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European health services and systems research – the way forward – EVENT REPORT

10 October 2017

Held in Brussels, Belgium at the European Commission premises on 12 September 2017, the workshop ‘European health services and systems research: the way forward‘ was an opportunity for the TO-REACH consortium to gather with key stakeholders including ministerial and funding bodies, national research organisations and European level bodies and institutions to discuss the future of European Health Service and Systems research.

Chaired by Prof. Kieran Walshe, Chair of the Scientific Advisory Council of the TO-REACH project and Professor of Health Policy and Management at Manchester Business School, the meeting had three objectives: map actions already funded and implemented in the EU Member States in the field of health systems and service research (HSSR), explore the added values of working together and ways to place it in action contextually, and discuss how new initiatives can be linked with the International Consortium for Personalised Medicine (IC PerMed).

Philippe Cupers, Deputy Head of the Strategy at the European Commission, DG Research and Innovation, kicked off the meeting highlighting the three main research areas funded by the EU, including: Population health, Health systems, and Global health. Within this framework, the Commission stressed the centrality of collaboration and complementarity, focussing on the importance of the participation of European countries in EU projects and in providing a broader overview on collaboration priorities, the interconnection between pre-clinical research, basic research and translational health systems research, and the necessity of aligning TO-REACH to the work already started by IC PerMed and other relevant joint EU initiatives.

Dr. Stefano Vella from the Istituto Superiore di Sanità (ISS), technical and scientific body of the Italian National Health Service and responsible for the coordination, presented the TO-REACH project. Dr Vella set out the common challenges faced by European health systems and how they are adapting to respond to these issues. Health systems in Europe share common values with regards to social protection, social cohesion and social justice and to maintain these, decision makers need to explore solutions to ensure the continuation of provision of high quality, affordable, accessible, responsive, equitable and financially sustainable health care.

Dr Vella contended that there is an evident gap between research already conducted in the field of HSSR and their partial implementation. Measures towards full implementation include systematically strengthening the potential of cross-national learning by developing a voluntary agenda for HSSR. This strategic research agenda is a central element of TO-REACH, which will focus on innovative solutions for health systems’ challenges and health improvement at EU scale, and to explore transferability of existing successful solutions across health settings. The link with ongoing existing initiative such as IC PerMed, HSPA and HTA initiatives will also avoid duplication and foster the European reach of the project.

The key complementarity with other EU-level initiatives was emphasised by the presentation of IC PerMed. It is a strategic platform representing ministries and funding agencies, with the role of European Commission as an Observer which aims at establishing Europe as a global leader in personalised medicine research and at providing evidence to demonstrate the benefit of PM to citizens and healthcare systems.

Following the presentations, a round table discussion among the participants highlighted the additional challenges of inter-transferability of successful solution across systems, the need for supporting contextual conditions for the successful implementation of innovative products, the heterogeneity of health systems among Member States and its resulting challenge at EU level and how the success of TO-REACH will provide a framework for a shared HSSR ‘language’ and a shared framework for a common programme aimed at improving health systems in Europe.Sasa Jenko, Public Health Head of Sector at the European Commission DG Research, introduced the concept of “Health systems research à la carte”, highlighting different existing European funding instruments. The EC is open to explore together with countries best ways to collaborate in the future to close the implementation gap. Feedback shared by Member States and collected by the European Commission emphasised the following needs and priorities in the field of HSSR: need for more networking (between researchers and Ministries representatives), need for best practices exchange by establishing common platforms and methodological approaches and the need for more implementation research.

The research agenda developed by TO-REACH will promote the willingness of decision-makers to commit to the long timespan needed in the provision of specific evidence. The agenda will also draw upon the continuous need to engage stakeholders on a common view to help understanding the areas of need around health systems. Points of reference will promote learning among different health settings and tackle previous lack of communication between funding agencies and member states need to be addressed.

Contribution Points in the discussion from the European Commission DG RTD and DG SANTE included stressing the need to find ways to transfer and implement innovation and the challenge for the Commission to find ways to support a map of adoptability of best practices. The discussion also highlighted that beyond transferring best practices, research on new best practices need to be done.

Additional relevant contribution points from Country Representatives brought the attention to the lack of data availability or benchmarking measures in support of the decision making process and to the need for researchers to look beyond their very specific contexts, to identify evidence-based research priorities, to improve the quality of evidence available for better policy implementation, to provide more knowledge exchange on how reducing health care system costs and on the service structures in social and healthcare, and to promote the harmonisation of research methodologies and solutions for data integration

TO-REACH is still in its initial stages and the project will seek to continue to enhance the collaboration between countries and support the synergies with ongoing initiatives. The EUPHA pre-conference TO-REACH session ‘Fostering Health Services and Systems Research in future research programmes’, held in Stockholm on 1^st November, was a further step towards the development of the Strategic Research Agenda and the enhancement of cross national implementation research in this scientific field.

A full programme of engagement will continue into 2018, kicking off with a Brussels based workshop on 29^th January 2018, which will allow the project consortium to share results and findings from the first year of TO-REACH with an expert audience, and a consortium meeting on 30^th January, which will provide the partners with the first occasion to meet the TO-REACH Policy Advisory Council (PAC). The PAC, composed of representatives of governmental and/or research funding organizations from all EU Member States, will contribute to optimal policy relevance of the project and assess the policy value of TO-REACH achievements and their innovative content with respect to current and future challenges.

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