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The TO-REACH project concludes with the Final Conference

22 May 2021

On Thursday, 20 May 2021 the TO-REACH project held its Final Conference, ‘Implementing and transferring innovations across health systems’. The conference brought together high-level speakers from the WHO, the European Commission and Ministries of Health, as well as project partners, academia, NGOs and the public at large to discuss the work done by the project over the past five years and the future of health systems and service research.

With over 230 attendees and an impressive speaker line-up, the Final Conference was the perfect chance to reflect on the challenges health systems are facing, the achievements of TO-REACH including its Strategic Research Agenda and Policy Briefs, but also to look forward at the Partnership on Transforming Health and Care Systems that the project helped building.

Opening session – Health systems and services in times of COVID-19

Moderated by Dr. Josep Figueras, Director at the European Observatory on Health Systems and Policies, this high-level opening session saw the participation of Dr. Hans Kluge, Regional Director for Europe at the World Health Organization (WHO); Ms. Maya Matthews, Head of Unit – Performance of national health systems, DG SANTE, European Commission; Dr. Vesna Kerstin Petrič, Director-General of Public Health Directorate at the Ministry of Health of the Republic of Slovenia; and Prof. Walter Ricciardi, Principal Investigator and Coordinator of the TO-REACH project.

Dr. Kluge discussed the priorities of the WHO work programme 2020-2025: universal health coverage; emergency preparedness; and health and wellbeing. To achieve this programmatic vision, Dr. Kluge mentioned the essential role of partnerships; the importance of policy country impact; and the WHO commitment to listen to health workers, patients, and by and large the primary care sector. Ms. Matthews highlighted the variety of funding instruments available to boost the recovery of Member States and the objective to build back better. Dr. Petrič discussed the priorities of the upcoming Slovenian Presidency, whose focus will be on how to better invest in innovation at the European level and strengthen health systems making the best possible use of EU funding instruments. In conclusion of the session, Prof. Ricciardi looked back at the achievements of TO-REACH and, by and large, health systems and service research. He reminded that health system and service research was ignored by most and unknown by many, whereas its importance and central role is now well understood.

What are key priorities when studying service and policy innovation in health systems?

The session was introduced by Dr. Nick Fahy, Expert Adviser on innovation and implementation at the European Observatory on Health Systems and Policies. Dr. Fahy stated that every health system is innovative, but the challenge is around understanding how an innovation works in one place but struggles to spread and function effectively in another. The aim of TO-REACH was to address this very challenge and facilitate the process of mutual learning across countries.

Dr. Johan Hansen, Senior Researcher at NIVEL, presented the policy brief produced by the TO-REACH consortium and focusing on the priorities of research in service and policy innovation, among which person-centred care, reconfiguring services and integration. In the following panel discussion, Prof. Silvio Brusaferro, President at Istituto Superiore di Sanità, stated how research plays a central role to overcome any other future challenges, and should therefore be supported, protected and invested in. With regards to the Italian priorities for research, Prof. Brusaferro mentioned digitalisation; developing more flexible systems; and integrating social and healthcare, starting from the workforce. Dr. Claudia Habl, Deputy Head of the Health Economics Department at the Austrian Public Health Institute (GÖG) presented the priorities of Austria. These are: streamlining healthcare pathways; demographic changes and healthy aging; improving decision-making with digital instruments; improving digital and health literacy; and workforce planning. Finally, Dr. Taina Mäntyranta, Director at the Department for Steering of Healthcare and Social Welfare at the Finnish Ministry of Social Affairs and Health, discussed the involvement of stakeholders during the consultations to define the Finnish research priorities. For Finland the TO-REACH experience was a great opportunity to engage with a diversity of stakeholders and especially with those whose voice is more difficult to be heard.

What do we know about transferring service and policy innovations between health systems?

Prof. Ellen Nolte, Professor of Health Services and Systems Research at the London School of Hygiene and Tropical Medicine, presented the second policy brief focusing on how to transfer service and policy innovations across health systems. The process of learning across countries is not new, but it is difficult and often resulting in the transfer failing. This may be because the transfer is uninformed; incomplete; inappropriate because of contextual factors; or not affordable, acceptable or politically suitable to address a problem. Therefore, more is to be done to fully understand the transferring process and the factors contributing to successful implementation.

Prof. Karine Chevreul, Director of the ECEVE team at INSERM, discussed examples of innovation transfer in France, such as in-hospital payment methods, payments for performance, and bundle payments, or the transfer of skills from one profession to another. For successful transfer, it is important to take into account the context of the donating country and the interests of all stakeholders involved. Finally, Ms. Valentina Polylas, Director at European Regional and Local Health Authorities (EUREGHA), brought forward the perspective of European regions. Ms. Polylas underlined the role of regions in innovation implementation, and reiterated the importance of having a European framework to share experience that can then be adapted at the territorial level.

The TO-REACH project also saw the participation of non-European partners. Dr. Arlene Bierman, Director at the Center for Evidence and Practice Improvement, Agency for Healthcare Research and Quality (AHRQ) and Dr. Rick Glazier, Scientific Director at the Institute of Health Services and Policy Research at the Canadian Institutes of Health Research (CIHR) brought forward the perspective of the US and Canada respectively. Dr. Bierman stressed the need to move from a health system that takes care of specific diseases to one that takes care of people living with diseases. The COVID pandemic has identified shortcoming in health systems but also the critical need for research, so that it can become “the science of care in addition to the science of cure”. Dr. Glazier presented the Canadian priorities that include accelerating the discovery of innovation that transform health care delivery systems; moderanise health systems with digital solutions; integrating evidence into health service and policy decisions; and strengthening capacity for solution-oriented research and evidence-informed healthcare system transformation.

What’s next? The future of health systems and service research

Ms. Irene Norstedt, Director at People Directorate of DG RTD at the European Commission, discussed the future of health system and service research with a focus on Horizon Europe. Ms. Norstedt mentioned how the TO-REACH project was at the origin of the European co-founded Partnership on Transforming Health and Care Systems, now included in Horizon Europe. This Partnership will provide the needed framework and ambition to meet the gaps in research and innovation, and will bring together the whole value-chain of healthcare stakeholders so that the complexity of health systems is duly addressed.

In conclusion of the conference, Ms. Sabrina Montante, Italian Representative within the MS-AC Core Group for the Transforming Health and Care Systems Partnership, underlined that putting cooperation into practice requires a partnership approach. As the transformation of European health systems is complex, it needs to be addressed from different angles and involve all actors at regional, national, and European level. It is crucial to helping healthcare systems with new knowledge and better implementation to become more resilient, sustainable, and enable equal access to innovations for all citizens. Ms. Montante concluded referencing the call for the Transforming Health and Care Systems Partnership that the TO-REACH project helped building as a great opportunity to mobilising major research innovation funding to inform policy and practice.