissioner Borg is aware that “Europe’s health systems are likely to undergo profound changes over the next decades. The role the EU will play is uncertain, given that key changes will be driven by fiscal coordination”, but at the same time he expressed his dream that “health should became a horizontal topic” where each Minister has responsibility for health in all policies.

EVENT SUMMARY: European Commission Chronic Diseases Summit

On 3 & 4 April, the European Commission held the first ever Chronic Diseases Summit which aimed to bring together key stakeholders to generate recommendations about priority actions at EU level to tackle chronic diseases in Europe. Focusing on all aspects of the chronic diseases epidemic, the conference invited stakeholders to contribute ideas and actions for EU added value in this area. In particular, there was a clear consensus from participants that a key factor in addressing chronic diseases is the re-organisation of care around the patient.  The conference also coincided with the publication of the European Commission Communication on effective, sustainable and resilient health systems, providing an overview of the foundations necessary to sustain health in Europe.

Opening the first day of the conference, John Ryan, Acting Director of DG Health and Consumers, gave an in-depth overview of the European Union ́s activities and policies to address chronic diseases and he pointed out the challenges chronic diseases pose to the sustainability of health systems. He invited all participants to help identify areas for future activities in order to launch a horizontal EU approach to chronic disease in the future.

The burden on health systems is immense and MEP Christel Schaldemose (S&D, Denmark), noted that 70 – 80% of health expenditure is spent on chronic diseases. She suggested that EU should allow bigger deficit on EU Member State budgets for investment in health prevention because “if we don’t spend it now, it will be more costly later on”.  Financing for health systems was addressed by Sinisa Varga, Director of the Croatian Health Insurance Fund. He declared that the cuts associated with the financial crisis will cause unnecessary costs in 10 – 15 years and suggested a new financing model based on pay for performance to increase efficiency in healthcare.

Discussing effective health policies for chronic diseases in the EU, Clive Needle, Director of EuroHealthNet suggested investing in education, training and health literacy. Like many other speakers and participants, he also highlighted that Member States must set up realistic, measurable, and smart targets to prevent and tackle chronic diseases.  Prevention was a key theme throughout the conference, echoed by a number of participants including Günter Danner, Director of the European Representation of the German Social Insurance (DE).  He added that the health and social security systems should have a primary interest in effective prevention. But, noted that prevention strategies can be effective without adding costs.  Patient representative Simon Gillespie, Chief Executive British Heart Foundation, again highlighted prevention as a key focus area for action saying that, “prevention is always better than care or cure”.

Following the first day of workshops, the second day was opened by the EU Commissioner for Health Tonio Borg.  He emphasised the European Commission’s role in tackling chronic diseases and he encouraged dialogue on new ideas to innovate in more effective and sustainable ways in national health systems. He invited stakeholders and Member States to “be bold, be brave, and be creative” when addressing the challenge of chronic diseases.

Various EU Member States gave national perspectives on chronic disease prevention and management within health and social systems. James O’ Reilly, Minister of Health of Ireland discussed the advancement of patient-centred care in Ireland and suggested that care must be reoriented toward primary care. He declared a need for “moving away from the episodic illness model, to a wellness service”. Minister O’Reilly reiterated that health is not a drain on budgets, but rather a driver of the economy and jobs and a healthy workforce is needed to have a healthy economy.

Giving an industry perspective on tackling the chronic disease epidemic, Joseph Jimenez, Chief Executive Officer at Novartis, maintained that health systems need to move from a transaction based approach to health, to an outcome based approach noting that incentives must exist to deliver these positive outcomes.  Building on the idea of an outcome based model for health, Zoran Stančič, Deputy Director-General at DG Communications Networks, Content and Technology, discussed how technology can improve the data and evidence of positive health outcomes since monitoring of chronic diseases can now be done monthly, weekly or even hourly.  Agreeing with Mr. Stancic, Brendan Barnes, Director for Societal Engagement and Partnerships at the European Federation of Pharmaceutical Industries and Associations (EFPIA), suggested that the “European Commission still needs to learn to love innovation a bit more” in order to utilise the full benefits of technology in healthcare.

Providing the Health First Europe perspective, Patron David Byrne summarised many of the key points raised during the conference including the significance of delivering efficient, patient-centred care to citizens before the development of chronic diseases. He suggested that a framework for community care based on the HFE Model should be developed at EU level, emphasizing the role of the EU institutions in supporting Member States to facilitate care outside of acute settings. He declared that the next Presidency of the Council should include an agenda item specific to community care so that Member States prioritise re-organisation of care towards the patient.

