What are the key priority areas where European health systems can learn from each other?

Abstract

Learning from other countries is a key tool for helping health systems to improve. Europe offers a unique potential for learning between health systems, bringing together many health systems with similar aims but all organized in different ways. However, these different approaches also mean that the process of learning from each other is not straightforward. Because each system is organized, governed and financed differently, what works in one place will not work identically in another. We need special methods to analyse how care has been organized well in one place; to disentangle the innovation and its local context; and then to transfer that innovation to a new, different context elsewhere. We need capacity for the research and application of these processes, which is currently seriously under-developed across Europe. And, as this process depends on working together across countries, we need a shared set of key priority areas on which we can collaborate. The TO-REACH project – Transfer of Organizational innovations for Resilient, Effective, equitable, Accessible, sustainable and Comprehensive Health services and systems – was funded by the European Union’s Horizon 2020 programme to help meet these needs. Its overall aim was to prepare for establishing a joint European research programme on health services and systems that will contribute to the resilience, effectiveness, equity, accessibility, sustainability and comprehensiveness of health services and systems. It brought together a wide range of partners (listed below). The key results from the TO-REACH project are set out in two policy briefs: one sets out how we can improve our ability for European health systems to learn from each other (see the complementary policy brief by Nolte & Groenewegen, 2021), while the other focuses on what topics this work should address (this policy brief). These messages are summarized in Figure 1 below. The COVID-19 pandemic has illustrated both the challenges and the opportunities of learning between health systems. Faced with the pandemic, health systems in Europe and beyond have been seeking to learn lessons from each other about how best to respond and to implement those lessons as quickly as possible, and often at remarkable speed. The speed with which some lessons have been shared and implemented in days or weeks highlights just how slow our existing processes normally are in comparison. But the challenges of learning from each other have also been highlighted, with a lack of clear means to identify the best innovations, how they exist within their organizational and system contexts, what is needed to transfer them elsewhere, and an overall lack of capacity for carrying out these tasks. While the TO-REACH project work was carried out before the pandemic struck, the challenges and potential solutions this project has identified will be even more relevant in the future reshaped by COVID-19. These findings will be especially important for the future European Partnership on Health and Care Systems Transformation envisaged under the Horizon Europe Research and Innovation Framework Programme. [excerpt]