In his closing remarks, John Ryan asserted some of the key issues brought forward by stakeholders during the event. More than anything, Mr. Ryan suggested that to tackle this epidemic, strong political leadership is necessary with the broad involvement of civil society and stakeholders.  Commissioner Borg closed the conference by asking that we all continue to strive together to not only bring “more years to life, but more life to years” for all European citizens.

For more information about the conference, see the European Commission overview at Storify here.

For more information about the Health First Europe Community Care Model, click here.

EVENT SUMMARY: Advancing patient safety in the EU – Reducing healthcare associated infections

On 27 November, Health First Europe together with MEP Christofer Fjellner (EPP, Sweden) organised a follow-up roundtable debate on Advancing patient safety in the EU: Reducing healthcare associated infections in the European Parliament from 14.00 – 16.30.  This event brought together high-level stakeholder to discuss the current state of infection control in Europe and the next steps for reducing HCAIs.

The timely discussion came after the publication of the European Commission’s report on 15 November 2012 and looked at the current status of Member States’ implementation of the recommendations on HCAIs. Focusing on the current status of infection control based on the evidence included in the report, the discussion quickly moved towards the next steps for implementing the recommendations and reducing HCAIs.

Panelists included the World Health Organization, the European Commission, the European Parliament and the German Society for Hospital Hygiene.

Please find below the full event summary:

EVENT SUMMARY: EP Open Forum Debate endorses Health First Europe Road Map for the future of patient safety in Europe

Health First Europe held an invitation-only roundtable event on 24 April in the European Parliament from 10.00-12.30 to debate the Future of Patient Safety in Europe. Under the Sponsorship of MEP Christofer Fjellner, (EPP, Sweden), the event was chaired by HFE Honorary President John Bowis with the participation of HFE Patron and Former EU Health Commissioner David Byrne, the Health Systems and Health Threats Units of the European Commission (DG SANCO), representatives of the European Centre for Disease Prevention and Control (ECDC) and HFE MEP Supporter and Member of the Environment, Public Health and Food Safety Committee, MEP Karin Kadenbach (S&D, Austria).  The event also included other high-level stakeholders to discuss and validate the HFE recommendations on patient safety and healthcare-associated infections.

Read here the full event summary.

EVENT SUMMARY: Health First Europe’s Road Map for the future of patient safety in Europe

Health First Europe held an invitation-only roundtable event on 24 April in the European Parliament from 10.00-12.30 to debate the Future of Patient Safety in Europe. Under the Sponsorship of MEP Christofer Fjellner, (EPP, Sweden), the event was chaired by HFE Honorary President John Bowis with the participation of HFE Patron and Former EU Health Commissioner David Byrne, the Health Systems and Health Threats Units of the European Commission (DG SANCO), representatives of the European Centre for Disease Prevention and Control (ECDC) and HFE MEP Supporter and Member of the Environment, Public Health and Food Safety Committee, MEP Karin Kadenbach (S&D, Austria).

Opening Health First Europe’s Open Forum Debate on Patient Safety, Patron of the Health First Europe Task Force on Patient Safety and HFE MEP Supporter Christofer Fjellner (EPP, Sweden) began by stating, “We can do more to protect patients.”

What we can do to better protect patients was at the heart of the Health First Europe high-level roundtable which brought together representatives from the European Commission, European Centre for Disease and Prevention Control, European Parliament, German Coalition for Patient Safety, World Health Organisation, European Patients’ Forum and various other important health stakeholders to discuss and debate HFE’s recommendations for patient safety.  Ensuring the highest quality of care for patients throughout the EU was at the forefront of the discussions moderated by Honorary President John Bowis.  MEP Fjellner and President Bowis together highlighted the urgent need for decision-makers to focus on the establishment of minimum standards, measurable improvement targets and a European strategy to prevent healthcare associated-infections.

The establishment of minimum patient safety standards was a key recommendation highlighted by Katja Neubauer, Deputy Head of Unit, Health Systems, DG SANCO.  She discussed that the review of the Council Recommendations on patient safety including the prevention and control of healthcare associated infections (2009), is showing that nearly all Member States have implemented at least some the recommendations adopted by the Council in 2009. However, due to the economic downturn, progress has been hampered. The European Commission is also working with Member States on provisions of the Cross-border Healthcare Directive to link them to the Council Recommendations and other dossiers of importance to patient safety (such as the Professional Qualifications Directive).

Another HFE recommendation of particular importance was that for harmonised reporting systems in order to collect comparable data across Member States on patient safety.  MEP Karin Kadenbach (S&D, Austria) was very supportive of this recommendation, but also cited the importance of “having ideas to convince Member States that standardised systems are in their interest.”  MEP Kadenbach also brought up the topic of health literacy – which remains a significant factor in the patient safety debate.  She also stated that “safety will always be a concern as long as people do not know how to live in our health systems.”

From the healthcare professional’s point of view, Dr. Günther Jonitz discussed the importance of the patient safety culture on the implementation of HFE’s recommendations. He cited the German case where the culture has changed over time and now when an accident happens, the question is no longer who to blame, but why the accident occurred. According to Professor Jonitz, “value-based systems that focus on outcomes, not inputs, needs to be established“. This strategy should include all health workers including doctors, nurses, ancillary workers and education and control to decrease post-surgical infections.

Chief Scientist from the European Centre for Disease Prevention and Control (ECDC), Dr. Johan Giesecke, presented some of the current surveillance and data collection activities of the ECDC.  Dr. Giesecke described the ECDC’s role in patient safety, which is to support policy, not develop it.  He showed participants some of the projects undertaken by the ECDC, which include the monitoring of surgical site infections and infections in intensive care units.  However, Member State involvement is voluntary, and less than half of Member States currently participate.

Dr. Antoon Gijsens, Policy Officer, Health Threats Unit, DG SANCO, supported the idea that a European strategy for healthcare associated infections is important, but also described that many Member States are already considering such strategies at national level.  He suggested action plans are the key to implementation, because without timelines and targets “strategies become a document of good intentions.”  He also emphasised the need to tailor strategies for decreasing infections to each healthcare institutions for greater success.

Many of the participants further supported the recommendations of Health First Europe on patient safety and also underscored the necessity for health literacy and patient empowerment as areas that need to be further addressed and developed in terms of patient safety. Valentina Hafner, Programme Manager at the World Health Organizations European Office, shared that the WHO is currently working on four studies which look at how to involve patients more actively in the management of health. Patients are the strongest proponent of safety and “Informing the patient about patient safety is an incredibly powerful tool“, underlined Katja Neubauer.  Additionally, Dr. Achyut Guleri, Consultant Microbiologist and Head of Department Clinical Laboratory Medicine at the Blackpool Teaching Hospital NHS Foundation Trust, also shared various projects implemented by Blackpool Teaching Hospitals which have been able to reduce HCAIs and MRSA and cut costs. Dr. Guleri suggested that the sharing of best practices throughout the EU is extremely important to overall reduction of HCAIs.

David Byrne, Former EU Health Commissioner and HFE Patron, summed up the discussions for the day by emphasising the importance of harmonised data systems, reporting of data, and issues of surveillance and transparency for protecting patients.  In particular, Mr. Byrne discussed the need for an “open method of coordination” to enable harmonization of data so that we can better know where we are protecting patients and where we are not.  He suggested that “what gets measured, gets managed.”  And we can do better managing the safety of patients.

You might download here below the full event report:

EVENT SUMMARY: Innovation Day 2011 – Health First Europe receives support from policymakers to research drivers of innovation

29 November 2011 – Health First Europe (HFE) organised its Innovation Day 2011 in the European Parliament gathering support from Parliamentary members for the need to research the drivers of innovation in healthcare. On this occasion, HFE launched its publication “Overcoming Barriers to Innovation in Health: Examining the drivers of innovation” which calls upon the European Commission to examine the value chain of innovation – from identifying where gaps in quality of care exist, to determining where best practices have occurred and how such practices can be utilised to address gaps in Member States.

In order to facilitate a comprehensive exchange and adoption of best practices in health innovation, delegations of HFE members including patients, healthcare professionals, hospitals and the medical technology industry together met with policymakers to discuss HFE’s publication, focusing on the adoption of best practices so that greater efficiency and better patient outcomes can be more easily achieved.

John Bowis, Honorary President of Health First Europe expressed:

“Health First Europe’s Innovation Day raised awareness about the important role the European Parliament has to play in encouraging the European Commission to undertake research in healthcare innovation. The meetings held between policymakers and HFE delegations focused on the importance of clearly identifying, validating and sharing best practices throughout the EU. The European Commission can add value to Member States by making data of this kind readily available so as to support the implementation of initiatives which will help to achieve a smart, sustainable and inclusive European economy. We are pleased to see that our initiative has received support from policymakers and we look forward to seeing this research undertaken as part of upcoming discussions in the Parliament on research and innovation.”

Concentrating research on a few key areas of concern, such as patient safety (healthcare associated infections) and chronic diseases like diabetes and heart disease, would provide significant insight into the factors which both drive and prevent access to innovation in health. The research would necessitate taking account of the disparities between member states, identifying the barriers to access, validating best practice and communicating these best practices throughout the EU. Health First Europe believes that innovative research of this kind could create a comprehensive exchange and adoption of best practices between Member States thus promoting the growth of innovation in healthcare throughout the Community.

HFE encourages the European Commission to undertake this research and calls upon policymakers throughout the EU to support examining the drivers of innovation as part of the upcoming discussions on the Common Strategic Framework for EU Research and Innovation Funding and the Health for Growth Programme 2014-2020.

Click here to read “Overcoming Barriers to Innovation in Health: Examining the drivers of innovation”. 

EVENT SUMMARY – “E-Quality in E-Health”

Thanking MEP Grossetête (EPP, France) and MEP Cabrnoch (ECR, Czech Republic) for their sponsorship of the event, Honorary President Mr. John Bowis opened the reception for the launch of the “E-Quality in E-Health” publication explaining the purpose of the event was to reach out to policymakers both within and beyond the European institutions to do more in the e-Health domain. The Member States particularly, need to undertake more concrete actions in the area of e-Health by putting it further up on their national agendas. He declared that “You cannot have a healthy economy – a competitive economy – without healthy people.”

Examining the benefits of e-Health for the patient, Mr. Bowis suggested that e-Health allows citizens to do more for themselves and to play a greater role in their health and healthcare. He reminded the audience that, “Health is not a burden, it’s a benefit” and policymakers must remember that e-Health gives patients the opportunity to monitor their own health which will inevitably reduce the impact of healthcare Member States budgets.

Mr. Bowis clarified the meaning of e-Health by quoting the contribution of Dr. Andrzej Jan Rys, Public Health and Risk Assessment Director (DG SANCO). He reiterated that e-Health itself includes technologies such as “health information networks, electronic health records, telemedicine services, personal wearable and portable communicable systems, health portals and many other information communication technology-based tool assisting prevention, diagnosis, treatment, health monitoring and lifestyle management.” Mr. Bowis asserted that all of these technologies can assist in providing the patient better care, if the technologies are accessible and patients are still supported by mechanisms within healthcare systems.

Building on Mr Bowis’s remarks, Patron David Byrne highlighted the timeliness of the e-Health publication stating, “The purpose of this entire exercise is not to develop technology, but rather to provide healthcare to the patient. It’s a patient-centred activity.” He demanded that Member States set benchmarks of access to e-Health and to examine the extent to which there may be reimbursements to patients who purchase the technologies encompassed within e-Health. Mr Byrne definitively stated, “We don’t want this to be something that just is available for those who can afford it. That’s why this document is entitled ‘E-Quality in E-Health.” 

In his concluding remarks, Mr. Byrne called on Member States to chart the increase of access for patients to e-Health as such an undertaking is “what the European Commission does well – it’s what the European Commission can provide.” He also urged the European Commission to push Member States forward by not being too timid in terms of its competencies in the health area. He considered that if the Commission pressures Member States, “We can get a better outcome which harnesses technology for the betterment of the patient.”

Read here the event summary.

EVENT SUMMARY – HFE reception at the European Parliament: “EU legislation to reduce injuries for healthcare workers”

On 23 March 2010, Health First Europe (HFE) celebrated the adoption by the EPSCO Council of the Directive implementing the Framework Agreement on the prevention from sharp injuries in the hospital and healthcare sector.

Over 40 people from across the healthcare sector (policy makers, regional officers, industry representatives, health workers and insurers) attended this event which was hosted by MEP Elizabeth Lynne (ALDE, UK) in the European Parliament.

Health First Europe, an organisation supporting the protection of EU healthcare workers from injuries with used needles and other medical sharps, has been campaigning in the past six years for the implementation of binding measures.

Mr Roy Bridges, an HFE Executive Committee member, thanked all speakers for seeking to protect healthcare workers from sharps injuries across Europe. “We were very happy to engage with Liz Lynne MEP and Stephen Hughes MEP in 2004. (…) It has been a long journey and there were challenging steps but owing to the commitment of all the stakeholders, especially the social partners, we’ll now change the nature of health workers protection in the EU” he said in his opening speech.

MEP Elizabeth Lynne who has been advocating for this cause from the very beginning commented that she had been happy to help HFE. She stressed that “without dedication, one could not achieve anything” explaining why she and so many others worked so hard over the years to push and bring the initiative forward.

She further mentioned MEP Stephen Hughes and former MEP John Bowis (now HFE Honorary President) who, along with her, had been liaising with former Commissioner Vladimír Špidla. Their political willingness had been conditional on the successful outcome. Liz Lynne also welcomed the dedication of nurses, healthcare workers and social partners “for not giving up”. “It is a victory for us all and shows that without [their] tenacity, we wouldn’t have legislation today” she added.

Mr Máximo González, President of the (Spanish) General Council of Nurses, reminded the audience the long path to the binding rules on sharp injuries. “30 years ago, it would have been impossible to have legislation at national level let alone in the European Parliament”, he observed.

He explained that in Spain, social and healthcare workers had started making tangible proposals 5 years ago. Now, in different regions in Spain, policy makers were developing and implementing laws by means of voluntary agreements.

Mr González therefore called for a thorough implementation of the European directive. In his view, there was still “a long way to go and many difficulties to overcome in order to do so because the transposition is complicated”. “We will be watching over the implementation in the regions, raise awareness and call politicians to action where appropriate”.

As to the future perspectives, the President of the General Council of Nurses had already engaged with the Spanish Presidency. The association will be distributing guidelines, preparing a European day of bio-security and also propose a yearly celebration for the anniversary of the directive’s approval (on 8 March).

Mr González finally thanked MEP Liz Lynne and MEP Stephen Hughes: “as MEPs you have many important things on your agenda, but remember that many lives will be saved due to this directive. Each life which is saved, you can be extremely proud of”.

Ms Ana Salegui, a Spanish nurse who got infected following a needle-stick injury, then took the floor picking up on Liz Lynne’s speech: “I have waited half of my working life to have this directive; and there are few moment’s in one’s life which are truly important. But today is one of those”.

She evoked the times back in the 1980’s where there were no prevention and no awareness rising campaigns, where healthcare workers were left alone and didn’t have anyone to talk to, where they were sometimes even practically shunned from society.

Ms Salegui voiced concerns that healthcare workers would still have difficult times. For the remaining cases of sharp injuries, it is worth remembering that they can ultimately lead to serious infections and to death and the lapse of time to get the results are sometimes unbearable.

She therefore hailed the adoption of the legislation as a positive step to combat segregation and discrimination against infected workers and, of course, to ensure a high level of security for medical staff and patients.

“Many people fear to be fired because of infection from sharps injuries, but all who have suffered and all who will be infected one day now have the directive. We can thank the European Parliament, Liz Lynne, Stephen Hughes, John Bowis, HFE and all who are not there. I now hope that the people responsible for applying the laws will be sensitive because we need implementation urgently, immediately”, she concluded.

Mr Paul de Raeve, Secretary General of the European Federation of Nurses, expressed his happiness that the directive was finally adopted. “Still, we need to keep the momentum going in order to make sure that it will be implemented. Thus, we look forward to working with you all”, he said.

Mr Bert Van Caelenberg, EUROFEDOP Secretary General, emphasised the rewarding cooperation between stakeholders and the European Parliament: “Members are here for us and we are here for the Members”. He then called for new member countries to join in the effort. As a conclusion, Mr Roy Bridges recalled the 2004 event organised in the European Parliament entitled ‘HFE warning on World AIDS day: Europe’s healthcare workers at risk’ which figured the start of the journey.

“The European Parliament may get a lot of criticism for national press but this is a good example of practical progress”. “Working together can lead to positive achievements which are cause for thanks and celebration”, he added before opening the reception.

Health First Europe is a non-profit organisation made up of patients, healthcare professionals, medical academics and experts. They are focused on ensuring that every European citizen is entitled to the very highest healthcare standards and access to innovative and effective treatments.

EVENT SUMMARY: Next Steps on Patient Safety in the EU: Eradicating Health Care Associated Infections in the 21st Century

Health First Europe’s roundtable in the European Parliament was co-hosted by MEPs Liz Lynne (ALDE, UK) and Amalia Sartori (EPP, Italy) and focused on the significant burden of Health Care Associated Infections (HCAIs) on Europe’s healthcare systems. The event highlighted how European healthcare systems are in crisis, requiring urgent and concrete EU action.

Download the programme here below: